virginia dental journal

HIGH

QUALITY

HEALTH BENEFITS

ARE HARD To FIND•••

•••UNLESS You FIND A COMBINATION SUCH

AS THE VDSC INSURANCE SERVICE CENTER

AND TRIGON BLUE CROSS BLUE SHIELD.

The Virginia Dental Association (VDA) and the Virginia Dental Services Corporation (VDSC) are proud

to announce a new association sponsored healthcare program through Trigon Blue Cross Blue

Shield. This new program is available for all dentists interested in setting up a benefit program

for themselves or their practice.

Call our toll-free number between 8:30 am VDA's HEALTH INSURANCE PROGRAM INCLUDES: and 5:30 prn, Monday through Friday. • Choice of Products - Indemnity, PPO, POS,

Simply dial 1-800-832-7001 for quick HMO, and MSAs.

• Trigon's extensive networks of participating and efficient service. It's that easy. The hospitals and doctors.

VDSC Insurance Service Center also has • Special Trigon "Value Added" and "Membership"

a toll free fax line, 1-800-886-4913. benefits available to you because of your association membership.

CALL TODAY for information on the wide variety of exciting health products

our association is offering for the upcoming year. Our service and marketing

departments will be delighted to answer your questions. Call the VDSC

Insurance Service Center at 1-800-832-7001 to find out how our

association is working to assist members in this important area.

VJ .. rr~

Leslie S. Webb, Jr. Tanya D. Moore William E. Z Editor Publications Business M

ASSOCIATE EDITORS 1. Barry I. Einhorn 4. Harry A. "Jack" Dunlevy 7. Carolyn 2. A. J. Booker 5. Barry K. Cutright 8. Melanie !J!

3. H. Reed Boyd III 6. Robert G. Schuster School of D~~j Thomas Burke

Volume 76 January - March 1999 Number 1

TABLE OF CONTENTS

4 Editorial 5 Message From the President 6 Abstracts

10 Great Question- Glad You Asked That... 12 Executive Council Actions in Brief 14 Candidate Information 17 Insurance Update 18 1998 VDA Leadership Conference 19 Strategic Planning Goals 23 From the Executive Director 25 Report on the ADA House of Delegates 28 Whiston Address 31 Health Practitioners Intervention Program 32 Five Ways You Can Help Lobby the Legislature 33 Medical Malpractice Cap 35 Upcoming Continuing Education 36 Membership Benefit Highlight 37 BUdget Committee Report 38 DR News 40 VDANews 41 Alliance News 41 Assistant News 42 Component News & Specialty News 48 Classified Advertising

COVER: James River Rapids; PHOTO CREDIT: Linda Gilliam PUBLICATION TEMPLATE: C:\Change

THE VIRGINIA DENTAL JOURNAL (ISSN 00496472) is published quarterly (January-March, April-June, July-Se , October-December) by the Virginia Dental Association, 5006 Monument Avenue, PO Box 6906, Richmond, Virginia 23230-0906, Tele 04)358-4927 SUBSCRIPTION RATES: Annual: Members, $6.00. Others $12.00 in U.S., $24.00 Outside U.S. Single copy: $ Second class postage paid at Richmond, Virginia. Copyright Virginia Dental Association 1996 POSTMASTER Send address changes to: Virginia Dental Journal, PO Box 6906. Richmond, VA 23230-0906. MANUSCRIPT AND COMMUNICATION for publications: Editor. PO Box 6906, Richmond, VA 23230-0906. ADVERTISING COPV, insertion orders, contracts and related information Business Manager, PO Box 6906, Ric VA 23230-0906.

VIRGINIA VDA COMMIITEE CHAIRMENJOURNAL

EDITORIAL BOARD

Ralph L. Anderson james R. Batten Cramer L. Boswell James H. Butler Gilbert L. Button Charles L. Cuttino 11/ Frank H. Farrington Barry I. Griffin Jeffrey L. Hudgins Wallace L. Huff Lindsay M. Hunt, Jr. Thomas E. Koertge James R. Lance Daniel M. Laskin Travis T. Patterson llJ W. Baxter Perkinson, Jr. Lisa Samaha David Sarrett Harvey A. Schenkein James R. Schroeder Harlan A. Schufeldt john A. Svirsky Ronald L. Tankersley Douglas C. Wendt Roger E. Wood

1999ADADE

Delegates: /4 William H. Allison (199 M. Joan Gillespie (2000 Ronald L. Tankersley ( 1

Alternate Delegates: Anne C.Adams (2000) Bruce R.DeGinder (200 Rodney J. Klima (2000)

Annual Meeting Bruce R. Hutchison

Auxiliary Education & Relations T. AndrewThompson

Budget & Financial Investments Raymond L. Meade

Cancer & Hospital Dental Service Michael E. Miller

Caring Dentists HarryD. Simpson, Jr.

Communication & Information Technology Corydon B. Butler, Jr.

Constitution & Bylaws Wallace L. Huff

Dental Benefits Programs Fred A. Coots, Jr.

Dental Continuing Education B. Ellen Bryne

Dental Delivery for the Special Needs Patient AI J. Stenger

Dental Health & Public Information AI J. Rizkalla

Dental Practice Regulation Albert L. Payne

Dental Trade & Laboratory Relations Jeffrey L. Hudgins

Direct Reimbursement David Swett

FOUNDATIONS

Relief Foundation Scott H. Francis

ON

Session, October 9-/3, /999, Honolulu, HI David C.Anderson (2001) Wallace L. Huff (200 1) Leslie S. Webb, Jr. (2000)

Richard D. Barnes (2000) Lindsay M. Hunt,Jr. (1999) Edward K.Weisberg (2000)

Ethics & Judicial Affairs M. Joan Gillespie

Fellows Selection Donald L. Martin

History & Necrology French H. Moore JII

Infection Control & Environmental Safety Paul F. Supan

Institutional Affairs Elizabeth A. Bernhard

Journal Staff Leslie S. Webb, Jr.

Legislative T. Wayne Mostiler

Membership H. Reed Boyd JII

New Dentist Carolyn C. Herring

Nominating Wallace L. Huff

Peer Review & Patient Relations Neil J. Small

Planning William H. Allison

Search Committee for VA Board of Dentistry Wallace L. Huff

VADPAC Rodney J. Klima

VDA Foundation William H. Allison

Charles L. Cuttino JII (2001) Emanuel W. Michaels (1999) Richard D.Wilson (1999)

Thomas S. Cooke1JI (1999) Bruce R.Hutchison (1999) AndrewJ.Zimmer (1999)

Representing and serving member dentists by fostering quality oral health care and education.

OFRCERS President: Charles L. Cuttino 11/, Richmond President Elect: Andrew J. Zimmer, Norfolk Immediate Past President: Wallace L. Huff, Sr., Blacksburg Secretary-Treasurer: Thomas S. Cooke III, Sandston Executive Director: William E. Zepp, CAE

P.O. Box 6906, Richmond, 23230-0906

EXECUTIVE COUNCIL COUNCILORS Includes officers and councilors listed and: I Edward J. Weisberg, Norfolk David C. Anderson, Alexandria - Chairman 1/ Bruce R. DeGinder, Williamsburg Gus C. Vlahos, Dublin - Vice Chairman III Harold J. Neal,Jr., Emporia Richard H. Wood, Richmond IV James R. Lance, Richmond William J. Viglione, Charlottesville V Edward M. O'Keefe, Roanoke

VI Ronnie L. Brown, Abingdon Ex Officio Members: VII James C. Gordon, Jr., Winchester Parliamentarian: Emory R. Thomas, Richmond VIII Rodney J. Klima, Burke Editor: Leslie S. Webb, Jr., Richmond Speaker of the House: D. Christopher Hamlin, Norfolk Dean, School of Dentistry: Ronald J. Hunt, Richmond

SOCIETY

Tidewater, I

Peninsula, II

Southside, III

Richmond, IV

Piedmont, V

Southwest, VI

Shenandoah Valley, VII

Northern Virginia, VIII

PRESIDENT

Stanley P. Tompkins 5830 Trucker Street Portsmouth, VA 23708

Corydon B. Butler, Jr. 1319 Jamestown Rd., #103 Williamsburg, VA 23185

Richard F. Roadcap 3501 Boulevard Colonial Heights, VA 23834

John S. Kittrell 2600 Grove Avenue Richmond, VA 23220

Mark A. Crabtree 407 Starling Avenue Martinsville, VA 24112

Robert G. Schuster P.O. Box 68 Laurel Fork, VA 24352

Robert B. Hall, Jr. 130 W. Piccadilly Street Winchester, VA 22601

James L. Gyuricza 5212-B Lyngate Court Burke, VA 22015

SECRETARY

Harvey H. Shiflet II/ 3145 Virginia Beach Blvd., 104 Virginia Beach, VA 23452

Wayne E. "A.J." Booker 6632 Geo Wa Mem Hwy Grafton, VA 23692

Richard W. Bates 3505 Boulevard Colonial Heights, VA 23834

H.A. "Jack" Dunlevy 11601 Robious Rd, Ste 130 Midlothian, VA 23113

Gregory T. Gendron 7 Cleveland Avenue Martinsville, VA 24112

Susan F. O'Connor PO Box 1086 Galax, VA 24333

J. Darwin King 1220 N Augusta Street Staunton. VA 244010

Neil J. Small 9940 Main Street Fairfax, VA 22031

PATIENT RELATIONS

W. Walter Cox 5717 Churchland Blvd. Portsmouth, VA 23703

Lawrence A. Warren 106 Yorktown Road Tabb, VA 23693

Richard F. Roadcap 3501 Boulevard Colonial Heights, VA 23834

William J. Redwine 6808 Stoneman Road Richmond, VA 23236

Craig B. Dietrich 604 E. Church Street Martinsville, VA 24112

Paul T. Umstott 300 W Valley Street Abingdon, VA 24210

Alan Robbins P.O. Box 602 Timberville. VA 22853

Paul N. Zimmet 5206 Dawes Avenue Alexandria, VA 22311

[II EDITORIAL I~

As I sat watching the ice storms of 1998 unfold before my eyes and contemplating an editorial for the Journal, my mind turned to the thought of how unpredictable life is in its twists and turns and how change is a major factor in life. Planning ahead helps us cope with life and change; however, even great plans have to be adjusted or changed due to unexpected circumstances.

As we begin a new year we make plans, set goals, and make resolutions to change. It is hard to change. Most of us resist its push, but change we must because change is constantly occurring around us.

Rather than resist change, flow with it and give it positive direction where you can. In your professionallife as a dentist, put your patients' care and concerns first no matter what occurs. Strive to stay abreast of all the new technology, materials and techniques. Keep your staff current in all aspects of patient care; maintain up-to-date office facilities capable of providing efficient quality. Be a positive force for change in your profession and in your community.

In order to anticipate and cope with a changing world and a changing profession be involved and flexible, continually be a student and maintain a sense of humor to laugh at what appears at times to be the insanity of it all.

of.dA. S. w.tt,J,.., D.D.S. Editor

4 Virginia Dental Journal

[II MESSAGE FROM THE PRESIDENT I~

I hope each of you had a very happy and safe Holiday Season.

