september 2013 wda journal

SEPTEMBER 2013 | Focus on: Adult oral health

WDA JournAl is A publicAtion of Wisconsin DentAl AssociAtion, inc. SEPTEMBER 2013 • Volume 89, No. 9

WDA grows with ninenew members! The Wisconsin Dental Association is pleased to welcome eight new members to organized dentistry. These new members, their cities of practice and/or resi-dence or components (if applicable) are:

Dentists, dental team members and patients share their feelings about the fifth WDA Mission of Mercy held June 28 - 29 in Lake Geneva, Wis. where $1.18 million in charitable care was pro-vided to 2,072 patient visits by 1,224 volunteers. WDA-TV is proud to present “Voices from MOM 2013.”

Dr. Susan Angel, Milwaukee Greater Milwaukee Dental Association

Dr. Jeffrey Chaffin, MadisonDane County Dental Society

Holly Kindschi, RDHPrairie du Sac

Dr. Julie Melbinger-Wagner, BrookfieldGreater Milwaukee Dental Association

Dr. Tawfiq Nadi, MilwaukeeGreater Milwaukee Dental Association

Dr. Chalsey Nelsen, Verona Dane County Dental Society

Dr. Estella Pizana, MilwaukeeGreater Milwaukee Dental Association

Dr. Cole Stockheimer, SaukvilleWashington Ozaukee County Dental Society

Advocate...Educate...Empower...Serve!

INSIDE THIS ISSUE

Make your voice heardat the WDA House ................................. p. 2

Comprehensive listing of federal, state poster requirements ................................. p. 6

MOM: More than just numbers ............................... p. 10

Philanthropy 101 ............................... p. 16

p. 11p. 8

Photo credit: Capitol photographer

Connect with us on and visit us online @ WDA.org

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Highlight

Gov. Scott Walker (seated center) was joined in his Capitol office by non-covered services legislation lead sponsors (standing left) state Rep. Joan Ballweg (R-Markesan) and (standing right) state Sen. Jerry Petrowski (R-Marathon) as he signed the bill into law. Also attend-ing were (far left to right): State Rep. Ballweg’s chief of staff Vince Williams, WDA Immediate Past-President Dr. Steve Stoll (Neenah), WDA Vice President Dr. Paul Levine (Milwaukee), NCS co-sponsor Rep. John Spiros (R-Marshfield), WDA Government Services Director Mara Brooks, WDA President-Elect Dr. Julio Rodriguez (Brodhead), WDA Northeast Region 2 Trustee Dr. Jeff Kraig (Fond du Lac) and Sen. Petrowski’s special guests, retired orthodontist Dr. Edward C. Fox (Lac de Flambeau) and his daughter Dr. Julie Fox (Wausau).

Wisconsin joins ranks of non-covered services statesCarol Weber, APR WDA Director of Public Relations [email protected]

Wisconsin became the 34th state to stop dental plans from setting fees for ser-vices they don’t cover when Gov. Scott Walker welcomed a small group of legis-lative co-sponsors and Wisconsin Dental Association leaders, dentists and staff to his Capitol office to witness his signing As-sembly Bill 109 (Senate Bill 131) into law on July 5. Thirty-three states have now passed stand-alone non-covered services legisla-tion on margins of 10-to-1 since 2009. New York has an existing law that prevents NCS capping. Wisconsin’s new 2013 Act 26 becomes effective Jan. 1, 2014 and will apply to the

modification or renewal of existing con-tracts or the signing of new contracts. (An-nual fee schedule updates are considered modifications of existing contracts.) Den-tists may need to proactively seek a modi-fication or renewal after the law’s effective date. “This law helps level the uneven play-ing field created by government antitrust laws that prohibit dental practices from joining together to create the amount of leverage necessary to actually negotiate meaningful changes to unfair provisions in their insurance contracts,” WDA Presi-dent Dr. Timothy Durtsche (La Crosse) said.

This latest WDA advocacy success got underway in June 2010. The WDA first introduced NCS bills during the 2011-12 session with 41 legislators (30 in Assembly and 11 in Senate) signing on as co-spon-sors. After last session’s failed attempt, the WDA immediately regrouped. Strategies were formulated for countering the strong influence of the insurance industry and Wisconsin Manufacturers & Commerce in both houses. The WDA wasted no time in readdress-ing NCS with legislative leaders in late fall 2012 and in early 2013, just before the kicking off of the 2013-14 Wisconsin Leg-islature.

ADVOCATE

2 WDA Journal September 2013 WDA.org

The Wisconsin Dental Association has had its American Dental Association state public affairs grant renewed for the remainder of 2013. The money is used for additional lobbying and public relations support on such important issues as non-covered services and community water fluoridation. The government services staff works with the Madison lobbying firm of Hubbard Wilson and Zelenkova, LLC, while the public relations team is assisted by Evan Zeppos and Brenna Sadler of the Milwaukee, Chicago and New York communications firm Laughlin Constable. From January 2010 through December 2013, the WDA has benefited from more than $350,000 in SPA funds. The ADA House of Delegates approved the SPA grant program in 2006. Approximately $30 from each member’s national dues is allocated annually to fund the SPA budget.

ADA renews state public affairs grant on heels of NCS successCarol Weber, APR WDA Director of Public Relations [email protected]

EMPOWER

Assembly Speaker state Rep. Robin Vos (R-Burlington) indicated WDA may need to “deal” with insurance plans (e.g., Hu-mana) and adopt model legislation more similar to that passed in other states. He set up multiple meetings between groups on both sides of the NCS issue and aisle. The WDA government services team worked diligently with the drafting bureau and legislative staffs to minimize confu-sion on specific language in the bill and

to demonstrate dentistry’s willingness to work with others. The final bills included compromise language similar to National Conference of Insurance Legislators model legislation plus the inclusion of an important “de minimis” clause. (Tennessee is the only other state with a de minimis clause.) Unlike other states laws adopted, Act 26 prevents insurance companies from paying a nominal fee (e.g., $5 for an im-

NCS continued from page 1

Make your voice heard at the WDA House The Wisconsin Dental Association House of Delegates will assemble Nov. 15-16, 2013 at the Madison Marriott West in Middleton. The face-to-face time with colleagues and WDA staff gives members the opportu-nity to ask questions, listen to or participate in discussions on dental issues and learn more about how the WDA and organized dentistry works.

Issues before the House • Elect president-elect, vice president and speaker of House • Adopt legislative agenda • Adopt 2014 budget • Set 2014 membership dues rate • Edits and additions to bylaws • Elect members to House nominating, bylaws and ethics committees • Proposed changes to the ADA House of Delegates delegation election process • Elect delegates and alternates to the 2014 American Dental Association House of Delegates to be held Oct. 9-14, 2014 in San Antonio.

If you are interested in running for one of these positions, submit your curriculum

vitae to the WDA Executive Office as soon as possible. Nominations will be held on Sat., Nov. 15. Please include positions held at the local, state and national dental society levels. A sample format is available by contacting Lisa Chandre at [email protected]. CVs will be shared with WDA House members. All members are welcome to attend the Mega Topic Discussion - Affordable Care Act and Reference Committee open hear-ing on Friday, Nov. 15. Visit WDA.org to RSVP by Oct. 28.

Component breakfast The seventh annual Component Officers’ Breakfast & Open Forum will be held Friday, Nov. 15, 2013 in conjunction with the WDA House of Delegates meet-ing. Any component officer who attends this event will be reimbursed a maximum of $120 plus applicable taxes for one night’s stay on arrival Nov. 14 at the Marriott Madison West (rate applies for reservations made before Oct. 15). When making your reservation, please mention the WDA room block to receive this rate.

Complete and submit the reimbursement form that will be distributed at the break-fast. Reimbursement forms are due to the WDA Executive Office prior to Dec. 2, 2013. Any received after this date will not be honored. If you have any questions, contact WDA Member Relations Coordinator Amy Landis at 414-755-4126 or [email protected]. What: WDA House of Delegates When: Nov. 15-16 Where: Madison Marriott West, 1313 John Q. Hammons Drive Hotel info: $120 for a single or double room, plus applicable taxes for sleeping rooms reserved before Tuesday, Oct. 15 by calling 888-745-2032 and identifying yourself as part of the WDA group. Checkin is at 4 p.m. and checkout is at noon.Contact: Lisa Chandre at 800-364- 7646, ext. 4104, 414-755-4104 or [email protected] with questions.

Preliminary list of events:Friday, Nov. 157 - 8:30 a.m. .......Component Officers’ Breakfast & Open Forum8:00 - 8:30 a.m. .................New delegate/alternate orientation8:45 a.m. - 9:15 a.m. ............ Reference/Elections committees’

orientation8:30 a.m. .......................House credentials available for pickup9:30 a.m. ......................................... House registration opens10:00 a.m. - Noon. ................................... First House sessionNoon - 1:00 p.m. ..........................................................Lunch1:15 - 3:15 p.m.. ..Mega Topic Discussion - Affordable Care Act*3:30 - 5:00 p.m ................ Reference Committee open hearing*5:00 - 6:30 p.m ............................Closed Reference Committee6:30 - 10:00 p.m ..................................President’s Reception/

Pyramids of Pride Award Dinner (under separate invitation)

Saturday, Nov. 167:00 - 7:30 a.m. ..............................Caucus breakfast available7:15 a.m. ................................... Reference Committee Reports

delivered to caucus rooms7:30 - 9:00 a.m. ............................................Region caucuses9 a.m. .........................................................House registration9:30 a.m. - conclusion .............................. Final House session

Guest Speaker - Dr. Marko Vujicic, managing vice president of ADA’s Health Policy Resources

Center “Dentistry at a Crossroads: A Look Back, A Look Forward”

*OPEN TO ALL WDA MEMBERS

EMPOWER

plant) and then calling the service “cov-ered” and being able to dictate the fee. Rep. Joan Ballweg (R-Markesan) and Sen. Jerry Petrowski (R-Marathon) stepped up and offered to be the lead sponsors of the new NCS bills. Their un-derstanding of small business dental prac-tices and personal ties with dentists back in their districts made a big difference in the bills’ success this session. In-person appeals to legislators by con-stituent dentists and Marquette University School of Dentistry students during WDA Legislative Day helped secure 70 biparti-san co-sponsors prior to the NCS bills be-ing reintroduced in both houses late last March. More co-sponsors were added after the bill was introduced, and the WDA would eventually boast of an amazing 90 NCS legislation co-sponsors (45 Republicans and 45 Democrats) out of a total 132 state lawmakers. The Assembly voted 89 - 8 in favor of its bill on April 17 and the Senate passed its version with a vote of 30 - 3 on May 7. “This bill represents a compromise between the WDA and the Alliance of Health Insurers. I believe society is best served when the prices are directly related to the costs of provided services and not set by a third-party who doesn’t pay for it,” Rep. Ballweg says in a press release issued by her office after the bill was signed into law. “This is a basic fairness issue,” Sen. Petrowski notes in a release posted on his official state website July 8. “If you don’t

pay for something you shouldn’t set the price for it.” The multi-year NCS legislative cam-paign involved hundreds of emails, tel-ephone calls and in-person meetings be-tween dentists, association staff, contract lobbyists and attorneys, state lawmakers and their staffs, administration representa-tives and insurance companies. It included an educational white pa-per, Legislative Day materials, prominent coverage in multiple issues of the WDA Healthy Choices E-Lert legislative news-letter, in-person testimony by WDA lead-ers at Assembly and Senate committee hearings and statewide media statements backed up by website information and so-cial media posts. WDA members were kept abreast of NCS developments via multiple print and electronic communications, includ-ing Capwiz, Executive Director’s Update, WDA Journal, WDA.org website and regular updates in the “Government Buzz” issue chart. “WDA members consistently rate leg-islative advocacy one of the top reasons they belong to organized dentistry,” WDA Executive Director Mark Paget explains. “This NCS victory is rooted in our asso-ciation’s mission to advance the interests of our members and the dental profes-sion by promoting professional excellence and quality oral health care for the public through programs and services that ad-vocate, educate, empower and serve,” he adds.