The ADA Annual meeting in October produced some resolutions which will impact our Association over the coming years. One of the biggest discussions at the meeting concerned the Public Awareness Campaign. The House of Delegates did not pass the Awareness Campaign and therefore did not increase the dues by three hundred dollars. The House did make available to the various states what had been produced for the national campaign. This material may be used as the state desires and includes consultation with the advertising agency that developed it. The cost of utilizing the Campaign will be borne by the states. This will necessitate an

assessment of our members if Virginia decides to present our own Awareness Campaign.

This will by necessity need to be considered by the VDA House of Delegates in September. I would ask each of you to look to your perception of the need for such a campaign and the potential cost to put such a campaign on. This is a membership issue and you the members must let your delegates know your wishes.

The Leadership Conference in November included a panel of our members who openly discussed the issues that affect their own diversity. This was well received by the leaders who witnessed and participated in the discussion. As someone told me, "We came up the mountain not thinking about this and we are going down the mountain with a lot of thought". This is an issue that we need to continue to discuss and find ways to open the doors to all in Virginia to be a part of our Association. My personal thanks to Jim Watkins, Rebecca Swett, Carole Pratt, Manny Michaels and Reed Boyd who led and provided their personal insights into Membership: Unity through Diversity.

Spring is right around the corner and by then we will know whether the acorns, berries and wooly worms were an omen of a harsh winter.

CIw.,.1e6 of. Cullino III, D.D.S. VDA President

Virginia Dental Journal 5

Schwartz RS, Murchison DF, Walker WA. Effects of Eugenol and Noneugenol Endodontic Sealer Cements ABSTRACTS on Post Retention. ~I I~ Journal of Endodontics 1998; 24:564-567.

The following abstracts were provided by the Department of Endodontics at VCU/MCV School of Dentistry. We appreciate the contribution that these individuals have made to the Journal.

Sousa SMG & Bramante CM. Dens Invaginatus: Treatment Choices. Endodontics & Dental Traumatology 1998; 14:152-158.

The purpose of the article was to discuss treatment options for dens invaginatus. Dens invaginatus results from the invagination of the enamel during the soft tissue stage of development before the hard tissue mineralizes. Salter wrote the first report on this condition in 1855, but it wasn't until 1859 that Tomes accurately described the condition.

Dens invaginatus affects between 0.04% and 10% of the population. The maxillary permanent lateral incisor is the most commonly affected tooth; however, malformations may occur in teeth anywhere throughout the oral cavity. A bilateral occurrence is frequently seen and this anomaly has been associated with other abnormalities such as taurodontism, microdontia, gemination and dentinogenesis imperfecta.

According to Oehlers, there are 3 forms of dens invaginatus. Type 1-an enamel-lined invagination confined within the crown, Type 2-the invagination extends to the amelocemental junction and may communicate with the pulp, and Type 3-the enamel-lined invagination penetrates the entire root without communication with the pulp.

Clinically, the labiolingual diameter of the crown can be greater than normal and the enamel may seem hypoplastic with a deep groove in the coronal lingual portion. It is advisable to take radiographs from various angles to provide a better understanding of the extension of the anomaly. Dental treatment is indicated because the invagination may allow irritants to enter into the pulp either directly when there is communication with the pulp or indirectly when caries develops in the invagination and eventually leads to pulp exposure. Various treatment modalities have been proposed for these teeth depending on which type of invagination is present. They include conservative restorative procedures, nonsurgical root canal therapy, endodontic surgery, intentional replantation or extraction. Extraction would normally be the last resort treatment option.

In summary, it is important that an early diagnosis of dens invaginatus be made so that pulpal and eventual periapical involvement can be prevented.

Dr John T. Marley is a first year-postgraduate student in endodontics at MCVNCU School of Dentistry. He received his D.D.S. degree from the State University of New York at Buffalo School of Dental Medicine in 1994. He is presently on active duty with the US Army and will continue to serve on active duty upon completion of the program.

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Resin cements are sometimes recommended to enhance the retention of posts in endodontically treated teeth. Many sealers used in endodontics contain eugenol, which has been shown to inhibit the polymerization of resins.

The purpose of this study was to evaluate the effects of a eugenol and a noneugenol sealer on the retention of posts. Sixty extracted canines were divided equally into four groups. Each tooth received conventional endodontic therapy and was prepared to receive a post. Two sealers were used in obturation: one contained eugenol (Roth's 801 Elite Grade) and one was eugenol-free (AH26). The posts were cemented with either Fleck's zinc phosphate cement or Panavia 21 resin cement. Each combination of sealer and post cement was tested for retention by using an Instron testing machine.

The type of sealer used had no effect on post retention with either cement. Post retention was significantly greater with the zinc phosphate cement than the resin cement.

Dr Sean O'Sullivan is a second year-postgraduate student in endodontics at MCVNCU School of Dentistry. He received his D.D.S. degree from the University of Maryland in 1991. Upon graduation he completed an AEGD-1 year with the US Army, and he continues to serve on active duty.

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Pagavino G, Pace P, Baccetti T A SEM Study of In Vivo Accuracy of the Root ZX Electronic Apex Locator. Journal of Endodontics 1998; 24:438-41.

The Root ZX electronic apex locator is a device capable of making an accurate measurement of the root canal length, even if a strong electrolyte is in the canal. The purpose of this scanning electron microscopy study was to assess the accuracy of the Root ZX in measuring the root canal length when vital tissue was present in the root canal system. Specifically evaluated were the effects of variations in the postion of the foramen (apical versus lateral) on the accuracy of measurement.

Thirty-five single rooted teeth from 19 patients were selected for use in this study. The teeth were scheduled for dental extractions for orthodontic reasons. Following administration of local anesthetic, the major part of the clinical crown was removed and entrance into the root canal was enlarged by means of a GatesGlidden bur. The Root ZX was used according to manufacturers instructions. The file insertion stopped when the inscription "AP~X': on the display flashed and the audible continuous signal Indicated that the anatomical foramen had been reached. The file was locked in place using the undercuts in the pulp chamber and light-curing composite material. The handle of the file was removed with a high-speed handpiece and the teeth were extracted, cleaned and rinsed. The position of the foramen and the relation between the file tip and foramen were observed and photographed at X40 magnification using a SEM. In 18 specimens the position of the foramen appeared to be centered in the root and coincident with the root apex (apical position). In 17 specimens the foramen deviated from the long axis (lateral POSition) and exited on the lateral aspect of the root.

The Root ZX instrument located the apical foramen in an absolute precise manner in only one tooth. In all the other examined teeth the file tip protruded beyond the most coronal border of the foramen. The protrusion beyond the apex varied between 0.12mm and 0.85mm. No tooth exhibited the file tip being short of the foramen. When the +/- 0.5mm protocol tolerance level was applied, the results demonstrated an 82.75% accuracy for determining the location of apically located foramina but the accuracy noted with laterally located foramina was significantly lower.

Overall the error in apex location by means of the Root ZX was always an overextension of the file tip in relation to the border of the foramen. It seems reasonable to recommend a withdrawal of the instrument of about 0.5 to 1.0 mm (in apical and lateral foramen) to avoid overextension of instruments during canal preparation.

Dr. Christian Achleithner is a second year postgraduate student in Endodontics at MCVNCU School of Dentistry. He received his D.M.D. degree from Oregon Health Sciences University in 1986. Dr. Achleithner is currently serving in the United States Army Dental Corps.

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Nusstein J, Reader A, Nist R, Beck M, and Meyers WJ, Anesthetic Efficacy of the Supplemental Intraosseous Injection of 2% Lidocaine with 1:100,000 Epinephrine in Irreversible Pulpitis. Journal of Endodontics 1998; 24:487-491.

The intraosseous (10) injection allows placement of local anesthetic solution directly into the cancellous bone adjacent to the tooth to be anesthetized. Currently, there is an 10 system marketed under the trade name Stabident. The purpose of this study was to determine the anesthetic efficacy of a supplemental 10 injection of 2% lidocaine with 1:100,000 epinephrine in teeth diagnosed with irreversible pulpitis.

Fifty-one symptomatic patients from age 19 to 68 yr, participated in this study. All teeth were vital maxillary and mandibular posterior teeth diagnosed with irreversible pulpitis. The teeth received conventional infiltrations or inferior alveolar nerve blocks of 2% lidocaine with 1:100,000 epinephrine. Pulp testing was used (EPT and Green Endo-Ice) to determine pulpal anesthesia after "clinically successful" injections. Patients who were positive to the pulp tests, or were negative to the pulp tests but felt pain during endodontic access, received an intraosseous injection using 1.8ml of 2% lidocaine with 1:100,000 epinephrine. The 10 injection was given with the Stabident system. The success of the 10 injection was defined as the ability to complete endodontic treatment without pain.

The discomfort ratings for the 10 technique were: infiltration injection - 86 to 100% had no pain or mild pain; Stabident perforation - 92% had no pain or mild pain and 8% had moderate or severe pain; and solution deposition - 96% had no pain or mild pain. Forty-six percent of the patients subjectively reported an increased heart rate with the 10 injections. Overall, 42% of the teeth required supplemental injections. Eighty-one percent of the mandibular teeth and 12% of the maxillary teeth required 10 injections.

Overall, the success rate of the 10 injection was 88%. The supplemental 10 injection of 2% lidocaine with 1:100,000 epinephrine

should be a valuable adjunctive technique when mandibular blocks and maxillary infiltrations fail to achieve adequate anesthesia to allow pulp extirpation in posterior teeth diagnosed with irreversible pulpitis.

Dr. Ellen Ramos Kelly is a second year postgraduate resident in Endodontics at MCVNCU School of Dentistry. She completed a residency program in Periodontics and received her certificate in 1997 from MCVNCU. Dr. Kelly is a graduate of the University of Pennsylvania School of Dental Medicine and received her D.M.D. in 1994.

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An Evaluation of Root Canal Treatment in Patients Who Have Received Irradiation to the Mandible and Maxilla. Oral Surgery, Oral Medicine, Oral Pathology 1998; 86:224-226.

Patients receiving head and neck radiation therapy are SUbject to many tissue changes including changes in the mucosal, muscular, vascular, osseous and glandular tissues. In nonirradiated patients, treatment alternatives for irreversible pulpitis or pulpal necrosis include extraction or root canal therapy. However, tooth extraction in the irradiated patient is associated with a high incidence of osteoradionecrosis. The preferred alternative for the restorable tooth is root canal treatment.

This study presented a retrospective analysis of 11 irradiated patients receiving 22 root canal treatments. The most common pulpal diagnosis before treatment was necrosis (16/22) with irreversible pulpitis being second most common (4/22). The following radiograph and clinical criteria were used to determine success rates: (1) radiographic evidence of the absence of a peri radicular inflammatory lesion, (2) absence of clinical symptoms, and (3) absence of a sinus tract.

Of the evaluated teeth, 11 were anterior and 11 were posterior. The mean time from last fraction of irradiation to root canal therapy was 50 months, with a range of 24-80 months. The mean time of endodontic follow-up was 19 months. Of the 22 cases, 20 (91%) were considered successful. Moreover, when considering patients with a preoperative periapical diagnosis of chronic apical periodontitis (CAP; apical radiolucency), the success rate was 89% (8/9). No cases of osteoradionecrosis were observed tollowinq root canal treatment.