WDA.org September 2013 WDA Journal 3

The Issue Current Buzz WDA Actions Next Steps

All Wisconsin dental and dental hygiene licenses must be renewed no later than Sept. 30, 2013.

The Dentistry Examining Board requires dental professionals to sign an affidavit verifying completion of the required hours of continuing education (30 for dentists and 12 for dental hygienists) for the preceding two-year (Oct. 1, 2011 to Sept. 30, 2013) licensure period as part of the licensure renewal process.

State law requires CE completion certificates be retained by licensees for at least six years.

CE must include a current certificate of profi-ciency in cardiopulmonary resuscitation and automated external defibrillators. CPR-AED training must include “...instructor-led, hands-on skill training and assessment”. Online courses without in-person, instructor-led skill training and assessment are not acceptable.Dentistry Examining Board guidance on accept-able CPR-AED training for dentists and dental hygienists can be found here http://1.usa.gov/11YY3IC. State statutes do not have a category for people who “retire…but keep their license.” The state assumes if you keep your license, you will be able to perform dentistry on the public. For that reason, it is fully expected that any dentist who maintains an active license (even though he/she does not practice full-time) will be expected to meet the 30 hour CE requirements.

The WDA offers a CE tracking form for use by DDS and RDH members to maintain records of their credits for the current licensure period. It is available on WDA.org (login in required): • Dentists can download their CE form here: http://bit.ly/12Dafg4. • Dental hygienists can download their CE form here: http://bit.ly/12GDCK1. On Aug. 1, 2012 the DEB finalized its review of CE regulations. Find answers to frequently asked CE questions here http://bit.ly/12uthSy.

Licensees are responsible for keeping evidence of their CE activities for six years fol-lowing license renewal and should diligently maintain CE information and records. Licensees may be audited randomly or as part of an investigation issued on a licensee. If audited, licensees must present proof of CE completion.Several easy, low-cost CE opportunities are listed on WDA.org at http://bit.ly/12uthSy.

Wisconsin’s Oral Health ImprovementRoadmap to Improving Oral Health,2013-2018WOHC has proposed significant edits to the “State Oral Health Improvement Plan” released in December 2012 and which WDA originally opposed. The WDA supports the edited draft, as no unexpected changes were made. Wisconsin Oral Health Coalition consists of 130+ individuals, organizations and agencies from various backgrounds (including dental). It focuses on dental access issues and improving the oral health of children and families. Children’s Health Alliance of Wisconsin pro-vides staff support through federal oral health grant from Centers for Disease Control and Prevention.

WDA issued concerns with the content and man-ner in which the December 2012 document was developed and released and refused to support sections promoting mid-level providers and a second dental school.At a June meeting, attendees restored trust in the groups’ cooperative relationships and identified opportunities for collaboration.A revised draft of the oral health “roadmap” was developed with input from the WDA and 17 other oral health advocacy groups.

Each entity is reviewing the plan’s broad-based strategy areas. After plan approval, each entity will then be able to develop specific policies to pursue alone or with others.

WDA leaders and Legislative AdvocacyCommittee members reviewed the revised “roadmap” and submitted the following comments by July 14 deadline: • Clearly define “dental safety net”; includes a broad base of dental providers - those who either contract with Federally Qualified Health Centers or see Medicaid/low-income patients indepen-dently. • Note importance of sustainable MA rates for all if access to care for patients is to increase. Include an explanation on the disparity of pay-ments provided when an MA patient receives care at FQHCs compared to payments made when a patient receives care at non-FQHCs. • Remove “insurance” term when referring to dental benefit coverage so roadmap reads: “Promote adequate and sustainable funding for publicly-financed dental coverage”.

The roadmap is on the agenda for the 2013 WOHC annual meeting which is scheduled for 8 a.m. - 3 p.m. on Wednesday, Sept. 18 at the Holiday Inn & Convention Center in Stevens Point.To encourage dentists and dental hygienists to attend the annual WOHC conference and participate in the discussions, the WDA will pay the $20 registration fee for each member who wants to attend. Contact Erika Valadez at 608-250-3442 or [email protected] to add your name to the WDA attendee list.

Wisconsin Dental Hygienists Association drafting legislation to give dentists authority to delegate administration of nitrous oxide inhalation analgesia to RDHs who earn the necessary certification.

The WDA has indicated support for the legis-lation as long as it requires this be performed only as part of a treatment plan issued by a dentist and that the dentist remain on the premises and available to the patient through-out the completion of the appointment.

WDHA is working with sate Sen. Shelia Harsdorf (R-River Falls) to introduce a nitrous oxide bill which will be circulated for co-sponsors in the near future. The WDA Board of Trustees was invited to review a preliminary draft of the legislation at its June meeting.

The WDA Board had very minor questions/con-cerns about the RDH nitrous oxide draft legisla-tion. These concerns were shared with the WDHA lobbyist.The bill, as drafted, is consistent with WDA expectations. WDA expects to offer support for passage of this legislation assuming no major changes occur prior to introduction.

The WDA has support for this item at “me-dium” in its 2013-14 legislative priority listing. “Medium” means the WDA advocates for or pursues meetings and activities on the issue, but prefers if possible to do so as part of a larger group or by reacting.

Legislative-related meetings

2013• Dentistry Examining Board: Sept. 4, Nov. 6; all meetings are held at Department of Safety and Professional Services, 1400 E. Washington Ave. in Madison and start promptly

at 8:30 a.m.• Sept. 18 – Wisconsin Oral Health Coalition: 2013 annual meeting; 8 a.m. - 3 p.m.; Holiday Inn & Convention Center, Stevens Point; WDA covers registration fee for any

member attending. Contact Erika Valadez in the Madison office at 608-250-3442 or [email protected] with questions or to add your name to the registration list.• Oct. 7 - Joint Racine County Dental Society, Kenosha County Dental Society and Burlington Dental Society Legislative Night; Bristol Oaks Golf Club, HWY 50,

Only 2 miles west of I-94; 6:30 p.m. cocktails, 7 p.m. dinner.

2014• Feb. 4 - Waukesha County Dental Society; Legislative Town Hall Meeting; 6 - 8 p.m.; details to be announced.

WDA Government Buzz gives members a snapshot of the current status of dental-related policies and legislation. The Issue tells you who, what and why; Current Buzz gives you a status update on the issue; WDA Actions highlights your professional associa-tion’s activity and position; and Next Steps anticipates what’s around the corner and, in some cases, identifies what WDA mem-bers can do. “WDA Government Buzz” is updated for each issue of the journal. Current “buzz” available on WDA.org website and accessed monthly via WDA Executive Director’s Update e-newsletter. For more information, visit WDA.org or call the WDA Legislative Office at 608-250-3442.

Updated information is highlighted.

Changes proposed to ADA, WDA house delegationsCarol Weber, APR WDA Director of Public Relations [email protected]

Recommendations for strengthening del-egations sent to both the American Dental Association and Wisconsin Dental Associa-tion House of Delegates for developing new dentist leaders by limiting the number of years individuals serve in the state and na-tional policy-setting bodies were approved by the WDA Board of Trustees at its June meeting in Egg Harbor. The Leadership Development Task Force (see box on page 15) was appointed by WDA President Dr. Tim Durtsche (La Crosse) in February. Changes approved by the BOT

include: • Limit to 10 years the length of time a member may serve as a delegate and/or al-ternate to the ADA. Exceptions include WDA officers (president, president-elect and vice president), Marquette University School of Dentistry dean and any internal-ly-announced candidates for ADA office. • Send a strong delegation to the ADA House by having the Executive Commit-tee review candidates’ curriculum vitaes in advance for regional representation; past WDA involvement; leadership experience;

ADA involvement and/or connections; dependability; knowledge; communication skills; leadership potential; previous expe-rience as an alternate delegate; and, good computer skills needed in the paperless ADA House. • Adopt formal procedure for selecting alternates to replace ADA House delegates who have to withdrawl. • Share the list of delegate/alternate pre-ferred experiences and skills with compo-nents for use in electing their WDA House delegation.

• Limit to 10 years the length of time a member may serve as a delegate and/or al-ternate to the WDA House, excluding years of service as a member of the MUSOD stu-dent delegation.

These proposed policy changes will be forwarded to the WDA House of Delegates for final action during its Nov. 15 - 16, 2013 meeting at the Marriott Madison West in Middleton. Not adopted was a task force resolu-tion prohibiting components from filling

EMPOWER

continued on page 15


Messages

Breaking down barriers to care

The never-ending fluoride fight

Timothy Durtsche, DDS, WDA President [email protected]

Robert Brennan, DDS, WDA Editor [email protected]

On April 22, former U.S. Surgeon General Regina Benjamin, M.D., MPA followed in the footsteps of her predecessors and endorsed community water fluoridation as one of the

most effective ways to improve the oral health of all community residents at every age simply by drinking fluoridated water. The American Dental Association 9th District, com-prised of Wisconsin and Michigan, is important in the history of water fluoridation. In 1945, Grand Rapids, Mich. became the first U.S. community to implement water fluoridation. A pivotal study in Antigo confirmed fluoride’s benefits by documenting a dramatic increase in the caries rate when fluoridation was stopped in 1960 after the com-munity had been fluoridating for 11 years. Despite extensive research showing fluoride’s effec-tiveness and safety and support from numerous health organizations and the dental community, we are still in a continuous battle to get and keep community water supplies fluoridated. The Wisconsin Dental Association has been fighting anti-fluoride activity for years. With all the positive research, you would think fluoridated water would be less of an issue today. However, anti-fluoride activity has been increasing. In the first six months of this year, we saw activity in 22 Wisconsin communities. Last year, the most noticeable incident was an attempt

by a Milwaukee alderman to remove fluoride from the city’s water supply. Thankfully, this was prevented. One bright spot was the number of organizations who joined with the WDA in a collaborative effort highlight-ing the benefits of fluoride. This was often not the case in the past.

Fluoridation is a public health issue and public health organizations need to be at the forefront on this issue. Unfortunately, I recently learned the pro-fluoride coali-tion’s efforts were not as successful as we thought. The compromise in Milwaukee involved a new city ordinance continuing fluoridation of the water, but at the lower level of .7mg/L. This is the level the U.S. Department of Health and Human Services has been con-sidering for some time and will likely implement later this year. However, after the ordinance passed, Milwaukee’s water works department has actually been fluoridating the water at a much lower level ranging from .48mg/L-.58mg/L. The

staff argues they need to do this because the language of the ordinance requires them to fluoridate “to a maximum of ” .7mg/L. They have decided to “underfluoridate” the water so Milwaukee’s 5th District Alderman James Bohl, who consistently monitors the level, never has a reason to complain they are over the .7mg/L level. This reduction greatly reduces the oral health benefits of fluoridation. By failing to hit the optimal level of fluo-ride, the city is doing a great disservice to their constitu-ents who are presently not receiving the full benefits of fluoridated water. Pleasing the anti-fluoridationists appears to be more important than the oral health of Milwaukee’s residents. This is public policymaking at its worst. There are times when I think this is really not worth the fight. Why should the WDA spend all this time and money fighting something that doesn’t benefit our members? Maybe we should just tell them to stop fluoridating if they want and create more business for dentists. However, reality usually sets in and I realize as a profes-sional association we have to advocate for what is best for Wisconsin residents. I encourage Milwaukee dentists to contact their alder-persons and express their dissatisfaction with the city’s failure to fluoridate its water at the .7mg/L level needed to receive optimal oral health benefits. Milwaukee residents deserve better treatment than they are getting from their city officials.

We need to be proactive about addressing barriers to care and educating the public that a visit to the ER will not provide a

definitive answer to dental pain. It may only temporarily alleviate the

symptoms. Only a dental visit can truly treat a problem.

I encourage Milwaukee dentists to contact their alderpersons and express

their dissatisfaction with the city’s failure to fluoridate its water at the .7mg/L level needed to receive optimal oral

health benefits.

The WDA Journal invites readers to express their views in letters to the editor. This provides a forum for discussing topics of interest to the dental profession. To be considered, letters must be 300 words or less and signed with an e-mail address or phone number. The Editorial Board reserves the right to edit for space, clarity, civility and accuracy. Any changes will be shared with the writer before publication. If your letter is selected, contact will be made to confirm receipt. Submit letters to the editor via email to [email protected] or fax to 414-755-4111. You may also mail your letter to: WDA Journal | Attn: Dr. Robert Brennan | 6737 W. Washington St. | Suite 2360 | West Allis, WI 53214

WDA style note: We make every effort to bold members’ names in articles.

Submitting letterS to the editorWDA Editor Robert Brennan, DDS, Neenah

920-725-0551 • [email protected]

Robert Darling, DDS, Sheboygan920-457-1717 • [email protected]

Ellyn English, DDS, La Crosse 608-775-2696 • [email protected]

Glenn Gequillana, DDS, Milwaukee414-649-3510 • [email protected]

Gene Shoemaker, DDS, Waukesha 262-542-0326 • [email protected]

editorial adviSory board

As I write this, we have just completed our fifth Wisconsin Dental Association and WDA Foundation Mission of Mercy on June 28 and 29.

With 2,000 patient visits and nearly $1.2 million in care given, I felt honored to have been a part of this event event and had a lot of fun. I volunteered in the extraction area where 1,846 teeth were removed in two days. This number may be impressive, but it is also disturbing to know we had that many teeth which couldn’t be saved. I felt especially concerned about the number of young adults needing multiple extractions. We are trying to get answers about dental coverage with the Affordable Care Act. In Wisconsin, there will be a reduction of coverage for adults without children. They will no longer be covered by Medicaid with the hope they will purchase dental coverage for themselves. However, this may not be the case. I think many will forgo purchasing coverage. This could potentially lead to an increase in the number of adults utilizing hospital emergency rooms and urgent care for dental care. There is a new push from the American Dental Association in regards to reducing barriers to dental care and trying to avoid ER visits for temporary treatment of dental pain.

For many people, the perception is they need dental insurance to get any dental care.

Our challenge is getting the message out that anyone can afford routine dental care; it is a matter of priorities. Statistically, only about 60 percent of dental care is paid by dental insurance and the rest is paid out of pocket. The concept of dental insurance is really a misnomer, as it really is prepaid dental care subject to co-pays, deduct-ibles and maximums. There is no catastrophic coverage for care beyond the annual maximum. I am always amazed at the number of people who state they cannot get dental care because of lack of insurance. Yet these same people will have premium cable service, an expensive cellphone and other evidence of a lack of prior-ity for dental care. How do we educate the public about preventive care,

restorative care, nutrition counseling, cancer evaluation and hygiene? That is a challenge for us all. Not everyone will be able to afford the latest in cosmetic dentistry, but we can hope to be able to provide basic den-tal care at an affordable fee for patients. The ADA’s Action for Dental Health is a good start. We need to be proactive about addressing barriers to care and educating the public that a visit to the ER will not provide a definitive answer to dental pain. It may only temporarily alleviate the symptoms. Only a dental visit can truly treat a problem. We have communities in Wisconsin where a network of dentists have coordinated with hospital emergency rooms and urgent care centers to be a resource for patient referral. This does not need to be complex. For example in La Crosse, patients are referred to an office for dental care during regular office hours. Perhaps this could be a project for your local dental society. If there are enough participating dentists, they will spread the call, so there is not as much for any individual or group. The care provided doesn’t need to be comprehensive and doesn’t require an office to accept the patient perma-nently unless they wish to. Many patients still have fear of dental visits and are looking for a dental home where they can be treated. Let’s work together on this issue. Please give it some careful consideration.


Mission of Mercy dentists and dental hygienists show great compassion

Mark Paget WDA Executive Director [email protected]

Executive Director Corner

Having been a part of our five Wisconsin Dental Association and WDA Foundation Mission of Mercy projects, I am continually amazed at the giving spirit of our members.

I cannot think of another profession that is more charitable than dentistry.

Not only do our members take time away from their practices to provide much needed care, but you also spend your own money to travel to the MOM site and pay for your own lodging.

The location for this year’s MOM was Badger High School in Lake Geneva. The facility was a perfect venue, provid-ing plenty of parking along with a good floor plan and lots of space.

The hallways at Badger featured many banners/posters with inspirational and

motivational messages for the students. I found one to be especially appropri-

ate for our event, show who you are, by what you do, with what you have.

When I saw the poster for the first time, I immediately thought of the den-tists, dental hygienists, lab technicians, dental assistants, X-ray technicians and hundreds of other volunteers using their God-given talents to help others.

Everyone working in the dental pro-fession is truly blessed with amazing gifts that improve the lives of your patients. When dental professionals use their unique and special skills to improve the oral health of the underserved, it is amaz-ing.

Hat’s off to the leadership team who put together this year’s event, MOM Chair

Dr. Thomas Raimann (Hales Corners), MOM Vice Chair Dr. Allison Dowd (Madison), MOM Local Co-Chairs Dr. Robert Dillman (Lake Geneva) and Ms. Judy Johnson.

WDA Associate Executive Director Lani Becker did another superb job serv-ing as program coordinator.

In closing, I want to personally thank the 228 dentists and 97 dental hygienists who helped make our Fifth Mission of Mercy project a huge success.

You truly demonstrated that the den-tal profession has a big heart and believes in giving back.

Once again, you made me extremely proud to be associated with such a won-derful organization!

Member Publication

SEPTEMBER 2013VOLUME 89, NUMBER 9

EditorRobert Brennan, DDS, Neenah

920-725-0551 • [email protected] Editor

Mark Paget414-755-4100 • [email protected]

Managing EditorEmily Bultman


OFFICERSPresident

Timothy Durtsche, DDS, La Crosse 608-784-7319 • [email protected]

President-ElectJulio Rodriguez, DDS, Brodhead

608-897-8645 • [email protected] Vice President

Paul Levine, DDS, Milwaukee414-355-0213 • [email protected]

Past-PresidentSteven Stoll, DDS, Neenah

920-725-4307 • [email protected] Treasurer

John R. Moser, DDS, Milwaukee414-273-9800 • [email protected]

EditorRobert Brennan, DDS, Neenah

920-725-0551 • [email protected] Executive Director/Secretary

Mark Paget, West Allis 414-755-4100 • [email protected]

Region 1 Northwest David Kenyon, DDS, Altoona

715-832-3385 • [email protected] Nehring, DDS, Mercer

715-476-3432• [email protected] Jennifer Peglow, DDS, Stevens Point 715-344-2324 • [email protected]

Region 2 NortheastPaul Feit, DDS, Sturgeon Bay

920-743-6976 • [email protected] Peter Hehli, DDS, Appleton

920-997-1557 • [email protected] Kraig, DDS, Fond du Lac


Region 3 Greater MilwaukeeThomas Kielma, DDS, Milwaukee

262-649-3510 • [email protected] Lepak-McSorley, DDS, Milwaukee

414-383-8787 • [email protected] Thomas Raimann, DDS, Hales Corners414-425-1510 • [email protected]

Region 4 SoutheastRyan Braden, DDS, Lake Geneva

262-248-0120 • [email protected] Hartmann, DDS, Greenfield

414-543-4700 • [email protected] Murphy, DDS, Racine


Region 5 SouthwestL. Stanley Brysh, DMD, Madison

608-417-6500 • [email protected] Clemens, DDS, Wisconsin Dells608-254-2345• [email protected]

Patrick Tepe, DDS, Verona 608-848-4000 • [email protected]

Region 6 Student RegionDerek Schmidt

Marquette University School of [email protected]

Speaker of the HouseRichard Lofthouse, DDS, Fennimore

608-822-3770 • [email protected] ADA 9th District Trustee

Dennis Engel, DDS, CDE, Mequon 262-242-8929 • [email protected]

Letter to the editor

Reflecting on antitrust and mobile dental operations

I read this article twice, “Antitrust, dentistry and YOU” in the June 2013 WDA Journal before I allowed myself to become disappointed. First, it truthfully reflects the fact Wisconsin is behind a number of states in establishing rules and regulations for mobile and portable dental operations. Wisconsin continues to dance around reporting structures and accountability issues while state after state passes laws providing for a safe and quality dental environment. Second, and very distracting is the statement indicating that, “WDA mem-bers should avoid discussing pricing, quality of services or other similar issues.” I find this statement detrimental to a clear understanding in the marketplace of portable and mobile dental operations taking place here in Wisconsin. Most everybody understands you should not discuss pricing, but discussing quality of service, potential motive and method of operations should be fair game, if truthful, in nearly any industry.

Sincerely, Robert G. Glass, executive director of Tri-County Community Dental Clinic

Our apologies

Wisconsin Dental Association new mem-ber Dr. Emily LaBadie’s (Burlington) component was incorrectly listed in the August 2013 WDA Journal.

Dr. LaBadie is a member of the Burlington Dental Society.


The purpose of this article is to keep dental employers informed of the poster requirements mandated by state and federal law. It is important that dental employers comply with information posting requirements. To ensure staff access to the information, the posters should be displayed in “plain viewing sight.” The following is a comprehensive list of state and federal posters required for either all employers (regardless of staff size) or for employers with 50 or fewer employees. For the purposes of this article, it is assumed that dental employers in Wisconsin generally maintain staffs much smaller than the referenced minimum of 50 employees. Therefore, any poster requirements that apply only to employers with 50 or more employees have been omitted from this listing. For more information on posting requirements, contact WDA Government Services Director Mara Brooks at [email protected] or WDA Dental Practice and Government Relations Associate Erika Valadez at [email protected].

State requirementswww.dwd.state.wi.us/dwd/posters.htm

NOTE: Posters can be accessed and printed directly through the state website. Posters printed directly from the state website meet posting requirements.

For document sales call 800-DOC-sale, or 608-266-6861. All employers (includes those with 50 or fewer employees):

Poster required Code Last revised ExplanationFamily and medical leave law English: ERD-7983-P

Spanish: ERD-7983-S-PSeptember 2011 Applies only to employers with 50 or

more employees

Employers with 25 to 50 must post a notice describing own policies with respect to family or medical leave

Fair employment law English: ERD-4531-PSpanish: ERD-4531-S-P

April 2013 All employers are required to display the poster

Hours and days of work minors may work in Wisconsin

English: ERD-9212-PSpanish: ERD-9212-S-P

December 2011 All employers, except agriculture and domestic service, who hire minors are required to display the poster

Retaliation protection for health care workers

RD-12210-P September 2011 All employers who are health care pro-viders or who own or manage a healthcare facility must display

Unemployment benefits, notice to employees about claiming

English: UCB-7-PSpanish: UCB-7S-PHmong: UCB-7-H

July 2012 All employers who are subject to Wisconsin’s Unemployment Compensation Law are required to post the poster

Federal requirementswww.dol.gov/osbp/sbrefa/poster/main.htm or http://www.dwd.state.wi.us/dwd/posters.htm

Phone: Each agency has a separate phone number; see below. All employers (includes those with 50 or fewer employees):

Poster required Code ExplanationEmployee Polygraph Protection Law (WH-1462)

No poster code listed

To order: call Wage and Hour Division with U.S. Department of Labor at 414-297-1590 (Milwaukee office)

All private employers covered by law (enterprises involved with interstate, commerce, etc.).