The pathophysiologic sequence of osteoradionecrosis is described as: (1) radiation therapy, (2) hypoxic-hypocellularhypovascular tissue changes, (3) tissue breakdown, (4) chronic nonhealing wound. It is also reported that increased postradiation time (more than 6 months) leads to further reduction in vascularity, less tissue perfusion and more fibrosis resulting in a greater susceptibility to osteoradionecrosis. When considering the criteria for endodontic success and the absence of osteoradionecrosis, this study demonstrates a relatively favorable outcome (91%). Therefore, root canal therapy should be the treatment of choice and should be completed as quickly as possible after diagnosis of pulpal and/or periapical pathosis.

Dr. Linda Baughan is a first year postgraduate resident in Endodontics at VCUlMCV School of Dentistry. She received a MEd from VCU in 1978, a D.D.S. from MCV in 1983 and a Graduate Certificate in Aging Studies from VCUlMCV in 1994,

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Garlock JA, Pringle GA, Hicks ML. The Odontogenic Keratocyst: A Potential Endodontic Misdiagnosis. Oral Surgery, Oral Medicine, Oral Pathology 1998; 85:452-56.

The odontogenic keratocyst (OKC) is classified as a developmental odontogenic cyst and is believed to arise from cell rests of the dental lamina. These lesions are more common in males than females, occur over a wide age range, are typically diagnosed during the second, third or fourth decades and manifest themselves as radiolucencies that can appear anywhere in the maxilla or mandible. There are reports of this cyst occurring in peri radicular areas that may masquerade as lesions of endodontic origin. The purpose of this retrospective study was to determine the incidence of OKC's occurring in the peri radicular area of teeth with necrotic pulps or previous endodontic treatment.

Pathology reports of 5,439 biopsy specimens during a 37-month period were retrieved, reviewed and classified according to the location of the lesion. Information regarding case history, treatment and follow-up was obtained for each of these cases.

Of a total of 239 OKC's diagnosed during the study period, 21 (9%) were located in the peri radicular area and of these, 12 (57%) were associated with teeth with necrotic pulps or with teeth that had previously undergone root canal therapy. The average age of the patients was 56 years, there was a male predilection in 83% of the cases and 50% occurred in the mandible. Eighty-three percent of the lesions were unilocular and most were 1-2 em in diameter. Over 90% of the cysts were located anterior to the molars with the anterior mandible being the most common site.

The differential diagnosis of a periradicular radiolucency associated with a tooth may include odontogenic cysts and tumors, nonodontogenic tumors and mesenchymal reactive lesions. The growth of the OKC is not dependent on inflammatory stimuli therefore root canal therapy will not resolve this lesions. Surgical treatment of any persistent or enlarging peri radicular radiolucency associated with a nonvital or previously root canal treated tooth should include thorough curettage to minimize the potential risk of recurrence.

Dr. Harold J. Martinez is a first year postgraduate resident in Endodontics at the VCU School of Dentistry. He received his D.D.S. degree from the Baltimore College of Dental SurgeryUniversity of Maryland in 1995. Dr. Martinez completed a oneyear AEGD while on active duty with the U.S. Air Force from 1995 to 1998.

Berry KA, Loushine RJ, Primack PO, Runyan DA. Nickel-Titanium Versus Stainless-Steel Finger Spreaders in Curved Canals. Journal of Endodontics 1998; 24:752-754.

The placement of endodontic spreaders to within 1 to 2 mm of the root canal working length has been advocated as a requirement for obtaining the most favorable apical seal during the lateral condensation of gutta percha. Lateral condensation with gutta percha and sealer has been shown to provide an excellent apical seal; however, the lateral condensation technique has demonstrated less favorable apical leakage


results in curved canals when compared with straight canals. Conventional stainless-steel spreaders usually fail to achieve the depth of 1 mm from the working length in curved root canal systems due to the resistance encountered when binding occurs against the canal walls.This inflexibility can lead to an inadequate apical seal or to a root fracture if the operator attempts to force the spreader to the proper length. Newly marketed nickel-titanium spreaders may offer an advantage in this regard due to the increased flexibility of these instruments.

The purpose of this study was to compare the differences in the penetration depths of nickel-titanium and stainless-steel finger spreaders in prepared straight and curved canals. Seventy mesial and distal mandibular molar canals were instrumented to a #35 master apical file size. Measurements of the canal curvature were made from preoperative radiographs. Canal curvature angles ranged from 0 to 51 degrees. The teeth were placed in a radiographic mount to ensure a constant focal length and postoperative radiographs were exposed with comparably sized stainless-steel and nickel-titanium spreaders inserted into each prepared canal. Measurements were made with a micrometer to the nearest 0.02 mm on the radiographs.

The analysis revealed a statistically significant advantage in the ability of the nickel-titanium spreader to approach the working length in canals when compared with a similarly sized stainless-steel spreader. The mean values for distance from the apex was 1.15 (+/-0.28) mm for the nickel-titanium spreader and 2.4 (+/-1.43) mm for the stainless-steel spreader.

Overall, the study concluded that the nickel-titanium spreader demonstrated a greater ability than a comparably sized stainless-steel spreader to achieve a depth of 1 to 2 mm from the working length in prepared curved root canal systems. The clinical use of nickel-titanium spreaders may enhance our ability to create better apical seals in curved canals.

Dr. Peter Mayer is a first year postgraduate student in Endodontics at theVCU School of Dentistry. He received his D.D.S. degree from Case Western Reserve University School of Dentistry in 1988. Upon graduation he completed a GPR at Southside Hospital in Youngstown, Ohio. Dr. Mayer served in the U.S. Navy Dental Corps from 1989 to 1998.

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for giving OUR seal of approval YOUR seal of approval!

1 8 7 \\

You want only professionals on your team ...

That's why the Virginia Dental Association has recognized members of the Virginia State Dental Laboratories Association. We are a group of dental laboratory owners dedicated to the highest standards of our industry. Our members have made a commitment to our organization AND to the dental profession. As members of the National Association of Dental Laboratories, our state com ponent is dedicated to continuing education for technicians and establishing voluntary standards in an unregulated industry.

So, look for our seal...

when you want a professional laboratory partner who will help you enhance the lives and health of your patients!

The Virginia State Dental Laboratories Association invites you to join us in Williamsburg for our

Fall Educational Event October 14·16, 1999


GREAT QUESTION- GLAD YOU ASKED THAT. ..[ II B. Ellen Byrne, R.Ph., D.D.S., Ph.D.

For several years now I have been fortunate enough to offer continuing education classes in pharmacology. After and during every program I receive very interesting questions. Sometimes I know the answers and sometimes I have to research the question before I can give an answer. I would like to share these questions and answers with the dental community. I would also like to encourage more questions. I believe in a better life through pharmacology. Call me at (804) 828-0784 or FAX me at (804) 828-4916.

1. My patient has "Dilantin hyperplasia" but doesn't take Dilantin (phenytoin). Are there any other drugs which cause this hyperplasia?

Yes, there are numerous drugs which can have this adverse effect on periodontal tissue. The most common drugs implicated in this condition include:

1. Dilantin® - phenytoin 2. Sandimmune® - cyclosporin 3. Calcium channel blockers

Bepadin®; Vascor® - bepridil Cardizem® - diltiazem Plendil® - felodipine DynaCirc® - isradipine Cardene® nicardipine Adalat®; Procardia® - nifedipine Ninotop® - nimodipine Calan®; Isoptin® - verapamil

USP-DI, (ed. 17) Rockville, MD, 1998, United States Parmacopeial Convention.

2. A patient called the office to tell us that he had tested positive for cocaine on a random drug screen. He wanted us to call his work place and tell them that he had received an injection of lidocaine and that it had caused his drug screen to test positive for cocaine. Is that possible?

No, that is a very old excuse for a positive drug test. While it is true that the first local anesthetic was cocaine isolated from the leaves of the coca bush, Erythroxylon coca, it is not true that lidocaine and cocaine produce the same metabolites or interfere with each other on a drug screen. Cocaine itself is not what they look for on a drug screen. The half-life of cocaine itself is very short, only approximately 20 minutes. Because of this the drug test is for the metabolite, benzoyl-ecogonine, which has a longer half-life at about 36-48 hours. The benzoyl-ecogonine molecule looks nothing like lidocaine or any of its metabolites. According to Dr. Alphonse Poklis, Professor of Pathology at MCVNCU the tests for cocaine are specific and there are no other drugs which would interfere with these tests. If it looks like a duck, quacks like a duck and walks like a duck... it's a duck. A positive cocaine test is a positive cocaine test. Time to call the parole officer.

3. My patient takes Antabuse (disulfiram) for alcohol abuse. Do local anesthetic contain any type of alcohol as a preservation?

No, local anesthetics used in dentistry are supplied in 1.8 ml single-dose cartridges. The cartridges contain pyrogen-free water with sodium chloride added for osmotic balance. Citric acid and sodium bisulfite are added as an antioxidant to help prevent the vasoconstrictor break down. Multidose Vials contain methylparaben as an antimicrobial. Methylparaben serves no purpose in dental cartridges and its incorporation has been discontinued in the United States.

Antabuse (disulfiram) is used in alcoholics to help maintain sobriety. It blocks the enzyme responsible for the metabolism of the ethanol metabolite acetaldehyde. The resultant accumulation of acetaldehyde produces flushing, nausea and vomiting, blurred vision and dizziness. Dental concerns for patients on Antabuse including warning the patient about use of alcohol containing products, including mouthrinses. Also patients can experience metallic or garlic like taste in their mouth.

Yagiela JA, Neidle EA, Dowd,FJ. Pharmacology and Therapeutics for Dentistry, (ed. 4) St. Louis, MO, Mosby, 1998, pg. 217-234.

Malamed, Stanley. Handbook of Local Anesthesia, (ed. 4) St. Louis, MO, Mosby, pg. 24-37.

USP-DI, (ed. 17) Rockville, MD, 1998, United States Parmacopeial Convention.


EXECUTIVE COUNCIL ACTIONS IN BRIEF ~I II] NOVEMBER 8, 1998

The Following Recommendations Were Considered:

1. Approved a recommendation that the 2003 VDA Annual Meeting be held at the Richmond Marriott.

2. Approved a recommendation to designate the scholarship money annually given to MCV as the David A. Whiston Scholarship.

3. Approved a recommendation to adopt the following resolution:

WHEREAS the House of Delegates at the 1998 Annual Meeting of the American Dental Association has approved support of alternative Dental Hygiene Education programs similar to the Alabama program.

BE IT RESOLVED that the Virginia Dental Association restate its position to continue to investigate and promote accredited Dental Hygiene Education programs to expand these educational opportunities for citizens of the Commonwealth.

The Executive Council recommends adoption of the above recommendations by the House of Delegates.

The Following Items Were Approved:

5. Approved a recommendation that the VDA adopt the PANDA Program resolution as follows:

Be it resolved that the Virginia Dental Association supports, in principle, a dental coalition aimed at educating dentists about the problems of child abuse and neglect, teaching them to recognize the signs of abuse and neglect, and informing them of their ethical and legal responsibilities in reporting suspected cases.

6. Approved a recommendation to eliminate the 1999 November Leadership Conference and schedule the 2000 Committee Meetings in mid-January, mid-April and mid-June. The Leadership Conference will be held in conjunction with the Mid-April Committee Meetings.

7. Approved a recommendation that the Legislative Committee support the Department of Health draft legislation 32.1-122.9 (conditional grants for certain dental students).

8. Approved a recommendation that the Legislative Committee prepare for the introduction of legislation in the 2000 General Assembly Session to change the definition of dentistry in the VA Code to conform to the 1997 ADA statement.