Equal Opportunity is the Law, Age Discrimination, Americans with Disabilities Act

No poster code listed

Contact: U.S. Equal Employment Opportunity Commission 800-669-4000800-669-3362

All employers covered by law

Federal minimum wage – Your rights under the fair labor standards law

WH-1088

Contact: U.S. Labor Dept. Wage and Hour Div. Milwaukee414-297-1590Milwaukee 414-297-3585

All employers covered by law

Job safety and health protection OSHA-300Contact: U.S. Dept. of Labor/ OSHAMilwaukee: 414-297-3315Appleton: 920-734-4521Madison: 608-441-5388Eau Claire: 715-832-9019

All private employers

Occupational Injuries and Illness Summary English: UCB-7-PSpanish: UCB-7S-PHmong: UCB-7-H

July 2012

Your Rights Under the Uniformed Services Employment and Reemployment Rights Act

No poster code listedU.S. Dept of Labor: 866-487-2365

The Veterans Benefits Improvement Act, enacted by Congress in December 2004, mandates that employers provide the notice to all persons entitled to rights and benefits under USRRA.

Additional poster not listed on the U.S. Department of Workforce Development website but also a Federal requirement:

National Relations Labor Boardwww.nlrb.gov/poster

Poster required Code ExplanationNotification of Employee Rights No poster code listed but available in English

and Spanish via board website or by calling: Milwaukee (Region 3)(414) 297-3861

Applies to all private-sector employers (includ-ing labor unions) subject to the National Labor Relations Act, which excludes agricultural, rail-road and airline employers.

Comprehensive listing of federal, state poster requirementsErika Valadez WDA Dental Practice and Government Relations Associate [email protected]

Failure to comply with state and federal consumer lending laws can result in substan-tial penalties, which can be enforced by the state, a federal agency or even a disgruntled patient and attorney. Lending laws do not apply unless a dental practice is both extending credit and doing so “regularly”. An extension of credit does not necessar-ily need to include an interest charge. Thus, any of the following payment methods count as an extension of credit: • Interest is charged for partial, slow or nonpayment (i.e., 12 percent per annum for amounts not paid within 30 days). • Payment is allowed over some period of time, but there is a discount for immediate cash payment (i.e., the patient can pay $200 a month for three months for a $600 bill, but can pay it all off at once for $575). • Payment is allowed in more than four installments, excluding the down payment and the arrangement is in writing (i.e., pay-ment of a $1,000 bill with $200 down and five monthly payments of $160).

Occasionally relying on one of these pay-ment arrangements will not automatically subject you to consumer lending laws unless you rely on these methods on a “regular” basis. “Regular” means more than 25 credit transactions in a calendar year. However, this is a federal definition. Wisconsin law is not as clear as federal law and does not define “regular”. Thus, the state may have a significantly lower threshold than 26 credit transactions if challenged. The 26th transaction is subject to the federal consumer lending law, as are all sub-sequent credit transactions that year. Further, once you go more than 25 trans-actions in a year, all credit transactions in the next year are subject to federal law. It is important to note that there are a number of payment methods that do not create an extension of credit. These include: • Accepting payment by credit card (only the card company is extending credit, not the dentist). • Cash payment discount, so long as you do not offer any form of “in-house” credit plan. • An “open-end” plan (i.e., allow the patient to incur charges of up to X dollars, so that when they pay some or all of it down they can again incur charges up to the X dol-lar limit). The plan must: • Specifically disallows interest/finance charges • Not be combined with a cash pay-ment discount • Contemplate payment in four or less installments • A “closed-end” payment plan, typically for one large bill (this differs from open-end credit since it covers a set dollar amount which is not renewed as paid), where pay-ment is made, with or without a down pay-ment, in no more than four installments; no interest/finance charge is imposed. The bottom line is that dental prac-tices must either comply with lending laws or structure payment alternatives, so as to avoid their application altogether (i.e., in a manner that will not be treated as involving credit extensions or that keeps the number of extensions below the threshold levels). Either way, you should strongly consider discussing your billing and collection prac-tices with an attorney familiar with dentistry and state and federal lending laws to ensure compliance.

BUSINESS of Dentistry

Lending Laws: Do they apply to your practice? Kate Bechen Attorney Michael, Best and Friedrich LLP


Key takeaways...

• Review required federal and state posters and display in plain sight • Verify billing and collection practices with an attorney to ensure compliance with lending laws• A dentist can delegate any remediable procedure to a dental assistant• Consider new tools to help generate positive online reviews such as practice signage or appointment card

Dental practice FAQ The Wisconsin Dental Association staff receives a multitude of phone calls and emails every day. Questions come from member dentists, dental hygienists, assistants, office managers, other organizations and patients who are looking for answers to dentistry-related topics. During 2013, a frequently asked dental prac-

tice question and answer will run periodically in the WDA Journal. For more information, visit www.wda.org or review FAQs in the WDA Sourcebook. Q.What services can I delegate to my assis-tant?

A. There is no laundry list of procedures a dental assistant can perform in the office. A dentist can delegate any remediable

procedure to a dental assistant according to Chapter 447 of the Wisconsin Statutes, Section 447.065 “Delegation of Remediable Procedures and Dental Practices”. Remediable procedures are defined as “...patient procedures that create changes within the oral cavity or surrounding structures that are reversible and do not involve any increased health risks to the patient.” The dentist must always be on the premises when assistants are performing any proce-dures. The dentist is responsible for all delegated functions the assistant performs.

TOP 10CALLER Q&A

You might not know it, but if you’ve been practic-ing for a while you probably already have a fairly well-established online reputation. For the supremely confident that sounds like noth-ing but good news, but for most health care profession-als it can also be a little daunting. The idea of unchangeable reviews, especially nega-tive ones from websites including Yelp, Yahoo and HealthGrades, can be unnerving. But, a good reputa-tion-tracking strategy can do wonders to alleviate yourstress. Your online reputation is more important than ever, and it will only continue to gain relevance in the future. Studies published by Local Consumer Review just last year indicate that a whopping 72 percent of consumers trust online reviews as much as personal recommendations, and 52 percent say positive online reviews make them more likely to use a local business. It’s very likely that these numbers are growing every day, so every practice should be watching its online reputation like a hawk. A sense of what your patients have to say makes it easy to pinpoint what can improve. With some extra

effort, you can even devise a plan to generate more positive reviews and ensure the good ones outweigh the bad organically. Unfortunately that effort takes a lot of time. Not only do you have to scour every corner of the web for wide-scattered reviews, you also need a way to compare them, detect trends and start making plans for improvement. It often takes so much time that it’s easy, even comfortable, to put your web presence out of sight and out of mind. A tempting idea, but also a dangerous one. The bottom line is that ignorance is far from bliss, and if you want online success, you need to stay abreast of your Internet reviews. Thankfully, there are professional services that can take care of the considerable legwork for you.

The best of these programs delve into the Web and extract every piece of conversation about your prac-

tice. They then funnel all that data into one place and add charts, graphs and analytics so you can determine exactly where to focus your efforts without pouring hours of your own time into research. Often, these services will even pro-vide you with tools to help gener-ate new positive reviews, including signage for your practice and after-appointment cards you can use to encourage satisfied patients to join the online conversation. Managing an online reputation can

be a hefty task, but in the end it’s more than worth-while – it’s essential. If you don’t have the time or know-how to do this on your own, consider a profes-sional service. Slowly, but surely, a properly managed awareness of your online reputation will help bring new patients to your door.

Making your online reputation work for youGlenn Lombardi Officite President [email protected]

REcoMMEndEd PRoducTS, PRogRaMS and SERvicES Your association did the research...you reap the benefits!

inSuRancE

Professional Liability and Office Protection WDA Group Health Insurance Program Auto and Homeowners Insurance Group Life and Disability Individual Health, Disability and Life HSAs, HRAs and MSAs Section 125 Plans Medicare Supplement Programs Long-Term Care Insurance Workers’ Compensation Direct Reimbursement Advanced Planning ServicesPaid Dental of Wisconsin

To take advantage of these quality plans and their high-level benefits geared to the special needs of Wisconsin’s den-tal community, call 800-242-9077, send e-mail to [email protected] or http://insuranceformembers.com.

PRacTicE ManagEMEnTThe Dental Record (patient records) Central Data Storage (online data backup and recovery)Patient eForms (online patient forms)DentForms by MedicTalk (electronic forms)800-243-4675 | www.dentalrecord.com

AED Brands (defibrillators) 800-580-1375www.AEDbrands.com

AMO - Association Members Only (office supplies) 800-420-6421 | www.goamo.com

CareerConnection (online job center) 866-364-7646 | http://careers.wda.org

Delta Gloves (examination gloves)800-633-6867 | www.DeltaGloves.com

FedEx Advantage Program (shipping) 800-members (800-636-2377)www.1800members.com/ada

InTouch Practice Communications (custom on-hold advertising and appointment reminder system)877-493-9003 | www.intouchdental.com

The Omnia Group (pre-employment testing and background checks)800-525-7117 | www.omniagroup.net

Officite (websites)888-738-8834 | www.officite.com/wda

The QTI Group (human resources) 888-575-3273 | www.qtigroup.com

Scientific Metals (metal refining)888-949-0008www.scientificmetals.com/wda

Sharps Compliance (medical waste disposal) 800-772-5657 | www.sharpsinc.com

FinanciaL SERvicES

ADA Visa Card from U.S. Bank (credit card)888-327-2265 x94225www.usbank.com/ADA94225

AMP Wealth Management (401k Plans, and Personal Wealth Management) 414-332-1011 | www.ampinvestment.com

CareCredit (patient financing)800-800-5110 | www.carecredit.com/ada

Chase Paymentech (credit card processing)800-618-1666www.bestpaymentprocessing.com/ada

Mercer Advisors (financial planning)800-898-4642 | www.merceradvisors.com

Transworld Systems Inc. (credit and collections)608-276-8307 web.transworldsystems.com/Madison

U.S. Bank Practice Financial(practice and commercial real estate financing) 414-765-5498www.usbank.com/smallbusiness/practice-finance

OTHER SMALL-BUSINESS PRODUCTS Hewlett/Packard (computers/printers)800-888-4164 http://www.hp.com/go/ADA

Mercedes-Benz (auto)866-628-7232 www.ada.org/mercedes Lands’ End (staff apparel) 800-990-5407www.ada.org/4270.aspx orces.landsend.com/ADA

Whirlpool Corporation (home appliances) 866-808-9274www.partners.whirlpool.com


Focus on:Adult oral health

Published in 1919, an article by Dr. William J. Gies in the first issue of the Journal of Dental Research eloquently states the importance of research to the profession of dentistry.1 “Research is the mainspring in the chro-nometer of science. It is the register of a pro-fession’s achievement and standing. With it there is life, growth and effectiveness, and enthusiasm in those who devote themselves to the high calling of a profession. Without research, however, empiricism, stagnation, inefficiency, and dis-couragement impair the usefulness of those who earnestly seek to render their best professional service.” Sadly, research has not always been an undertaking that dental practitioners value and many view it as purely an academic activity conducted by others for the benefit of those who aren’t obligated to participate in the process. This scenario, where the practitioner is disengaged from any sort of scholarly activity, leads us one step closer to becoming a voca-tion rather than a profession. Historically, there has been a gap between those that perform research and those that practice clinical dentistry, with most of these individuals firmly entrenched in one camp or the other. The objective of contemporary dental edu-

cation is not to make every dentist a scientist, but rather to make every dentist a man or woman of science. Only by becoming a person of science is there any hope that the practitioner will be able to acquire and assimilate new knowledge

and adapt to the changes in practice and in the profes-sion that the future always requires.2

The general trend in dental education has been to become more evidence-based and the Marquette University School of Dentistry has been at the forefront in this curricular evolution. Our graduates are well-versed in not only the meth-odology of evidence-based practice, but more impor-

tantly, they recognize its value in practical clinical application. Now is the time for our more experienced practitioners to join our new colleagues, dis-pel old beliefs and open themselves to an exciting way of helping advance the sci-ence of dentistry by challenging the notion that only “researchers” can and should do research. Funded by the National Institute of Dental and Craniofacial Research, the National Dental Practice-Based Research Network or PBRN was implemented to bridge the gap between research and dental practice thereby helping dental professionals directly improve the efficiency and effectiveness of dental care.

Enrolling a large number of practicing den-tists in a variety of practice types and loca-tions will result in more reliable outcome measures, while contributing to the develop-mentof knowledge that can improve oral health on a national scale. There is no cost to join and enrolling in the network is as simple as completing the enroll-ment questionnaire at www.nationaldentalp-brn.org where you are allowed to choose one of three levels of participation: • Informational – receive newsletters and correspondence • Limited – receive newsletters, correspon-dence and participate in surveys • Full – receive newsletters and correspon-dence, participate in surveys and engage in research

Thanks to the strength of Wisconsin Dental Association membership, we have the potential to significantly influence the success of this important program. Your enrollment, even at the informational level, will help us toward achieving this goal. In the coming months, I hope to provide more insight into evidence-based practice and the National Dental PBRN at WDA component dental society meetings. Until then, I would be happy to answer any questions you might have at [email protected].

1- Bertolami, C. N. (2002). The role and importance of research and scholarship in dental education and practice. Journal of dental education, 66(8), 918–926.

2- Smith, A. J. (2005). Research Through the Years-the Foundation for Dentistry Today. Journal of dental research, 84(10), 870–870..

Dental examinations don’t just begin and end in the oral cavity. It is imperative that we, as clinicians, extend our scope to the head and neck. After all, did we not study head and neck anatomy? There are many approaches to a recall examination, but one of the aspects that should not be neglected is the palpation of the thyroid gland.

The thyroid is a butterfly shaped gland that sits at the base of the neck, superior to the clavicles, and anterior to the esophagus. The functions of this gland are in metabolism, growth and development, and temperature. The palpation of this gland begins with the

clinician positioned behind the patient and using the fingertips to roll through the gland as the patient swallows. The act of swallowing allows the thyroid to move upward in an effort to isolate it from other throat structures. Once isolated, as your fingers roll through the gland, the clini-cian should look for asymmetry of the gland, enlargement or small lumps or nodules. With frequent palpation of the gland during recall exams, one learns to become more proficient and the fingertips become more discerning. Once an abnormality is detected, a formal medical consult is sent to the patient’s primary care physician. It is important to include the location, size, firmness/softness and to follow up with both blood work and an ultrasound of the gland. Blood work alone may not demon-strate any abnormalities; thus, the ultrasound is necessitated. Concern for the patient is crucial. Once informing a patient of any lumps or nodules, their thoughts immediately race to cancer. Differential diagnoses can be given which span that of a goiter, benign nodules and cancer. The patient must be reassured that further testing is required. Patients with thyroid abnormalities may be experiencing some of the symptoms or display-ing the signs even without a diagnosis. Some signs and symptoms are changes in weight, muscle/joint pain, menstrual or fertility issues, cholesterol issues, depression, anxiety and fatigue or lack of energy.

These are just a few red flags that could aid in sending your patient for a medical consult. The focus in dentistry has always been that of prevention, but we must also learn to work with our medical counterparts and achieve a multidisciplinary approach to our patients. Patients are looking toward us as their advo-cates. The efforts in thyroid awareness only instills more trust in patients toward dentists, but con-versely, it opens lines of communication with the medical community and fosters a sense of trust.

Practice-based dental research – advancing and improving dentistry

Identifying thyroid abnormalities

Gary L. Stafford, DMD MUSOD Department of General Dental Sciences Chair [email protected]

Glenn l. Gequillana, DDS WDA Editorial Advisory Board Member [email protected]

Gary L. Stafford

A close-up of the thyroid palpation exam.

MUSOD student Samuel Albiero con-ducts a thyroid exam on fellow student John Girgis while their mentor Dr. Glenn Gequillana (Milwaukee) observes.

Rachel of Lake Geneva has no words to describe her patient expe-rience at the Wisconsin Dental Association and WDA Foundation Mission of Mercy 2013 in Lake Geneva. “I will never forget this experience as long as I live. I am forever grateful to have received dentures at MOM,” she said. Rachel was one of 18 patients who were prescreened in the month prior to MOM and received dentures dur-ing this year’s event. Dr. James Morgenroth (Brookfield) said 27 dentures were made during the two day clinic. Providing dentures was added to the list of services last year in Madison. This was made possible by a new type of one-step denture. WDA member dentists Drs. Mark Huberty (Sheboygan), Ron Stifter (Saukville) and Gene Shoemaker (Waukesha) received training on this system. Production this year was improved because dentists were more familiar with the system. Two dental chairs were assigned for denture patients and at times a third one used from the prosthetics department. The supplying clinics and MOM Local Chair Dr. Robert Dillman (Lake Geneva) provided the prelimi-nary models for each case. “To take someone who has no teeth and provide them with the means to look somewhat normal again and function even minimally is a life changing event for all of our edentulous patients,” Dr. Morgenroth said. Introduced in 2008 by Dr. Larry Wallace of California, the Larell One Step Dentures have been providing patients with functional, esthetic and comfortable dentures. Utilizing the patented templates, a full set of dentures can be completed, start to finish, in about an hour. The Larell dentures are different, because they come in five sizes and then are carefully molded to indi-vidual patients on-site. Nationally, an estimated 37 mil-lion people live without teeth, about 20 percent don’t have dentures. The denture system was originally devel-oped for nursing home patients, but it has been able to meet the needs at MOM. WDA Associate Executive Director Lani Becker said Wisconsin is one of the few states who offers this service.

Emily Bultman WDA Communications Coordinator [email protected]

New denture system offered to prescreened MOM patients


A 60-year-old Caucasian male visited the Marquette University School of Dentistry clinic for a comprehensive

oral exam. Upon the radiographic exami-nation, a well-defined round radioopacity was noted near apex of #22 (Figure #1). During the clinical exam, upon palpa-tion, a 1cmx1cm hard nodule was noted to the left of midline in floor of mouth. When questioned, patient indicated that “occasionally the area becomes tender” and if he presses under chin, pus would be expressed into oral cavity which would alleviate the tenderness. Questions:

1- What would you consider in your differential diagnosis?

A. Pyogenic granuloma B. Mucocele C. Salivary stone D. Salivary gland tumor E. All of the above

2- What would you do to make a definitive diagnosis?

A. Take an occlusal radiographB. Brush biopsyC. Excisional biopsyD. Incisional biopsyE. Do nothing and observe

Answers on page 15

FIGURE #1

Q&A

presented by

Ezedin M. Sadeghi, DDS, MS, MUSOD Associate Professor and Oral Pathology Director [email protected]

CASE

STU

DY #

147

In Memoriam

The Wisconsin Dental Associa-tion extends its condolences to the families and friends of the fol-lowing dentists who have passed away:

Dr. Jordan M. Weigler Mequon, Wis. Passed away June 10 Member for 54 years Help us keep our information current. If you are aware of a colleague who has passed away, please call the WDA at 800-364-7646.


2,072 patient visits by 1,977 adults and children | $1.18 million in donated care | 1,846 extractions | 1,450 fillings 823 sealant/fluoride treatments | 719 cleanings | 100 partial dentures | 32 root canals

Every patient that walks through the doors of a Wisconsin Dental Association and WDA Foundation Mission of Mercy is more than a number - they are individuals who need the kind of help only our volun-teers can provide, and they each represent hundreds more that could use our help. On June 26, 2009, Steven entered the La Crosse Center to become our very first MOM patient. The self-employed artist/painter waited in line overnight, because he could not afford dental care. Fast-forward to June 28, 2013 and James of Lake Geneva arrived at Badger High School to wait in line. He thanked WDA Executive Director Mark Paget and other volunteers as he was given his patient number. Even before receiving dental care, he was already grate-ful.

“Thanks a lot. All you guys are heaven sent. This is how people show they care for others who don’t have the means. God bless each and every one of you always,” James said.

Even though he was our 10,000th patient, James was more than a number.

We marked the special occasion by giv-ing him a pair of electric toothbrushes and six replacement heads. It was humbling to see his appreciation when he received the gift - something most of us don’t give a second thought to each time we brush our teeth. He will think of all the volunteers that helped him that day every time he uses it. Despite this milestone, we know too many of our neighbors still need our help. Like MOM in general, it was a bitter-sweet moment. Each year is a celebration of what is possible when volunteers work together and donors provide funding to make the event possible. State legislators and policymakers attend the event and see the need firsthand as they talk to patients and hear their stories. They see the dedication and passion

of dentists and dental hygienists who are treating patients, but they have yet to take action. Elected officials realize this isn’t a solution to access nor is it a cost-effective means of helping those in need. So, why do the WDA and the WDA Foundation keep hosting MOMs? Because, there are patients like Steven and James who need our help. And, for the most part, they appreciate it. There are always exceptions, but most patients feel like Alex from Waukesha, “I just want to say I know there are plenty of easier and more fun volunteering oppor-tunities out there, but few, if any, provide the amount of focused, immediate aid that Mission of Mercy accomplishes here. As far as I know, it is unprecedented. Sincerest thanks for your hard work,” she said. It is said that actions speak louder than words, so if patients’ words don’t adequate-ly express their appreciation, then their actions do. Steven and James both returned as vol-unteers after receiving care. Steven spent part of his Saturday birthday as a patient escort and James came back on Sunday to assist with clinic teardown. Brian, a patient in Sheboygan in 2010, has returned every year with his wife, Michelle, to volunteer. They’re pleased to report that their circumstances have changed, so they no longer need MOM for their dental care. We do make a difference to the people who come to the clinic; over time, we hope to decrease the need for WDA Mission of Mercy events. Our sincerest thanks to all of you who have supported the five WDA and WDA Foundation MOMs by volunteering and/or making financial contributions. WDA members, their teams, families and friends truly care about others and are some of the

most generous people around. As long as there is need and we have your support, we will continue to organize a MOM program. Plans are already underway for our next WDA Mission of Mercy to be held June 27 - 28, 2014 at the KI Center in Green Bay, Wis. Dr. Zach Graf (DePere) is serving as local chair.

Special thanks to five year supporters

The Wisconsin Dental Association and the WDA Foundation acknowledges those donors and sponsors who have supported all five Mission of Mercy events, 2009 through 2013, at these donation levels:

$25,000+Delta Dental of Wisconsin Charitable FundHenry Schein Dental

$2,500 - $7,500Kwik TripValley Expo and Displays

Up to $2,500Dr. Tim and Sue DurtscheLa Crosse Library Sunshine ClubCity Press

We appreciate all individuals, orga-nizations and businesses who have con-tributed to WDA and WDA Foundation MOM events. Visit www.wda.org/wda-foundation/mission-of-mercy for a com-plete listing and please thank them for supporting MOM the next time you talk with them. Since 2009, nearly 6,000 volunteers have logged 11,379 patient encounters and provided $5.8 million in free dental care.