9. Approved a motion that an expense allowance of $800.00 be established to cover the expenses of the Parliamentarian.

The Following Items Were Referred To Committee:

2. Referred to the Budget & Financial Investments Committee a recommendation that the Committee investigate the establishment of a sequestered building fund and a three-year dues increase to capitalize the fund.

3. Referred to the Planning Committee a recommendation that the Committee explore the possibility of having VDA Annual Meetings outside the confines of the Commonwealth and report back to the Executive Council at the 1999 June Committee Meetings.

4. Referred to the Planning Committee a motion that the Committee evaluate ways to involve non-VDA members, such as members of the Old Dominion Dental Society, members of other dental groups within Virginia and other non-members, in the VDA Annual Meeting. Consider inviting them to attend the Annual Meeting at VDA member fees.

5. Referred to the Executive Committee for further study and a decision on support, a resolution that the Legislative Committee supports the Board of Dentistry draft legislation #DEN-1. (Relating to license, application, qualifications and examinations.)

6. Referred to the Constitution & Bylaws Committee for review the following changes to the membership of the Planning Committee:

Article VIII, Section 4 A 12. Planning Committee a. Membership: This Committee shall consist

of the President-Elect, fettf two most recent Past Presidents aRe four memBers at lar~e,

two of WRom sRall Be appoiAtee for two year terms By tRe PresieeAt Eleet. OM of tRese at lar~e memBers sRall Rave ~raeuatee from eeAtal seRool witRiA tRe past teA years. and the chairmen of the tollowinq Regular Standing Committees; Annual Meeting, BUdget and Financial Investments, New Dentist, Dental Benefit Programs, Dental Delivery for the Special Needs Patient, Dental Practice Regulations, Auxiliary Education and Relations, Legislative, Membership, Ethics and Judicial Affairs, Direct Reimbursement and any other committee that the President may specify. The Committee shall elect its own chairman annually.

b. Duties: ....... (no changes)

7. Referred to the Legislative Committee a recommendation that the Committee encourage VDA members to


get petitions signed by patients reiterating the patient's 15. right to have assignment of benefits honored.

Items 8 - 27 are referrals from the action plans developed at the Strategic Planning Workshop November 6, 1998.

8. Referred to the Legislative Committee:

Promote a training session for liaison dentists. Promote increased one-on-one contact with each 16. individuals own legislator Determine and prioritize issues which affect the practice of dentistry and membership issues as a whole Increase the number of VDA members in attendance at legislative and regulatory committee meetings Utilize the assets of other states in identifying issues and strategies common to our constituent society Increase the exposure of legislators to dentistry

9. Referred to VADPAC:

Increase PAC contributions and awareness 17. Identify those legislators chairing committees which impact dentistry Increase the exposure of legislators to dentistry

10. Referred to the Dental Practice Regulations Committee:

Increase the number of VDA members in attendance at legislative and regulatory committee meetings 18. Continue to monitor the actions of the state regulatory boards

11. Referred to the Budget & Financial Investments Committee:

19. Consider increasing funding for lobbying efforts of the Association

12. Referred to the Executive council: 20.

Consider increasing funding for lobbying efforts of the Association

13. Referred to all:

Utilize the Alliance in legislative initiatives

14. Referred to the New Dentist Committee:

Invite senior and graduate dental students to Janu- 21. ary Committee meetings and reception. Action target date - January 1999. Continue presentations to senior dental students, which outline the benefits of membership. Action target date - ongoing. VDA sponsored breakfast for freshmen dental students with a panel of dentists discussing the benefits of membership. Action target date September 1999.

Referred to the President and President-Elect:

Form sound relationship with present Dean and suggest mandatory student and faculty membership in ASDA and VDA respectively. Action target date - November 1998. Appoint dental students as ad-hoc members of state committees. Action target date - January 1999.

Referred to the Membership Committee:

Approach dental supply companies to develop VDA discounts on certain products. Action plan date January 1999. Communicate through various types of technology (fax, e-mail, phone) to elicit feedback on satisfaction of members with their membership in VDA. Action plan date - spring 1999. Through phone calls or personal meetings, articulate benefits of membership that would be of interest to long standing non-members (insurance plans, credit cards, legislative issues, etc.) Action plan date - ongoing.

Referred to the Component Membership Committee:

Component Chairman - have a mentor-mentee program in place in all components. Action target date - ongoing. Introduction of new members at annual component meeting. A mentor should be the person to take this new member to that meeting. Action target date - spring 1999.

Referred to Components:

Treat new or non-members, on a one time basis, to free CE at component level. Action target date immediate.

Referred to the Component Executive Committee:

Have a combination CE course and New Member Reception. Action target date - ongoing.

Referred to Component Staff:

Communicate with members and nonmembers through monthly e-mail messages (For example: "what the VDA has done for you this month ... ") Action target date - ongoing. Continue working on e-mail directory to improve communication with dentists. Action target date ongoing.

Referred to VDA staff:

Continue working on e-mail directory to improve communication with dentists. Action target date ongoing. Communicate on a component level with members and nonmembers through monthly e-mail messages. Action target date - ongoing.


Develop the VDA as an information resource to 27. Referred to the VDA President: keep members informed of developments to managed care and DMSO contract arrangements. Ac- Pursue corporate partnerships for the different tion target date - ongoing. endeavors of the VDA.

22. Referred to the Ad Hoc Committee on Communication and Information Technology, a motion that the Committee consider their dissolution and re-establishment as a Regular Standing Committee in Article VIII, Section 1.A with their input in the development of the duties of this Committee and to report their recommendations back to the Executive Council for action at the January Committee Meetings.

23. Referred to the VDA Foundation:

VDA Foundation should increase revenue sources not only to fund CE but also VDA charitable endeavors.

24. Referred to the Budget & Financial Investments Committee:

Review the role of investments as a non-dues revenue source. Pursue corporate partnerships for different endeavors of the VDA.

25. Referred to the Annual Meeting Committee:

Pursue corporate partnerships for the different endeavors of the VDA. Review the role of the VDA Annual Meeting as a non-dues revenue source.

26. Referred to the Building Committee:

Pursue corporate partnerships for the different endeavors of the VDA.

28. Referred to the Executive Council:

Encourage VDA membership participation in VDSC endorsed programs.

The Following Items Were Received As Information Only:

1. Received as information only that the Executive Committee has directed the Central Office staff to delay publication of the Membership Directory until January 1999.

2. Received as information only from the Annual Meeting Committee:

Dr. Michael Miller was re-elected vice-chairman. A Casino Night will be held at the 1999 Annual Meeting.

3. Received as information only from the Legislative Committee, the following list of Legislative priorities for 1999:

1. Assignment of Benefits 2. Medicaid Issues 3. Reimbursement for General An

esthesia for Dental Procedures/ Special Needs

4. New Definition of Dentistry

PUBLICATION OF CANDIDATE INFORMATION IN THE VIRGINIA DENTAL JOURNAL

Nominations for the elective offices of the Virginia Dental Association may be made either by a Component President on behalf of the Component he/she represents, or by obtaining signatures from a minimum of twenty-five members of the Association. These nominations should be directed to Dr. Thomas S. Cooke III, VDA Secretary-Treasurer. The following positions are up for election at the 1999 Annual Meeting in Reston: President-Elect; SecretaryfTreasurer (2 year term); four ADA Delegate positions (3 year term); four ADA Alternate Delegate positions (2 year term).

All candidates must have submitted their CV's, pictures (black & white head-shots preferred), and biographical information to the attention of Dr. Leslie S. Webb, Jr., Editor at the VDA Central Office no later than March 1, 1999, for publication in the April-May-June issue of the Virginia Dental Journal. Forms for submission of Candidate Information have been mailed to all VDA Component Society Presidents.

Candidates for the offices of President-Elect and Secretary-Treasurer of the Association will be allowed a maximum of 500 words. Candidates for all other offices will be allowed a maximum of 250 words. Candidates are asked to limit their biographical information to major accomplishments, but to include such pertinent data as education, memberships, honors, positions of leadership held in the ADA, VDA and Component Society, and community leadership activities. Due to space limitations, the VDA Journal Editor will reserve the right to condense biographical information, as necessary.

Should you have any questions regarding the Journal criteria, please contact Dr. Les Webb either by phone 804-282-9781 or by fax 804-282-3647. If additional Journal submission forms are needed, please contact Tanya Moore at the VDA Central Office either by phone 800-552-3886 or by fax 804-353-7342.


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INSURANCE UPDATE [I ~J MEDICAL INSURANCE

Over the past several years the VDA has worked hard to ensure that the major medical plan through CNA remained financially competitive while offering excellent benefits and unparalleled service. However, the CNA policy underwent higher than anticipated rate increases that were unacceptable to all involved. Therefore, effective December 31, 1998, the VDA endorsement of the CNA plan ceased.

In response to the needs of the members and in order to ensure a more financially competitive product for the future, the Virginia Dental Services Corporation (VDSC) negotiated a new program with Trigon Blue Cross Blue Shield. This new program is available for all dentists interested in setting up a benefit program for themselves or their practice.

Some of the exciting new benefits now available are:

• Choice of Products - Indemnity, PPO, pas, HMO, and MSAs • Extensive Networks of Participating Hospitals and Doctors • Special "Value Added" and "Membership" benefits

Please call the VDSC Insurance Service Center at 800-832-7001 Monday through Friday from 8:30am to 5:30pm for more details. You will speak with experienced benefit consultants who are solely dedicated to the servicing and marketing of the VDA major medical program.

PROFESSIONAL LIABILITY INSURANCE

After reviewing numerous insurance carriers, in August 1998 the Board of the Virginia Dental Services Corporation (VDSC) endorsed The Medical Protective Company because of their flexible product design, fee structure, customer service(s), and their commitment to the dental professional.

The Medical Protective Company invented professional liability insurance in 1899. Through their partnership with The Hartford, they are able to provide all your practice coverage in The Package. You can purchase professional liability, property, workers' compensation, employment practices liability and pension plan coverage in convenient, one-stop shopping.

In order to speak with an agent please call 800-344-1899.

The VDA and the VDSC are proud of the insurance

programs we offer to the members of the VDA

and hope that you take advantage

of these benefits.


DIVERSITY, MEMBERSHIP AND STRATEGIC GOALS HIGHLIGHT 1998 VDA LEADERSHIP CONFERENCE

Andrew J. Zimmer, D.D.S., VDA President-Elect

The 1998 Leadership Conference was held at the Wintergreen Resort November 4-8, 1998. Participants were treated to some spectacular fall color on the mountainsides and chilling temperatures on the mountaintop. More than thirty members participated in a Stragetic Planning Workshop facilitated by Mary Byers, CAE of Word Works. Mary quickly established fairly intense audience participation by utilizing consensus identification of our Association's Strengths, Weaknesses, Opportunities and Threats. These categories were then considered in establishing five priorities: Membership, Communication, Legislative, Non-dues Revenue and the (Virginia Dental) Association Building. The proposed implementation action plans and appropriate committee referrals for our Strategic Goals are listed on pp.19 -21 of this journal issue.