Lani Becker CAE WDA Associate Executive Director [email protected]

MOM: More than just numbers

Posts, videos and photos were pushed out on all social media platforms; Facebook, Twitter, LinkedIn, Flickr, YouTube and Pinterest while at the Wisconsin Dental Association and WDA Foundation Mission of Mercy in Lake Geneva.

Big WDA public relations team thank you to everyone who shared their MOM experience and photos on WDA social media sites.

There’s still time to share your MOM pictures and experiences on Facebook and Twitter or email them to [email protected].

In addition to our social media efforts at MOM, the WDA also sent out a Healthy Choices E-Lert to legislators from the clinic floor on on June 28 and updated on WDA.org website regularly.

Social media missionAmanda Brezgel WDA Electronic Communications Coordinator [email protected]

communiqu e´

Since Monday, June 24, 2013 (pre-event) – Tuesday, July 2 (post-event):

14 posts, 43 more fans360 likes, 34 comments41 shares, 15,697 people reached

10 posts, 22 more followers,16 re-tweets, 1 favorite,

6 mentions

118 photos113 views

3 videos,421 views

25 new followers,1 re-pin

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EDUCATE

Brian and his wife, Michelle received dentalwork in 2010 at MOM in Sheboygan. Eventhough they no longer need MOM for their dental care, the couple returned to volunteer at the Madison and Lake Geneva MOM events.

Photo credit: Alec Paget

In 2009, Steven became the first patient at the MOM event in La Crosse. More than 1,900 adults and children came to this year’s event.


A salute toMOM volunteers!228 dentists142 dental students97 dental hygienists193 dental assistants43 dental front office personnel8 dental equipment technicians4 dental supply representatives19 dental lab technicians26 nurses4 pharmacists6 pharmacy technicians1 physician3 physician assistants38 interpreters3 X-ray technicians409 general helpers

1,224 volunteers

Marquette University School of Dentistry students volunteer at the fifth WDA and

WDA Foundation Mission of Mercy.

Photo credit: Emily Bultman, WDA

For the fifth year, many public officials and staff members visited and volunteered at the Wisconsin Dental Association and WDA Foundation Mission of Mercy. • State Rep. Andy Jorgensen (D-Fort Atkinson) • State Sen. Neal Kedzie (R-Elkhorn) • State Rep. Debra Kolste (D-Janesville) • State Rep. Janis Ringhand (D-Evansville) • Ms. Theresa Allen-Hubka on behalf of state Rep. Amy Loudenbeck (R-Clinton) • Ms. Lonna Morouney on behalf of state Rep. Amy Loudenbeck (R-Clinton) We extend our most sincere thanks to all who took timeout of their schedules, rolled up their sleeves and helped us give brighter smiles to thousands of people. Special thanks to these legislators, staff-ers and county representatives who toured the MOM clinic: • State Rep. Tyler August (R-Lake Geneva) • Walworth County Administrator David Bretl • Health and Human Services Board Chair and Walworth County Supervisor Jerry Grant and wife, Shirley • State Rep. Tod Ohnstad (D-Kenosha) • State Rep. Melissa Sargent (D-Madison) • Walworth County Supervisor Tim Schiefelbein • Ms. Kelsey Nugent on behalf of U.S. Sen. Tammy Baldwin (D)

Lawmakers, policymakers see need firsthand

From left, State Sen. Ned Kedzie (R-Elkhorn),WDA Southeast Region 4 Trustee Dr. Ryan Braden (Lake Geneva), Dr. Mark Braden and state Rep. Tyler August (R-Lake Geneva) visit at MOM 2013 at Badger High School.

The Wisconsin Dental Association and WDA Foundation’s Mission of Mercy is a memorable experience for many. James of Lake Geneva was the WDA’s 10,000th MOM patient since 2009. He vis-ited us at the fifth WDA Mission of Mercy held June 28 - 29 in Lake Geneva. James arrived at Badger High School around 5:40 a.m. and spent approximately 12 hours at MOM on Friday. It was worth every minute, according to James. “It wasn’t a hard process, but a long one. These are extremely caring people. They are giving back to the less fortunate. I owe these people,” James said. While awaiting his turn to move on after routing, he was surprised when WDA Executive Director Mark Paget came up to him and announced loud-ly, “Congratulations, James, you are our 10,000th WDA Mission of Mercy patient!” Everyone in the area broke into applause as James was presented with an electric tooth-

brush and several replacement heads by WDA Foundation President Dr. Anthony Sciascia (Mondovi). After a few photos, an on-camera video interview and handshakes all around,

James continued with his MOM experi-ence which included two extractions. Returning Saturday, Mr. 10,000 was fitted with his front partial denture by his smile team: Dr. Kenneth Geiger (Sheboygan), Dr. Rachel Steele (Black River Falls) and Marquette University School of Dentistry student Christopher Gorski. James has lived in Lake Geneva for 16 years and works for a newspaper printing company. A co-worker suggested he visit the free dental care clinic that was taking place right in his “backyard”. “I’ve got my smile ability back,” James exclaimed after receiving his new partial. He was so grateful that he returned Sunday as a volunteer to help dismantle the clinic. Watch Mr. 10,000’s story on WDA YouTube channel at http://bit.ly/11h1ZDW. We love to make you smile!

Amanda Brezgel WDA Electronic Communications Coordinator [email protected]

10,000th patient welcomed at fifth WDA Mission of Mercy

From left, WDA Executive Director Mark Paget, 10,000th MOM patient James, MOM Prosthodontics Lead Dr. Kenneth Geiger and MOM 2013 State Chair Dr. Thomas Raimann.




Classifieds

For sale – Shorewood Office, 2321 E. Capitol Dr. 3 complete operatories with older equipment, all supplies and instruments included. Great satellite office, produces $100,000+ on 2 half days/wk. Unlimited potential if more time devoted. Rent: $845/month. Call 414-332-7700. #09-2013-02

Edge Advisors has 15 and counting dental practices for sale! Want to sell your real estate with the practice? Contact Jessica at [email protected] or call 715-379-1796 to find out about how to sell both at the lowest price in the industry. #11-2012-09

Western U.P. practice, near Wisconsin border, will gross buyer over $300,000 the first year, after debt service. Contact Mark Breit, Paragon Dental Transitions, 906-250-9666 or [email protected]. #04-2013-05

Madison - Dental condo unit for sale or lease. 3 operatories, front office, private office, sterilization area. Ideal for a new startup. In a well-established dental building (with an orthodontist) in a desirable east Madison neighborhood. Contact [email protected] or call 608-217-1727. #02-2013-09

General dentist seeking a practioners, preferably with own patient base, to share office space. Ideally suited for general dentist, prosthodontist, periodontist or orthodontist. Four operatories and laboratory available. Respond to Wisconsin Dental Association, Blind Box 0403, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214. #04-2013-03

Dentist seeking associate position (with buy-in potential) or practice to purchase on Madison’s west side or surrounding suburbs. Respond to Wisconsin Dental Association, Blind Box 0301, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214 #03-2013-01

Practice for Sale/Lease

Dentist Available/Position Wanted

Classified Advertisements The rate for classified advertisements for Wisconsin Dental Association members is $65 for 30 words or less; additional words 50 cents each. Nonmember rate is $90 for 30 words or less; additional are 50 cents each. Make your ad stand out by adding a company logo for $30 per month or add a blind box for confidentiality for $10 per month. Boxed classified ads also are available in three sizes: one inch = $100; two inch = $150; or three inch = $200. Make your ad stand out with a full color, mini-display. Save 10 percent when you run a display ad for three months or more. Mini-display classified ads now available in three sizes: two inches = $225; or three inches = $275; or four inches = $325. Artwork can be created for you at an additional charge: $75 for initial mini-display creation $50 per hour for edits after initial run (one hour minimum will be charged). Visit WDA.org to view rate sheet and download classified contract.

Cancellation of ads must be received in writing. Please note all ads must be pre-paid. Please include payment (check or credit card number) with your classified ad when submitting. You can download the contract online at WDA.org or call 414-755-4110. To place an ad, mail, fax or email [email protected] copy to the Wisconsin Dental Association, Attn: Emily Bultman, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214; fax to 414-755-4111. Classified ads submitted after the deadline can be posted on the last business day of the month as a web only ad at the standard rate. It is against WDA policy to do unauthorized mailings pertaining to individu-al classified advertisements. When responding to a Blind Box, please indicate the blind box number on the envelope. When they are received by the WDA office, they are forwarded unopened to the address of the person holding the blind box. Sample: Wisconsin Dental Association, Blind Box #10, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214.

Wausau, WI – Busy Central Wisconsin Dental Practice (in business for 30 years) looking for a full-time associate dentist to join a family friendly dental practice. This growing practice offers a very competitive plus compensation and benefits. Please send your information to [email protected]. #09-2013-05

Associate Dentist – State of the Art Dental Facility located in Wauwatosa, WI has an opportunity for an experienced dentist to join our dedicated staff. Full-time with benefit package or part-time available. No evenings or weekends. Respond to Wisconsin Dental Association, Blind Box 0510, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214.#05-2013-10

Madison Eastside Associate Dentist Wanted-Busy, well-established general dental practice is seeking an associate dentist with 3+years experience. Please email resume/cover letter in confidence to [email protected] #09-2013-06.

Door County – Full-time Associate Dentist needed to join expanding practice in beautiful Door County. This is an excellent opportunity for an associate to step in and contribute immediately and be part of a friendly work and community environment. Our facility is located in Sister Bay, WI. Our office has been recently updated, including 2 hygiene rooms and 3 operatories. This position will include a competitive salary commensurate with experience and an excellent benefit package, with opportunity for a buy-in. Please submit resume to Lisa McDermid at [email protected]. #09-2013-03

MADISON, WISCONSIN: Dental Health Associates of Madison, Ltd. (DHA) in Madison, Wisconsin is looking for an ASSOCIATE to practice general dentistry. We offer a great opportunity with guaranteed salary to start and potential for partnership. For more information regarding our practice, visit our website at www.dhamadison.com. You can apply online or send your resume/CV to: Human Resources Director, Dental Health Associates of Madison, Ltd., 2971 Chapel Valley Rd, Madison, WI 53711 or email [email protected]. #09-2013-02

Excellent General Dentist opportunity (2-3 days/week) in a successful private practice located in Sheboygan, WI. We perform comprehensive family dentistry with 4 ops, 2 assts., 2 hygienists. Our office is computerized(Dentrix), digital X-rays, Cerec machine, CBCT and are an amalgam-free office. If you are looking for a progressively growing practice, and are a team player, please contact us [email protected]. #09-2013-01

Superior

Midwest Dental is seeking candidates for a full-time practice opportunity in Superior, Wisconsin. Since 1968, our philosophy of supporting doctors and staff has lead to unmatched consistency and paved the way for future growth. We pride ourselves on providing doctors the ability to practice in a traditional, non-HMO practice environment coupled with the flexibility and rewards that a group can offer. We’d enjoy the opportunity to learn about your practice philosophy, career goals and expectations. To learn more, please contact Andrew Lockie at 715-579-4076 or [email protected]. Visit us online at www.midwest-dental.com. #07-2013-05

FULL-TIME DENTIST POSITION: Heartland Dental Care is seeking affiliate opportunities for a General Dentist in the central Wisconsin area. We offer excellent compensation and benefits package as well as continuing educational opportunities, as well as a sign on bonus and relocation package. If you’re an outgoing, positive Dentist looking for career satisfaction and continuing education opportunities, join the HDC family. For more information on affiliate opportunities in central Wisconsin, call 866-903-6426 or email [email protected]. #07-2013-02

Andy Lehmkuhl and your local team at Edge Advisors have transitioned 30 practices in the past two years. We charge less and get the best results in the industry. Need help hiring an associate? Currently we have more than 14 available. See what your colleagues are talking about at www.EdgeAdvise.com. Contact 414-255-5669 or [email protected]. #11-2012-10

DNT Inc. seeks a General Dentist for its Mitchell St. Office. Must have a Doctor of Dental Surgery degree from a accredited University and license to practice dentistry in the state of Wisconsin. Interested candidates should send/email resume directly to; Mr. Don Lee, DNT Inc., 710 West Historic Mitchell Street, Milwaukee, WI 53204 or [email protected]. #07-2013-04

Appleton, WI – Associate position available for 2 Dr. practice looking to add a 3rd Dr. 3,000 patient base. Sign-on bonus and no non-compete initially. Buy-in option available. Please call 920-225-0123. #02-2013-14.