The theme for the 1998 Leadership Conference was "Membership: Unity through Diversity". Mary Byers gave a stimulating presentation titled Intentional Leadership: Leadership by Design offering many tips on more effective stewardship and focused participation in the Association. Dr. John Zapp (ADA Executive Director) and Paul Jarr (Director of ADA Membership Services) provided extensive membership information and insight. A Membership Diversity and Sensitivity Panel that courageously addressed diversity issues such as age, gender and ethnic heritage highlighted the day. The entire program was informative and thought provoking and will undoubtedly catalyze some changes in our approach to membership in the future.

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STRATEGIC PLANNING GOALS [II I]

November 6, 1998

NON-DUES REVENUE

Recognizing the need for increased expenditures in carrying out the mission of the VDA, and the desire for limiting increases in dues, the VDA is working towards increasing revenues from non-dues revenue sources. No time line.

Action Plan

• VDA Foundation should increase revenue sources not only to fund CE but also VDA charitable endeavors. (VDA Foundation)

• Review the role of investments as a non-dues revenue source. (Budget & Financial Investments Committee)

• Pursue corporate partnerships for the different endeavors of the VDA. (President, Building Committee, Annual Meeting Committee, BUdget & Financial Investments Committee)

• Review the role of the VDA Annual Meeting as a non-dues revenue source. (Annual Meeting Committee)

• Encourage VDA Membership participation in VDSC endorsed programs. (Executive Council)

Due to the mission of the VDA, CE should not be used as a non-dues revenue source.

MEMBERSHIP GOALS AND STRATEGIES

Background:

• Membership is an increasingly important issue due to a 1/2 to 1 % decrease in market share over the past 10 years.

• Traditionally membership in our organization was seen as an obligation. Now, new dentists are more concerned with "perceived value" of membership in the organization.

• There appears to be a lack of response to changing practice conditions.

Action Plan for Dental Students

• To invite senior and graduate dental students to January Committee meetings and reception

Budget: $500.00 Group responsible: New Dentist Committee Action target date: January 1999

• Appoint dental students as ad-hoc members of state committees

Group responsible: Presidential appointment Action target date: January 1999

• Form sound relationship with present Dean and suggest mandatory student and faculty membership in ASDA and VDA respectively

Group responsible: President and President-elect Action target date: November 1998

• Continue presentations to senior dental students which outline the benefits of membership

Budget:? already established Group responsible: New Dentist Committee Action target date: Ongoing

• VDA sponsored breakfast for freshmen dental students with a panel of dentists discussing the benefits of membership

Budget: $100 Group responsible: New Dentist Committee Action target date: September 1999

Action Plans for New Dentists

• Have a mentor program in place in all components Group responsible: Component membership chair Action target date: Ongoing

• Treat new or non-members on a one time basis to free CE at component level

Group responsible: Component members Action target date: Immediate

• Introduction of new members at annual component meeting. A mentor should be the person to take this new member to that meeting

Group responsible: Component Membership Committee Action target date: Spring 1999

• Components having a combination CE course and New Member Reception

Budget: $200 for reception Group responsible: Component Executive Committee Action target date: Ongoing


• Communicate on a component level with members and nonmembers through monthly E-mail messages (for example: "what the VDA has done for you this month ...")

Group responsible: VDA / component staff Action target date: Ongoing

• Continue working on email directory to improve communication with dentists

Group responsible: VDA / Component staff Action target date: Ongoing

Action Plans for Retention of Members

• Develop the VDA as an information resource to keep members informed of developments in managed care and DMSO contract arrangements

Group responsible: VDA staff Action plan date: Ongoing

• Approach dental supply companies to develop VDA discounts on certain products

Group responsible: Membership Committee Action plan date: January 1999

• Communicate through various types of technology (fax, email, phone) to elicit feedback on satisfaction of members with their membership in VDA

Group responsible: Membership Committee Action plan date: Spring 1999

Action plans for long standing non-members

• Through phone calls or personal meetings, articulate benefits of membership that would be of interest to this group (including insurance plans, credit cards, legislative issues, etc.)

Group responsible: Membership committee Action plan date: Ongoing

LEGISLATIVE

Due to the continuing and increasing threat from numerous sources, the Virginia Dental Association shall promote the policies of the Association through proactive legislative and regulatory advocacy.

Time Line: Ongoing

Actions and Committee referral:

• Promote a training session for liaison dentists Legislative

• Promote increased one-on-one contact with each individuals own legislator -Legislative

• Determine and prioritize issues which effect the practice of dentistry and membership issues as a whole Legislative

• Increase PAC contributions and awareness - VADPAC • Increase the number of VDA members in attendance at

legislative and regulatory committee meetings - Legislative and Dental Practice Regulations

• Identify those legislators chairing committees which impact Dentistry - Legislative and VADPAC

• Utilize the assets of other states in identifying issues and strategies common to our constituent society Legislative

• Consider increasing funding for lobbying efforts of the Association - Budget and Financial Investments and Executive Council

• Utilize the Alliance in legislative initiatives - All • Continue to monitor the actions of the state regulatory

boards - Dental Practice Regulations • Increase the exposure of legislators to Dentistry

Legislative and VADPAC

COMMUNICATION

Communications are the lifeblood of any organization. They must be timely, effective and easily accessed. Modern information technology must be integrated into the communication system to increase speed and availability.

Currently our membership communication efforts are centered on a web page, mass mailings, faxes, and the VDA journal and directory. New technologies should be incorporated as they evolve.

Additionally, an action plan should be developed for public awareness and education.

Action Plan

Membership Communication • increase effectiveness of current communication

mediums • develop and implement improved e-mail/fax

communications • explore mentorship opportunities for educating new mem

bers on current issues and available benefits • improve the chain of personal communication between

officers, executive council, & committee members to the general membership

• one on one "personal contacts" with members and non-members

• establish a statewide phone tree • continue to monitor new technologies that become avail

able in this field and implement as indicated

Public Awareness • develop mechanisms to effectively disseminate

information to the public • establish a spokesperson training program


We recommend the Ad Hoc Committee on Communication 2. Site selection and Information Technology be dissolved and re-established as a Regular Standing Committee in the VDA By-Laws. 3. Existing building vs custom built

We further recommend that these action plans then be de Preliminary report should be presented to the veloped and implemented by the new Regular Standing Com Executive Council in June, 1999. mittee on Communication and Information Technology.

If possible include a dentist who is also an architect and a dentist who is also a contractor or dentists

BUILDING who are knowledgeable in these fields.

At the 1998 Strategic Planning Workshop at Wintergreen, it B. Send the information presented by the Ad Hoc Comhas become evident that the Central Office Building is now mittee to the Budget & Financial Investments Cominadequate in size to accomodate our needs. In order to mittee to research specific or alternative ways to maintain our current functions and in order to grow as an finance the recommendation of the Ad Hoc Commitorganization a new facility is necessary. tee. A preliminary report from the Budget Commit

tee should be presented to the House of Delegates in September 1999.

Action Plan Overall time line is three years.

A. Request that the following be researched by a new ad hoc committee or current Ad Hoc Building Committee:

1. Size and composition of new central office building (meeting space, work space, computer space, etc.)

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~I FROM THE EXECUTIVE DIRECTOR. .. II

I am struggling with this column for several reasons, not all of them connected with avoidance and denial. It is honestly difficult both to determine what will be of interest to you, the members, and to determine if it will be of interest to you in mid-February when you will read it versus midJanuary as I write it.

In addition, I share a common past-life with Tanya Moore, the VDA Publication and Meetings Coordinator: we were both high school English instructors. She gave me this assignment well in advance, has reminded me in positive terms of the impending deadline, and has smiled knowingly every time I say, "I'm working on it." The last two days I have avoided her on the stairs and I've been cutting third period. Actually, between the current Journal deadlines and the 1999 Membership Directory, Tanya has no time to badger me.

Now that Christmas 1998 has become another Christmas Past, things are back in high gear for the VDA staff and leadership. Activities associated with the General Assembly will be reported in other columns and articles. However, I would like to mention our appearance before the House Subcommittee on Health & Human Resources on January 12. Lisa Finnerty,VDA Public Affairs Coordinator, arranged, coordinated and introduced a presentation to the Subcommittee on Medicaid access and funding by Dr. Burton Edelstein, Director of the Children's Dental Health Project. Dr. Edelstein is the foremost national authority on Medicaid and dentistry. We know that the Subcommittee was favorably impressed with dentistry's position and feel that the Medicaid situation will continue to improve. Again, we encourage your renewed participation in Medicaid in the effort to provide access to Virginia's underserved children.

A mini-Spokesperson Training Seminar was held on January 11 to prepare selected members from throughout the Commonwealth to respond to media questions regarding a planned segment on children's deaths from dental anesthesia on the new CBS program "60 Minutes II," which premiered January 13. Drs. Charlie Cuttino, Pat Dolan, Christy Hamlin, and Roger Wood were trained by Dick Green, Director of Communications at the ADA Washington office. This training was scheduled on short notice, due to the impending telecast, and provided a preview of the full ADA Spokesperson Training program, scheduled for April 23 in Richmond. Component representatives will be selected in late January.

Ronya Edwards developed and distributed a marketing survey for the VDSC in January to attempt to determine members' interests and needs regarding potential product endorsements. Hopefully, you took the time to respond to the survey to assist the VDSC Board in their planning session in late February.

Dues collection has been a major priority for both Connie Jungmann and Linda Gilliam since early December. Linda's life is further complicated by the end of the year closing and reporting requirements for all VDA and VDA-related accounts. Connie is also currently investigating the IMIS Association Management software system as a potential backup to the ADA TAMS program, which seems to have suffered some recent setbacks. She will visit the Pennsylvania Dental Association offices to observe IMIS in action. PDA has used the program for approximately five years.

We are awaiting word on a grant proposal submitted to the CFX Corporation Community Resources Award program by Liz Keith. She is seeking additional funding to supplement the current grants to operate the Donated Dental Services program. DDS continues to grow; Barbara Rollins, our newest staff member, assists Liz on a part-time basis.

The January Committee Meetings will also be January Committee Meetings Past by the time this is published. These annual meetings in Richmond involve all staff, but none more so than Bonnie Anderson. Bonnie prepares the materials for the Executive Committee, Executive Council, and the vast majority of the VDA Committees and has been occupied accordingly since we returned from Wintergreen and the Leadership Conference. So if all goes right in late January, it's to my credit - any problems ... talk to Bonnie.

We're all looking forward to 1999 and serving the VDA membership.

William Go Z.pp, CAE Executive Director


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REPORT ON THE ADA HOUSE OF DELEGATES II II Wallace L. Huff, D.D.S., Chairman of the Virginia Delegation to the ADA House

The 139th Annual Session of the American Dental Association held in San Francisco was a great success as more than 47,000 dentists, dental team members and guests from around the world were in attendance.

One of the reasons for these outstanding numbers was due to the popularity of San Francisco. But I believe that the primary reason was due to the popularity of the ADA President, our own Dave Whiston! Dave's leadership style has set a new standard for the office of the ADA President. He and Julie have worked tirelessly throughout the year on our behalf. They have made all of us proud to be a member of the ADA and on behalf of the Virginia delegation, I want to thank them again for their contributions to our profession

Dr. Timothy Rose, a periodontist from Appleton, Wisconsin was installed as the 135th President of the Association. Dr. Richard F. Mascola, a prosthodontist from Jericho, New York and currently serving as 2nd District Trustee on the ADA board of trustees, was elected by the house as President-Elect of the ADA in a four-way race.

Dr. Richard Smith a general dentist from Atlanta, Georgia was elected by the house as 2nd Vice-President of the ADA in a two-way race.

Candidates for the offices of the First-Vice-President and speaker of the House of Delegates ran uncontested as did trustee candidates for four districts. Elected unanimously were Dr. Bettie R. McKaig of Raleigh, North Carolina as first Vice-President and Dr. James T. Fanno from Canton, Ohio who was reelected to a fourth term as speaker of the House of Delegates.

The four new trustees are Dr. Howard B. Fine, 2nd District; Dr. Leo R. Finley, Jr., 8th District; Dr. Steven Bruce, 11 th District and Dr. Eugene Sekiguchi, 13th District. Dr. Rene M. Rosas is beginning his third year as treasurer of the ADA.

As anticipated, Resolution 99 as presented in board report 13 (Public Awareness Campaign) created the most activity on the house floor. With the approval of the HOD House Speaker James T. Fanno limited discussion of the measure to 30 minutes-- 15 minutes for those in favor of the Res. And 15 minutes for those opposed. At the end of the allotted time, twenty-eight (28) delegates had spoken to Res. 99.14 were in favor and 14 were opposed. But after all was said and done, Res.99 (the proposed three year, $30 million a year campaign) failed by a three-to-one margin 174 for and 309 against.

With Res.99 defeated, the HOD adopted Res. 100 which authorizes an additional funding of $982,000 to assist state

and local societies who want to adopt the campaign. Those states that want to participate in the campaign will be responsible for their own media buys.

Other resolves in Res. 100 are:

• that Jordan Associates (the Oklahoma-based advertising agency) and the ADA staff in consultation with the Council on Communications be available to help those states that wish to participate in the campaign.

• that new and existing campaign messages be tested through necessary research.

• that new products (broadcast and print) be developed based on research findings.

• that the appropriate ADA agencies meet with state dental associations to explain the program and to seek their input and participation.

• that the council on communications be in charge of accessing current and future public relations activities which may supplement public awareness advertising activities, particularly those activities related to consumer education.

• that a progress reporton the above program be presented in resolution form to the 1999, ADA HOD.

This years House of Delegates was particularly interested in the entire board of trustees budget presentation. The proposed budget was returned to the board of trustees during the second business session because the board requested a two dollar ($2.00) dues increase to balance an operating budget of $65,285,700.00. The House of Delegates wanted a balanced budget!

Other significant resolutions adopted by the 1998 House of Delegates concerning budget and business matters were: • The House of Delegates approved a 1999 budget of $66.8

million and a $17.00 dues increase. As of January 1, 1999, the ADA's membership dues went from $365 to $382.

• The $17 dues increase is projected to boost the 1999 revenues to $66,781,250 with anticipated on budgeted expenses of $66,777,500 which will leave a projected net surplus of $3,750.

• Res. 114S-1 urges the Board of Trustees to set the ADA's reserve at 30% of the association's annual operating budget.

• The proposed ADA headquarters Phase H asbestos abatement/renovation was amended and referred back to the board for review. This project (Res. 27RC) would have necessitated an additional dues increase of $62, for three years and will be considered by the 2000 House of Delegates.


Other key resolutions that were passed by the House: tice of dentistry as described in the 1996 house approved definition of professional dental care and the

• Res. 22 allows installment options for active and active 1997 definition of dentistry. life members to pay their dues.

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Res. 3 IBS-1 states that the ADA supports the alternate pathway model of dental hygiene education as used in Alabama; that a committee be formed to develop a workbook for creating alternate pathway models for dental hygiene as used in Alabama; and that this workbook (after being approved) be made available to all constituent and component dental societies, educational institutions and others.

Res. 325-IB urges the commission on dental accreditation to consider outcome-based evaluation of hygiene education programs and that the commission submit a report to the 1999 ADA-HOD's which identifies the exact outcomes assessments used to evaluate hygiene programs.

Res.38 amends ADA policy on the use of conscious sedation, deep sedation and general anesthesia in dentistry under the section on state regulation

Res. 56 urges all ADA constituents to submit formal proposals to their state dental licensing agencies to accept, for the purpose of licensure in their state, the completion of a licensure exam administered by any recognized individual state or regional testing agency.

Res. 59 calls for the ADA to urge its constituents to promote and support high-school level dental assisting programs approved through state vocational education recognition programs.

Res. 61 calls for the association agencies to study the feasibility of seeking legislation or regulations that would require licensed dentists to publicly disclose their proprietary connection with a DMSO or a dental practice not owned by a dentist.

Res. 94 urges the ADA health foundation to solicit proposals for the second phase of a research project on ascertaining acceptable levels of nitrous oxide in the dental office. Funding for the project will be sought from government, industry and other sources. The ADA will contribute up to $67,300 to help finance the research.

Res. 15 adopts a policy statement by the ADA on the health hazards of intraoral/perioral piercing. It also directs ADA agencies to continue both to monitor scientific literature on the subject and educate the public about those risks.

Res. 98 calls for the Board of Trustee's to direct the strategic planning committee to review the ADA strategic plan; 1998-2000 for the purpose of developing language that would reflectthe broadened scope of the prac-

The ADA House of Delegates considered more than 117 resolutions this year. I would encourage all VDA members to consult their ADA news (Nov. 16 and Dec. 14) issues for a more complete summary. In addition, please feel free to contact any member of our delegation if you have any questions concerning the actions of the 1998 ADA House of Delegates.

I want to thank all members of the Virginia Delegation for the hard work and conscientious effort each demonstrated at the district caucus in Durham, NC to the convention caucus, reference committee hearings and house of delegate sessions in San Francisco, California. Every member of the delegation demonstrated real responsibility to those who elected them- you, the members of the VDA. Everyone is to be commended fortheir preparation.

On behalf of the Virginia delegation, I want to thank:

Jack Sowter (NC) for his leadership as the 16th

District Caucus Chairman.

Faye Marley and Charlotte Johnson of the North Carolina Dental Society who made all the necessary arrangements for a productive and enjoyable meeting.

Our Trustee, Greg Chadwick who has been an involved and effective leader and has represented us with distinction at the ADA in Chicago.

A special thank you goes to:

The outgoing delegation members Gary Arbuckle and Raleigh Watson. Both Gary and Raleigh have played key roles in the success of the VDA delegation. Both have been an asset to our profession and the ADA. Both of them will be sorely missed, not only by the members of the VA delegation,but by all who have been fortunateenough to have served with them. Thanks for a job well done!

Dick Wilson, who chaired the reference committee on Dental Education and Related Matters. As always, Dick did a superb job in delivering his report to the ADA House of Delegates.

Ron Tankersley who served on the ADA reference committee of Dental Benefits, Practice and Health and also as Vicechairman of the ie" District Caucus. As always Ron was well prepared and did an outstanding job.

Joan Gillespie who served on the reference committee on Presidents' Address and Administrative Matters and is an outgoing member of the council on Ethics, Bylaws and Judicial Affairs.


Les Webb who is the outgoing Council on Dental Benefits For the VDA members information the 16th District passed Chairman. unanimously a motion that the district acknowledge the

memory of Pat Watkins' husband by each delegation donatAnne Adams who is the retiring Council on membership Chair ing to the Virginia Dental Foundation. (Executive Committee (Anne remains on the Council one more year). to determine amount of memoriam.)

Ellen Byrne-outgoing Council on Scientific Affairs member. The 1999 16th District Caucus will be September 24-26 at the (Ellen is not a member of the ADA delegation but I would like Boar's Head Inn, Charlottesville, VA. Our Executive Directo recognize her because she has done such a tremendous tor, Bill Zepp will be in charge of the arrangements. job for our profession at the local, state and national level.)

Will Allison who served as 16th District Teller in San Francisco and as Parliamentarian at the 16th District Caucus.

Bill Zepp our Executive Director who got us the best seats in the house at the ADA Presidential Dinner Dance.

Congratulations to:

Christy Hamlin who has been appointed to ADA Council on Ethics, Bylaws and Judicial Affairs.

Charlie Cuttino who has been appointed to ADA Council on Dental Benefits.

Bettie McKaig (NC) who was elected as First Vice President of the ADA.

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ADA PRESIDENT'S ADDRESS ~I ~] David A. Whiston, D.D.S., ADA Immediate Past President

For the American Dental Association to be successful, I believe we all understand that we have to be relevant, we have to be responsible and we have to be representative of this changing profession.

We've tried very hard to push for a sense of urgency within the Association this year to accomplish these goals - to be more relevant, responsible, and representative.

That includes a sense of urgency--eertainly on the membership side-in the scientific and legislative arenas and also, for a specific example, with our for-profit subsidiaries. We listened to you and, I believe, made some great progress by changing the structure of each SUbsidiary. l\Iow a volunteer-a non-trustee, non-staff volunteer dedicated only to that job-is the president of each of our for-profit subsidiaries.

I'd like to add that this was all done with the assistance and support of the executive director and senior management staff, with all of us understanding that we do a better job with increased volunteer input.

In some ways there's a similar sense of urgency at this year's House. And regardless of how we feel about the issues that we talk about, the important thing is that we're talking. The important thing is that we are asking members what they think. They're in the debate. For that reason alone, when we leave here we've got a big job to do; and we'd better do it with a sense of urgency.

For example: with the Public Awareness Campaign, obviously there are those for the campaign and there are those against it. Most disappointing of all, though, are those (and it cuts across all areas of the membership, including private practice, academics, federal services) who are using this proposal as a litmus test for deciding whether or not to stay in the Association.

So either way-and it's not just the Council membershipall have the difficult, complex job of explaining, really, a very simple fact: The profession of dentistry, as we know it, cannot exist in this country without the leadership of the American Dental Association. And the American Dental Association, as we know it, cannot exist without strong member support.

It's really very simple: the profession needs the American Dental Association and the ADA needs its members.

As we leave here, let's focus on that membership issue, and let's do it with a sense of urgency.

responsible manner in all of our areas of influence. And to accomplish these goals, we need to ask the right questions on every issue; we need to make decisions more quickly; and we need to make good decisions, always, always remembering that often saying no is the best decision we can make.

Let's look at a couple of examples here, first on the scientific side.

This year we were invited nationally and internationally to pursue initiatives that would compromise the integrity of the ADA Seal of Acceptance. Not that these things can't be rationalized at times. But it's a very comforting feeling to talk to Consumer Reports or Time or Newsweek and say, "No, we don't get a dime. Not only do we not get royalties on seal products, we don't grant the Seal exclusively to anyone. We reject thirty to forty percent of applicants. And our members foot about seventy percent of the bill."

When Barron's refers to ADA standards as higher than the FDA's, and when the AMA News refers to the American Dental Association as "long being held up as the model for health care products testing and endorsement," I think we all realize that our scientific integrity really stands for something, and we all realize we can't do anything that would compromise that integrity.

Let's look at another example of a time to say no, this time on the legislative front.

As you well know, after the evaporation of PARCA we were invited to go down several roads on the so-called patient protection front. At that time, the Republicans offered patient protection with essentially meaningless choice; and the Democrats promised some choice, with essentially no chance of achieving it.

We met or talked with all the players; on the Senate sideSenators Nickels, Kennedy, Daschle; on the House siderepresentatives Armey, Ganske, Linder, Norwood and Speaker Gingrich.

We heard what they said. We heard what they didn't say. And as the landscape got hazier and hazier, one thing became very clear. It was time to take a good hard look at our principles and what we stand for.