ForwardDental is in search of exceptional Dentists to join our busy Wisconsin practices. Positions offer competitive compensation, enhanced benefits and the opportunity for ownership! Contact Kelly at [email protected]. #10-2011-05

Temporary/Flexible/Dynamic Opportunities

Do you have a passion for patient care? Do you enjoy new challenges and desire a flexible work environment? Our team is looking for doctors who are interested in covering maternity leaves, military leaves and extended vacations in our fee-for-service practices. If you’ve ever considered the benefits of temporary coverage, give us a call. With us, you can work as much or as little as desired. Midwest Dental has practices in Wisconsin, Minnesota, Iowa, Illinois, Kansas and Missouri. Mountain Dental has practices in Colorado and New Mexico. Merit Dental has practices in Pennsylvania, Michigan and Ohio. To learn more, please contact Laura Anderson Laehn at 715-225-9126 or [email protected]. Visit us online at www.midwest-dental.com www.mountain-dental.com www.mymeritdental.com. #06-2010-1

Dental Dreams desires motivated, quality oriented associate dentists for its offices in IL (Chicago & suburbs), DC, LA, MI, MA, MD, NM, PA, SC, TX and VA. We provide quality general FAMILY dentistry in a technologically advanced setting. Our valued dentists earn on average $230,000/yr plus benefits. New graduates encouraged! Call 312-274-4524 or email [email protected]. #03-2013-05

Green Bay – I am in need of an associate to perform all phases of general dentistry in a well-established practice in Green Bay. This will quickly lead to a full-time position. Buy-in/buy-out is available and will be discussed and decided prior to employment. Contact Dr. Stephen A. Sevenich at 1551 Park Place Suite 300, Green Bay, WI 54304 or 920-737-7619. #03-2013-03

Wisconsin - Milwaukee (Western Suburb) Seeking a pediatric dentist for a full-time or part-time associate position. We offer a great benefit package and compensation. Be part of our understanding team in providing pediatric dental care. Please email your curriculum vitae to [email protected]. #08-2013-05

Properties/Office Space Available

Practice PositionOpportunity

SzmandaDental Center


To PLacE a diSPLay oR cLaSSiFiEd ad, PLEaSE conTacT

EMiLy BuLTMan aT [email protected].

Periodontist – Sheboygan

Midwest Dental is seeking a full time Periodontist to join a long standing, fee-for-service practice in our Sheboygan Specialties office. We offer the opportunity to lead your own clinical team while shedding the administrative and financial burdens. Our philosophy of preserving and supporting the traditional private practice setting provides a great work-life balance, excellent compensation and benefits, and unlimited opportunity for professional growth. If you possess a passion for providing quality care and are looking for a rewarding practice opportunity, call Andrew Lockie at 715-579-4076 or e-mail [email protected]. Visit our website at www.midwest-dental.com. #08-2013-01

Opportunities Available - Wisconsin. The Wisconsin Office of Rural Health has detailed information on general and specialty dentist positions in both smaller towns and larger cities located throughout Wisconsin. Most of these positions qualify for the $50,000 loan repayment program from the State of Wisconsin. The Wisconsin Office of Rural Health has recently added a Dentist Placement Program to our successful Physician Placement Program. Located at the University of Wisconsin School of Medicine and Public Health, we are a not-for-profit organization dedicated to helping improve the quality of health care for the people of Wisconsin. For information, call Marsha Siik at 800-385-0005, email [email protected], or fax CV to 608-261-1893. #03-2013-06

RLJ Dental is seeking a full-time general dentist for our Plymouth and Fox Valley area offices. Our offices offer a family oriented dental atmosphere with state of the art dental technology. RLJ Dental offers an excellent compensation and benefits package. We are looking for energetic people for our growing practices. Please email reply to [email protected]. #08-2013-07

Miscellaneous

Advertising IndexThank you for supporting

the WDA Journal!AFTCO ........................................ 13 www.aftco.net Baker Tilly .................................... 10 www.bakertilly.comDelta Dental ................................. 11 www.deltadentalwi.comDental Practice Advisors ................... 2 dentalpracticeadvisors.comEdge Advisors ............................. 16 www.edgeadvise.comOfficite .......................................... 9 www.officite.comMidwest Dental ............................... 5 www.midwest-dental.comParagon ....................................... 13 www.paragon.us.comPIP .............................................. 16 www.insuranceformembers.comSharps ........................................... 9 www.sharpsinc.comWest Bend Mutual Insurance Co. ..... 15 www.thesilverlining.com

La Crosse

Midwest Dental is seeking candidates for the La Crosse, Wisconsin area. Since 1968, our philosophy of supporting doctors and staff has lead to unmatched consistency and paved the way for future growth. We pride ourselves on providing doctors the ability to practice in a traditional, non-HMO practice environment coupled with the flexibility and rewards that a group can offer. We are currently working on new opportunities in La Crosse. We’d enjoy the opportunity to learn about your practice philosophy, career goals and expectations. To learn more, please contact Andrew Lockie at 715-579-4076 or email [email protected]. Visit us online at www.midwest-dental.com. #07-2013-11

Grow and Prosper In A Welcoming Community. Searching for an Associate dentist who ideally would become a partner. Our area in Northeast WI is known for quality of life, great outdoor recreation and low cost of living. Great place to raise a family and close enough to larger cities to have the best of both worlds. We are a busy, progressive, fee-for-service general practice and offer a modern facility with an excellent & committed staff. Competitive compensation with the potential for much greater financial and professional success. Contact Us and Explore the Possibilities. Please submit CV/resume to:[email protected] #07-2013-08

Wisco Dental is currently searching for an experienced orthodontist to join our practice in Appleton, Wisconsin. Our practice is brand new with state of the art technology and guarantee referrals. To learn more about this orthodontic practice opportunity please email reply to [email protected]. #08-2013-06

Outstanding Opportunity: Partners in Care is seeking a part-time general dentist, 3 and a half days per week, for our new Southeastern Wisconsin location. We offer excellent benefits and a minimum pay guarantee to start. We are looking for candidates with at least two full years of experience to be a part of our dedicated

team of professionals. Visit our website at: www.chicagolanddentists.com to see our other four locations. Email Resume/CV to [email protected]. #04-2012-11

Wausau and Merrill Practice Opportunities

Midwest Dental is seeking a full time dentist in our Wausau and Merrill practices. We offer the opportunity to lead your own clinical team without the administrative and financial burdens.Our philosophy of preserving and supporting the traditional private practice setting provides a great work-life balance, excellent compensation and benefits, and unlimited opportunity for professional development. If you possess a passion for providing quality care and are looking for a rewarding practice opportunity in the Wausau or Merrill areas, please contact us at 715-926-5050 or email [email protected]. Visit us online at www.midwest-dental.com. #07-2013-10

FULL OR PART-TIME GENERAL DENTIST – JUNEAU COUNTY, WI Karas Dental of Elroy and Necedah is seeking an ambitious general dentist to join our practice. This opportunity offers competitive compensation, outstanding benefits and potential partnership. Contact Amy Karas at 608-479-1273. #08-2013-06

Are you happy in your current office? Before you make a move or accept another offer, be sure to check us out! Our dental practice, located in Southern Wisconsin, is looking for a long term associate to join our steadily growing practice and community. We service all aspects of general dentistry, including implant placement and restoration. Come and be a part of our fun, talented and enthusiastic team! We are offering a top base salary, production bonus program, and a generous benefits package. Please submit CV/resume to: [email protected]. #03-2013-04

MORE REASONS TO SMILE! We’ve always believed in putting patients first. In fact, Dental Associates was built on the notion that everyone deserves access to affordable dental care of the highest caliber. From a small solo practice that launched more than 35 years ago, Dental Associates has grown to 10 multispecialty dental centers. We’re proud to bring quality, progressive treatment to communities across with the day-to-day business tasks. Put all your focus back on your patients and you will enjoy more of those rewarding moments! We’d love to have you join us. Visit our website at dentalassociates.com, call or send resume/CV in confidence to: [email protected] or Dental Associates Attn: Susan Bullen, 11711 W. Burleigh St., Wauwatosa, WI 53222, 800-315-71107, 414-456-9911(fax). #02-2013-02

E4D Acquisition, Milling & Oven System. Excellent Condition. High Definition Camera, Updated Mill, Current Software and Maintenance. Price Includes $6,700 in EMax blocks. Asking $59,995 OBO. Contact 262-567-4466 or [email protected]. #09-2013-04

Mike Bark – The ONLY accredited “Institute of Dental CPA’s” certified Wisconsin CPA/Accountant and best valued. Give us a call and let’s talk about how we can help you improve your situation. Contact 414-759-9629 or [email protected]. #11-2012-11

Office Equipment for Sale


Calendar*Shaded events offer continuing education credits.

Visit WDA.org for upcoming componentmeetings and events.

The WDA Journal is published monthly by the Wisconsin Dental Association (USPS 0285-460), 6737 W. Washington St., Ste. 2360, West Allis, WI 53214. Phone 414-276-4520. Yearly subscriptions are $20 for WDA members; $100 for nonmembers; $25 for associate members; $30 for dental school students; $45 for dental schools and agencies and $125 for foreign mailings. Periodicals postage paid at Milwaukee, Wis. POSTMASTER: Send address changes to WDA Journal, 6737 W. Washington St., Ste. 2360, West Allis, WI 53214. The Wisconsin Dental Association reserves the right to illustrate and/or edit all reader contributions. Views expressed in the WDA Journal are not necessarily those of the WDA. All advertising in the WDA Journal must comply with the advertising standards of the WDA. The publication of an advertisement is not to be construed as an endorsement for approval by the WDA or any of its subsidiaries unless the advertisement specifically includes information that such approval or endorsement has been granted. The deadline for all display advertisements is the second Tuesday of the month, two months before advertisement insertion (For example, if you want your ad to appear in the November 2013 WDA Journal, which is mailed to members in mid-October 2013, all advertising materials must arrive in the WDA Executive Office by the second Tuesday of September 2013.) Advertising space is limited, so advertisers are encouraged to reserve space early. Back issues of the journal are available for six months following publication or while supplies last. Communications and copy for publication should be addressed to Dr. Robert Brennan, editor, and may be mailed to the WDA at 6737 W. Washington St., Ste. 2360, West Allis, WI 53214; faxed to 414-755-4111 or emailed to [email protected]. Portions of the WDA Journal can also be found on the WDA Web page, WDA.org.