First and foremost is real patient choice. And let's just focus on choice for now, although we certainly have other principles such as plan accountability and anti-discrimination language.

Now-as we look to the future, it's our job to make sure that we're a relevant, representative association that acts in a


But our job is not to get credit for passing a specific bill-it's to help push the debate so we get the best protection for our patients.

When Senator Nickles was voicing his considerable displeasure over our original support of PARCA, we reminded him that without dentistry's grassroots, we wouldn't even be discussing these issues.

In fact, let's recognize the ADA grassroots effort for the progress we've made on these issues-especially the Georgia Dental Association and Charlie Norwood.

Then after leaving Senator Nickles' office, we heard from the other side of the aisle, as Senators Kennedy and Daschle and Representative Ganske explained their latest promise of choice, leading with the fact that the American Medical Association had already signed on.

The AMA, by the way, predicated their endorsement on "the five key factors that should be part of any truly effective patient's bill of rights." And they are all laudable goals:

1. full disclosure;

2. an end to physician gag clauses;

3. an external appeals process for patients over health plan decisions;

4. access to emergency services based on a prudent lay person standard; and

5. health plans accountability for their decisions.

If anyone heard the word choice in there, please raise your hand.

And this is not an AMAJADA face off. I'm just calling attention to the fact that our number one is not one of their five.

And most times-if it's a head to head issue-we lose. We lose for one reason, and that is a number and that number is seventeen. That's the seventeen million dollars that they've thrown at this issue over the past couple of years-just a little more than we've spent. And I don't want to minimize our role, because we have become a very important player in the health care arena; and we'll be more important as we return to the debate year after year after year. And there's no choice on that issue.

Somerset Maugham said, "It's a funny thing about life, if you refuse to accept anything but the best, you often get it."

That's certainly true on the scientific side, and it's often true on the legislative side. Compromise is such a way of life inside the Capital Beltway; but in these situations we answer to a higher power: our patients.

We've got a great story to tell. We have great principles and

our principles bring clarity to that hazy landscape, wherever it may be.

Thanks to you, I've had the privilege of delivering our message to the toughest media in this country, to the Senate and House, and to the Cabinet members and the President and the Vice President of the United States. And again, it's a great feeling of security to know that your statements are backed by the integrity and the strength of our Association and our profession. And that also is thanks to you.

So as we move forward in a relevant, responsible, representative way, let's aggressively pursue these goals. Let's maintain that integrity. Let's stand for our principles. Let's make the greatest profession in this country even better.

Thank you very much for the honor of representing you as president of the American Dental Association.

1999 VIRGINIA BOARD OF

DENTISTRY

The Virginia Board of Dentistry is appointed by the Governor and is composed of seven dentists, two hygienists and one citizen representative. Contact the Board office or a member of the Board on questions on rules and regulations.

Nora M. French, D.MD. Monroe E. Harris, Jr., DD.S. Michael J. Link, DD.S. French H. Moore, Jr., D.D.S. Edmund E. Mullins, DD.S. Gary Taylor, D.D.S. Richard D. Wilson, D.D.S. Carolyn B. Hawkins, R.D.H. Stephanie P. Olenic, R.D.H. Pat K. Watkins

STAFF Marcia J. Miller, Executive Director Pam Horner, Administrative Assistant Kathy Lackey, Administrative Assistant Lychia Morris, Office Services Specialist 6606 W. Broad Street, #401 Richmond, VA 23230-1717 (804)662-9906 FAX(804 )662-9943


NEW LAW HELPS HEALTH PROFESSIONALS WHILE PROTECTING PUBLIC

Mark Christie

The Health Practitioners Intervention Program (HPIP), enacted by the 1997 General Assembly with the support of the Virginia Dental Association has now been in effect for one year.' Based on my own experience representing healthcare professionals before regulatory boards, the new law appears to be working.

The legislative intent of the new law was to provide an alternative to disciplinary action for healthcare professionals such as dentists, dental hygienists, physicians, nurses and pharmacists who suffer from impairments whether physical or mental. The law defines "impairment" broadly, to include not only substance abuse, whether of alcohol or drugs, but also mental impairments such as severe depression.

Let's use a hypothetical example to illustrate the way the new law is supposed to work: Dr. John Doe has been a heavy drinker for several years and the effects of his drinking have become noticeable to his own staff and patients. A complaint is made to the Virginia Board of Dentistry, which initiates an investigation and disciplinary proceeding pursuant to its mandate to protect the public. Before the HPIP law was enacted, Dr.Doewould have had no altemative but to attempt to fight the Board's disciplinary proceeding or negotiate a consent order, which could have included a temporary or permanent suspension of Dr. Doe's license to practice dentistry.

With the HPIP law now in effect, however, Dr, Doe has an alternative to disciplinary action. Dr. Doe could voluntarily enter the program (sometimes called the "diversion" program). Dr. Doe would sign a participation agreement, which would require him to undergo an alcoholic treatment regimen monitored by a case manager. He may also be required to accept limitations on his practice or stop practicing dentistry altogether while undergoing treatment depending on whether he is considered a threat to the health and safety of his patients.

While Dr. Doe is participating in the program, the Board of Dentistry's disciplinary proceedings against him would likely be suspended. Ultimately, if his cooperation level remains high and his treatment shows indications of success, the Department of Health Professions HPIP Committee has the authority to grant an indefinite stay of disciplinary proceedings against him. If a stay is granted, no further

disciplinary proceedings will take place as long as Dr. Doe meets the conditions of the stay, which would likely include a requirement that he continue to seek treatment for his alcoholism.

Most important for Dr. Doe, there would be no action taken against his license to practice dentistry, thereby keeping his record clean and the proceedings and records of the HPIP Committee are considered confidential and not to be disclosed under the Virginia Freedom of Information Act.

The new law is intended to encourage healthcare professionals such as dentists and dental hygienists to seek help for their impairments. It provides a non-punitive alternative to disciplinary action. Often the key to whether the new law works is whether the healthcare professional is willing to cooperate fully and voluntarily with the HPIP program. If the healthcare professional violates the terms of his participation agreement, the HPIP Committee has the authority to dissolve the stay it previously granted, in which case the regulatory board with jurisdiction over the practitioner will resume disciplinary proceedings.

A key factor that the regulatory boards and HPIP Committee seem to be considering in applying the new law is whether the practitioner represents a present threat to the health and safety of the public. This is an appropriate factor to consider. After all, the reason we have health regulatory boards is to protect the public from incompetent or dangerous healthcare professionals.

When the new law works as intended, it represents a "win/ win" that gives impaired healthcare professionals a nonpunitive incentive to seek help for their problems, while at the same time protecting the public. The HPIP law is a positive step that will serve the interests of both healthcare practitioners and their patients.

1 Va. Code 54.1-2515 et seq., effective January 1, 1998.

(Mark Christie is an attorney with the Richmond-based firm of Williams, Mullen, Christian & Dobbins whose practice includes representing healthcare professionals before health regulatory boards. He was formerly chief counsel to Gov. George Allen.)


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FIVE WAYS YOU CAN HELP VDA LOBBY THE LEGISLATURE

Lisa M. Finnerty, VDA Public Affairs Coordinator

1. Join VA's Key Contact Legislative Network 3. Contribute to the Governor's Club

Do you personally know a state legislator, either in the Virginia House or Virginia Senate? If so, why not consider serving as a VDA Contact Dentist?

VDA Contact Dentists form an essential part of the VDA's legislative program, by providing one-on-one contact between the profession and members of the Virginia House & Senate, as well as members of Virginia's U.S. congressional delegation.

VDA will provide information on issues via phone, fax, email and mail for quick response as legislation moves through the Session. You provide the contact.

2. Contribute to VADPAC and the Commonwealth Club

Contribute to VADPAC and the Commonwealth Club. Your dollars fund the VADPAC contributions to legislative candidates who support dentistry's issues. A minimum $50 contribution automatically enrolls you as a member of VADPAC as well as the ADA's political action committee, ADPAC, which funds equally important contributions to congressional candidates. Your support of the Commonwealth Club provides VDA with the money needed for lobbying and VDA's key contact network. A $100 contribution is suggested in addition to the active VADPAC/ADPAC dues of $50.

Contribute to the Governor's Club, a higher level of giving to VADPAC. A contribution of $500 includes regular active VADPAC/ADPAC membership, active Commonwealth Club membership, ADPAC Capital Club membership, two tickets to the Annual VADPAC Leadership Dinner, and a private meeting & briefing with a key political figure.

4. Attend the Annual VADPAC Leadership Dinner

Dinner with legislators each year during the January Committee Meetings. A key political player is invited to be our keynote speaker to provide an update on the General Assembly and the state of the Commonwealth. In the past we have hosted the Governor, Lt. Governor, Attorney General and a Sr. VA Senator.

5. Attend the Annual Alliance Day on the Hill

The Alliance of the Virginia Dental Association annually goes to the State Capital to promote children's dental health month and dentistry in general. Legislators and staffers are presented with a Virginia apple and a dental health packet compliments of both the Alliance and the VDA. This is a perfect opportunity to educate legislators on VDA positions while at the same time promoting oral health.

VDA Legislative Key Contact Network

Phone: FAX: _ E-mail: _

Name of Legislator: Please list the name of any state legislator with whom you are acquainted and/or are willing to contact regarding dental issues:

How do you know this legislator?

Would you be interested in becoming a grassroots contact for an U.S. Senator or Congressman? If so, please list the name(s):

Return to: VDA, P.O. Box 6906, Richmond, VA 23230 or by FAX 804/353-7342


Dr. Guy Levy, PDS Immediate Past President, and wife Robin share a laugh with Delegate Phil Hamilton.

Members of the Tidewater Dental Association gather at their legislative social with honored guests: Senators Randy Forbes, Louise Lucas, Yvonne Miller, Frederick Quayle, Edward Shrock, Ken Stolle, and Stanley Walker; Delegates Harry Blevins, Jerrauld Jones, Chris Jones, Bob Purkey, and Robert Tata.

Jocelyn Lance presents Senator Walter Stosch from Richmond a contribution at the fundraiser held on his behalf.

Dr. Dave'Anderson and Dr. Bruc~J'Hutchison attend the....NVDS legislative brunch held at the Boyhood Home of Robert E. Lee which was attended by fifteen legislators.

ir~

MEDICAL MALPRACTICE CAP [I II Charles R. Duvall, VDA Lobbyist

On Friday, January 8, 1999, the Supreme Court of Virginia issued an opinion with regard to Virginia's Medical Malpractice Cap. It upheld a prior ruling that the cap on medical malpractice damages of $1 million is legal and valid.

The 1999 Session of the Virginia General Assembly, in spite of that decision, will see the introduction of legislation dealing with the cap. The Virginia Trial Lawyers Association will undoubtedly introduce legislation that will attempt to increase the existing $1 million cap significantly.

The Medical Society of Virginia and the Virginia Hospital and Health Care Association jointly plan to seek legislation designed to address those rare cases where a patient's medical fee may exceed the current $1 million limit.

Their proposal would allow an injured patient to have the choice of pursuing one of two options. First, an injured patient could choose to pursue a remedy for an injury seek

ing damages subject to a cap that would be increased by 25% ($1,250,000). The second option for an injured patient would be to recover future medical costs under a catastrophic plan. This is a plan similar to one that was introduced several years ago in the Virginia General Assembly. Though receiving unanimous support in the Senate, it was not voted out of the House Courts Committee.