18“Clinical Dental Update 2013” 6 CE credits Visit www.marquette.edu/dentistry for more information

24-25Laser dentistry 2-day course for dental hygienists Northeast Wisconsin Technical College Green Bay 8 CE credits Contact Anne Piotrowski at anne.piotrowski for more information

31ADA Annual Session New Orleans Visit ADA.org/session for more information

NOVEMBER1-3ADA Annual Session New Orleans Visit ADA.org/session for more information

3ADA Mission of Mercy New Orleans Visit ADA.org/session to sign up to volunteer –––––––––––––––––––––––––––––––Do you have an event you’d like to include in the WDA Journal Calendar of Events?

If so, please call WDA Managing Editor Emily Bultman at 414-755-4110 or 800-364-7646; fax to 414-755-4111 or email to [email protected].

Summer HoursWDA Executive and Legislativeoffices will be open Monday through Thursday from 8 a.m. to 4:30 p.m. and on Fridays from 8 a.m. to noon from May 28 through Aug. 31.

SEPTEMBER2 WDA offices closed for Labor Day

4Dentistry Examining Board8:30 a.m.Department of Safety and ProfessionalServices1400 E. Washington Ave., Rm 121AMadison

6“The Christensen Bottom Line”Gordon Christensen, DDS, MSD, Ph.D. Presented by MUSOD and Lord’s Dental 6 CE creditsVisit www.marquette.edu/dentsitry for more information

9Wisconsin State Dental Golf Tournament North Hills Country Club Menomonee FallsVisit WDA.org for more information

13WDA Insurance Programs Risk Management Seminar Radisson Inn Paper Valley Appleton Visit www.insuranceformembers.com for more information

“Photo Documentation: Simplifying Photography and Case Presentation” Dennis Braunston, BS3 CE credits Visit www.marquette.edu/dentsitry for more information

14 & 28“Restoring Implants! What Do I Need to Know?”Harshit Aggarwal, DDS 15 CE credits Visit www.marquette.edu/dentistry for more information

18Wisconsin Oral Health Coalition2013 Annual Meeting 8 a.m. - 3 p.m.Holiday Inn & Conference Center Stevens PointWDA members contact [email protected] to register

19-20Academy of Orthodontics for the General Practitioner annual meeting “Sleep Dentistry from A to ZZZ” and“Orthodontic Office Pearls (How to Have More Fun at Work)”Mark Paschen, DDS The Geneva Inn, Lake Geneva 12 CE credits For more information, contact Dr. Frank Galka at [email protected] or 414-276-4455

20“Oral Cancer: What Happens to Your Patients After You Make the Diagnosis” Denis Lynch, DDS, Ph.D.; Michelle Michael, M.D.; Bruce Campbell, M.D.; Becky Massey, M.D.; Christopher Schultz, M.D.; Stuart Wong, M.D.; and Amir Sifi, DDS, Ph.D.6 CE credits Visit www.marquette.edu/dentsitry for more information

25-26ADA 9th District Pre-Caucus Grand Rapids, Mich.

27-28WDA Board of Trustees meeting Crowne Plaza • Wauwatosa

Reminder!License renewal deadline for Wisconsin dentists and dental hygienists is Sept. 30, 2013. Visit www.dsps.wi.gov for more information.

430Renewal deadline for Wisconsin dental and dental hygiene licenses Visit www.dsps.wi.gov for more information.

30Mentor Program Kick-Off Dinner5:30 p.m. - Cash bar 6:30 p.m. - Dinner Marquette Union Alumni HallContact Susan John at [email protected] for more information.

OCTOBER1“Airway Management” Mr. Richard Mason 2 CE credits Visit www.marquette.edu/dentistry for more information

2“Advanced Cardiac Life Support Certification” Mr. Richard Mason 8 CE credits Visit www.marquette.edu/dentistry for more information

3“Advanced Cardiac Life Support Recertification” Mr. Richard Mason 5 CE credits Visit www.marquette.edu/dentistry for more information

4-5Wisconsin Dental Hygienists’ Association Indigo Conference Kalahari Resort and Convention Center, Wisconsin Dells Visit wi-dha.com for more information

Plan to get away next winter and earn continuing education

WDA and MUSOD 7-night CE Western Caribbean cruise

Jan.19 – 26, 2014 | Celebrity Cruise LineEarn up to nine continuing education credits during three, 3-hour sessions presented by

Dr. Joseph Best (Waukesha)The CE fee is as follows:

Booked before Sept. 1, 2013 Dentists $245; team members $195

Booked after Sept.1, 2013 Dentists $345; team members $295

Cabins start at $995 per person based on double occupancy. This includes meals, ship-board activities, entertainment, port charges

and government fees.To book your trip, visit http://bit.ly/1cxRYpR or call 800-326-0373.

Book by Sept. 1, 2013 to receive $100 discount!


1) c

2) c

Case study continued from page 9

Q&AA:

Final Diagnosis: Sialolithiasis (salivary stone)

DiscussionSialolithiasis or salivary stone is a

well-defined calcified structure found in a duct of minor or major salivary gland. Submandibular glad is the most common site for development of salivary stone.

Sialolithiasis is not associated with hypercalcemia or any other systemic con-ditions, and no specific secretory predis-posing factor has been linked to salivary stone. A small nidus composed of pro-tein, mucin and desquamated epithelial cells on which calcium salt precipitated in a duct is usually beginning of a sialolith.

The salivary stone increases in size as layer after layer of calcium salt becomes deposited particularly, the ones that are deeply seated. The small stones or micro-liths would easily be expelled into the saliva.

The larger stones cause obstruction of the duct and consequently cause pain and swelling. The pain becomes more severe at the meal time. Radiographic evaluation of the salivary gland would help to find the location and size of the stone. Bacterial infection is a complica-tion of long-standing salivary stones.

Manual manipulation of the stone can help to remove the superficially located stones. Surgical intervention is required for larger sized stones and the ones that are deeply seated and associated with sialadenitis. Antibiotic therapy is needed to control the infection prior to the surgery.

Acknowledgement: This case was contributed by MUSOD student Sarah Graesser.

Ezedin M. Sadeghi, DDS, MS Oral & Maxillofacial Pathologist Associate Professor, Marquette University School of Dentistry Referral and Consultation: 414-288-6559. Biopsy Service: 414- 805-8440.

Delta Dental offers faster, more effective way of delivering information

You wanted faster, more effective delivery of vital information for your patients and Delta Dental of Wisconsin has done it.

The top 50 most-requested information elements are now included in our faxbacks and on Dentist Connection, the secure dentist portal of www.deltadentalwi.com.

There is no need to call our benefit center when answers to your questions are at your fingertips. In fact, we are so confident these improvements will satisfy your needs that we have made them our default means of providing benefit-rundown information.

Now, when you look up benefits using www.deltadentalwi.com or call 800-236-3712 to request a faxback, you will also receive a benefit- verification number. If you need to call for other details, just provide your ben-efit-verification number and our benefit center team will be happy to help you.

By using our improved self-service options and making fewer phone calls, you save time and money. You also free up our staff so they are available when you really need them, allowing them to consistently deliver quality ser-vice in a timely manner.

For more information on how to use faxback or Dental Connection, visit www.deltadentalwi.com/dentist.

New Product/ Service Corner

BOT continued from page 3vacancies in their WDA House delegations with someone serving on behalf of another component or MUSOD. The ADA has requested that all delega-tions include at least one new alternate be-ginning in 2015. Also at the June BOT meeting, WDA Insurance and Services Corp President Mara Roberts announced that WDA Insur-ance Programs would be consolidated under the Professional Insurance Programs title by the end of this year. It is the latest effort to streamline processes, reduce redundancies and eliminate the cost of doing business as two separate companies. Dr. Monica Hebl (Milwaukee) outlined the ADA’s national Action for Oral Health for the Board. States are asked to implement programs and services that actively support the initi-ative’s major objectives: Reduce dental-re-lated emergency room visits; expand access to care for nursing home residents; increase charitable care outreach programs; provide more care through contracts between pri-vate-practice dentists and Federally Quali-fied Health Centers; increase dental health

protections and simplify administration under Medicaid; increase the number of Americans who have access to fluoridated drinking water; increase the number of Community Dental Health Coordinators; and, strengthen collaborations with other health professionals and organizations. The next WDA Board meeting will be held Sept. 27 - 28 at the Crowne Plaza Hotel in Wauwatosa, Wis.

Wda LEadERShiP dEvELoPMEnT TaSkFoRcE

Dr. Paul Levine (Milwaukee), chair Dr. Tim Durtsche (La Crosse), exofficio Dr. Ned Murphy (Racine) Dr. Jeff Nehring (Mercer) Dr. Tom Reid (Madison) Dr. Steve Stoll (Neenah) Dr. Albert Zambito (Lake Geneva) Mark Paget, executive director Lani Becker, staff liaison


Philanthropy 101Not all donations created equal

Donations to your favorite charity can take many forms. They can be made in cash, by check or credit card, through stock or as a planned gift. Each donation is valuable and appreciated, but not every donation is the same.

Q: What is the difference between restricted and unrestricted donations?

A: Just as the name implies, a restrict-ed donation is given by the donor with stipulations attached. In other words, it is given to be used for a specific purpose only…it may be in support of a program, a scholarship, an event or a charitable campaign.

Once specified, the gift cannot be used for any other purpose without the consent of the donor.

An unrestricted gift can be used wherever the need is the greatest. It is a gift given with “no strings attached”.

Unrestricted donations may not be the most glamorous gifts, but they are of criti-cal importance to every nonprofit organi-zation. Unrestricted money is flexible. It allows an organization to run smoothly, enables innovation and provides fuel for growth. It unlocks potential and makes it possible for organizations to weather crises without losing momentum.

Q: Which type of donation, restricted or unrestricted, is easier to obtain?

A: Donors are often more likely to make restricted donations because sup-porting a program feels more “concrete.”

This attitude is especially true of grant-making foundations and corpora-tions. Unfortunately, the local charity that may be able to raise thousands of dollars to support a specific program or to purchase new office space may not be able to scrape together enough money to keep the organization running efficiently or to keep its donors informed due to a lack of general funds.

Q: Which type of donation, restricted or unrestricted, is most important to the well-being of a nonprofit organization?

A: Both are vitally important to the well-being of a nonprofit. Donations that are specifically designated to a program, a scholarship or a service ensure that these important efforts are there when they are needed. Unrestricted gifts more often support operations such as administra-tion and fundraising…functions that may not be exciting, but which are extremely important to ensure good management and future sustainability of the organiza-tion.

Q: Are both restricted and unrestrict-ed donations tax-deductible?

A: Each donation, whether restricted or unrestricted, is tax-deductible to the full extent of the law when it is made to a qualified 501(c)(3) charitable organiza-tion.

Q: Why is it important for me to make a donation to the Wisconsin Dental

Association Foundation on my dues state-ment? Is it tax-deductible?

A: Each donation made on a WDA dues statement is unrestricted and creates a financial base for the foundation; allow-ing for efficient management and effective use of funds.

It also impacts the foundation’s abil-ity to provide grants to nonprofit dental programs and scholarships to dental and dental hygiene students.

The WDA Foundation is a quali-fied 501(c)(3) charitable organization and every donation is tax-deductible to the fullest extent of the law.

Q: Where can I learn more about the effect my donations have on the WDA Foundation?

A: If you have questions on any aspect of the WDA Foundation, you can go to www.wda.org/wda-foundation or contact Vicki Bohman at [email protected] or 414-755-4198.

Vicki Bohman WDA Executive Director [email protected]

september 2013 wda journal

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