The catastrophic plan would allow injured parties to choose to seek a $1 million cap on a malpractice award but receive lifelong payments for their medical fees (not to exceed $2.7 million) once their out-of-pocket actual medical expenditures had exceeded $300,000.

Obviously, the Trial Lawyers proposal to raise the cap and the proposal being advanced by MSV and the Virginia Hospital Association will be very aggressively debated and lobbied during the 1999 Session of the Virginia General Assembly.


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UPCOMING CONTINUING EDUCATION

Month Component Meeting Location SpeakerfTopic

Feb. 18, 1999 NVDS (8) CE Program/ Fairview Marriot Dr. George Blakey, "Dental Emergencies/ Dinner Pharmacology"

March 5, 1999 NVDS (8) CE Program Fairview Marriott Dr. John Svirsky, "Oral Pathology/ VDA co-sponsored Radiography"

March 12, 1999 Peninsula (2) CE Program Omni Hotel, Newport News Dr. John Svirsky, "Oral Pathology for the VDA co-sponsored Fun of It"

March 12, 1999 Southwest (6) CE Program Van Dyke Center, Emory Dr. Jeffrey Hutter, "Facial Space Infections of Dental Origin & Traumatic Injury Update"

March 18, 1999 Richmond (4) CE Program/ Embassy Suites Hotel, Dr. James Soderquist, "Orthodontics to Dinner Richmond Enhance Your Restorative Dentistry"

March 19, 1999 Shenandoah(7) CE Program Holiday Inn, Dr. David Sarrett, "Sticking to the Principles Winchester of Esthetic Adhesive Dentistry"

March 26, 1999 Richmond (4) CE Program/ Embassy Suites Hotel, Dr. Dan Fisher, "Everyday Adhesive Dinner Richmond Dentistry"

April 9, 1999 Tidewater (1) CE Program Holiday Inn, Dr. Dick Barnes, "Creating the Successful VDA co-sponsored Chesapeake Practice"

April 15, 1999 Richmond (4) CE Program/ Embassy Suites Hotel, Drs. James Schroeder and AI Stenger, Dinner Richmond "Successful Associateships"

April 21, 1999 NVDS (8) CE Program/ McLean Hilton, McLean Dr. Art Mourino, "Pediatric Dentistry" Dinner

Apr. 3D-May 2, 1999 Piedmont (5) CE Program/ The Homestead, Dr. Daniel Becker, "Update in Pharmacology Annual Meeting Hot Springs, VA for the Dentist"

May 14-16,1999 Southwest (6) CE Program/ Pipestem State Park, Dr. David Chance Annual Meeting Pipestem, WV

Aug. 13, 1999 Southwest (6) CE Program Higher Educational Center, Dr. Samuel B. Low, "Successful VDA co-sponsored Abingdon Management of the Perio Patient"

Sept. 17, 1999 VDA CE Program/ Hyatt Regency Reston, Dr. Dan Sullivan, Restoration of Annual Meeting Reston Implants

Sept. 18, 1999 VDA CE Program/ Hyatt Regency Reston, G.L. Johnson, Practice Annual Meeting Reston Management

Nov. 5, 1999 Southside (3) CE Program TBA 113A VDA co-sponsored

Nov. 12, 1999 Southwest (6) CE Program Donaldson Brown Dr. Michael V. Dishman, "Bleaching & ConferenceCenter, Cosmetic Dentistry" Blacksburg

AIDA C·E.R..P CONTINUING EDUCATION RECOGNITION PROGRAM The VDA is recognized as a certified sponsor of continuing dental education by both the ADA CERP and the Academy of General Dentistry.


MEMBERSHIP BENEFIT HIGHLIGHT [II II Kimberly S. Swanson, D.D.S., VDA Membership Task Force

The Annual Session of the American Dental Association offers over 160 continuing education courses on topics including the science, art, and practice of dentistry, dental technology, and quality of life issues. It is the premier dental meeting in the world. The next meeting will be October 9-13 in Honolulu, Hawaii and the 2000 meeting will be in Chicago on October 14-18.

In conjunction with the Annual Session, the ADA offers two unique pre-session programs. Technology Day presents over 25 programs on dental technology and methods for incorporating the technology into the dental office. The format includes lectures, question and answer sessions, and technology exhibits. The Team Building Conference is an opportunity for the dentist and staff to develop and enhance their most valuable resource- the dental team. This interactive program teaches dental teams to maximize the strengths of individual members and to maximize the strengths of individual members and to develop a common vision and cohesiveness.

For details, call the Annual Session 24-hour information line at 1-800-232-1432. For Annual Session course attendance verification, contact the Council on ADA Sessions and International Programs, extension 2745.

The 13th National Conference on the New Dentist will be July 29-31,1999, in Nashville, Tennessee. The theme for the conference is "Networking in Nashville ... Dentistry for a New Century". Course topics include practice management, clinical topics, professional issues, and leadership. Virginia Dental Association members who attended last summers' conference in Seattle indicated that they found it to be educational, fun, and very worthwhile. I encourage any interested VDA member to attend next years' conference. The Committee on the New Dentist also hosts the "New Dentist Committee Network Idea Exchange and Open Forum", a discussion format for new dentist issues and idea sharing. The nationwide New Dentist Network also helps new dentists get involved in organized dentistry. For more information about the conference, the forum, or the nationwide network, contact the ADA Committee on the New Dentist, extension 2779.

The "Calendar of Dental Meetings" is a complete and comprehensive listing of state dental society meetings and other dental meetings held throughout the United States and Canada. It is free to members through the Council on ADA Sessions and International Programs, extension 2745.

The ADA Commission on Dental Education assures the maintenance of rigorous and consistent educational standards. Many members have become directly involved in the accreditation process- a professional growth opportunity reserved for ADA members who are dental educators. Contact the Commission on Dental Education at extension 4660 for details on the nominating process.

A listing of advanced dental, postgraduate, and allied educational programs in the United States and Canada is also available through the Commission. This publication is free to members.

For more information on the many benefits of membership in organized dentistry, call the ADA at (312) 440-2500, or use the member-only 800 number listed on the back of your membership card. You may also call the Virginia Dental Association at (804) 358-4127 or 1-800-552-3886.

Membership matters!


BUDGET AND FINANCIAL INVESTMENTS COMMITTEE LETTER OF INFORMATION TO VDA MEMBERS

Raymond L. Meade, D.D.S., Budget and Financial Investments Committee Chairman

These are exciting times in the VDA. Our committee wants you informed and knowledgeable about how your dues are used and how other non dues income help support the VDA budget and programs. For your information the budget for the Virginia Dental Association for 1999 is over $764,000.00. The Budget and Financial Committee takes preparing a budget of this magnitude very seriously.

First the good news-since 1994 there has only been a $15.00 increase in general operating fund dues for the VDA. Non dues income from different sources as the MBNA credit card, VDA annual meeting, insurance sponsorships, specialist organization management, and investments have increased from about 15% in 1994 to just over 33% in the 1999 budget. The Budget and Financial Investments Committee has made some hard choices and worked with other committees to keep dues increases at the present level over the past few years.

What does the future hold? The VDA building has become crowded due to increased services and programs. The VDA Executive Committee has appointed a new building planning committee. Their charge is to determine what facilities the VDA will need in the future. The Budget and Financial Investments Committee has been charged with how to pay for it. We are looking for ideas. The plan is to have building plans and funding options to present to the 2000 House of Delegates. A new building is a big project that will require additional resources.

Other programs and activities are occurring in the VDA. In the Virginia legislative area our lobbying has been very effective and has required considerable funding. Additional funds for lobbying may be needed if we are to continue to keep our gains and deal with future issues. The DDS "Donated Dental Services" Program has been a success for dentistry in Virginia. The program was started by grants that are decreasing over a period of years. Where will the funds come from to continue this program? The VDA is presently searching for additional grants and/or corporate sponsorship so this program remains self-supporting. Also our committee is studying the amount needed in a capital reserve fund for an organization the size of the VDA and how to subscribe such a fund.

As you can see many different programs are in the future for the VDA and its members. You are probably thinking it sounds like there is a dues increase in the making. That may be true but our committee remembers what happened to the ADA awareness campaign and will justify any increases necessary.

The Budget and Financial Investments Committee is open you. If you desire to attend our meetings please feel free to come and share your insights. If you have comments or questions contact me or your component representative listed below. Also speak with your component Executive Council member or House of Delegates delegate because they are the ones who vote on our committee suggestions.

Budget and Financial Investments Committee Component Representatives:

James Baker (1) Gary Riggs, Jr. (2) Raymond L. Meade (3) Charles E. Gaskins, III (4) William W. Martin (5) David L. Stepp (6) Gerald J. Brown (7) Charlie French II (8)


DR NEWS I~ Connie Jungmann, VDA Assistant Executive Director

1998: A Year of Progress

Internal research conducted by the ADA in November 1998 has helped to assess the year's DR promotional efforts thus far, according to Ms. Maria Ellis, assistant manager of the ADA's Purchaser Information Service (PINSERV). "This year has seen a dramatic rise in the number of inquiries generated and in the number of DR plans implemented." For example, between January 1 and October 30, 1998:

Total number of inquiries generated: 5,282 Total number of new plans implemented: 223 Total number of new employees covered: 50,616 Total number of new lives covered in 1998: 118,756

Topping the number of new plans implemented in 1998 are California and Pennsylvania; Virginia, Louisiana and Nebraska top the list of most number of employees covered by new plans.

These statistics were reported in the December-January 1999 issue of the ADA's Direct Reimbursement News. The numbers reported were taken from the DR Lead Tracking Reports, as submitted by the states.

Virginia Advertising Enhances ADA's Campaign

As the ADA continues it's national advertising campaign for DR, the VDA has taken two of the ads currently being used and has modified them for the Virginia market place. The first of these full-page, full-color ads was placed last year in the Virginia Business Magazine, as well as the Virginia Health Care Buyer resource guide. The second ad, "'Save time, Save money, Save teeth" will be used during our 1999 print advertising campaign. A black-and-white version of this ad is provided on the facing page.

Four More Virginia Businesses Choose DR

The New Year is off to a good start for Direct Reimbursement with the announcement of four new DR plans put into place as of January 1.

Chesapeake Masonry Corp. - Newport News Referred by: Dr. Paul Orphanidys

Labat-Anderson, Incorporated - McLean Referred by: ADA direct mail campaign

Moseley, Harris & McClintock - Richmond Referred by: Dr. Edward Griggs

Rutherfoord Benefit Services - Richmond Referred by: Jon Swan, Benefits Administration

Our thanks to Dr. Griggs and Dr. Orphanidys for their time and efforts. If your office is interested in getting involved in promoting Direct Reimbursement, please contact Ronya Edwards or Connie Jungmann at the VDA Office. Brochures and other DR educational materials are available to VDA member dentist at no cost upon request.


Virginia Dental Association

The family that can choose any dentist it wants.

The H.R. manager who The boss who's pleased with can breathe a little easier. the bottom line.

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It helps you save time because it's easy for everyone

to understand, and there are no complicated claims

procedures. It can save money because, instead of paying

monthly insurance premiums, even for employees who don't

use dental benefits, you pay for actual treatment received. It

allows employees to get the treatment they need from dentists

they choose.

So you can offer a quality dental benefit at less cost and with

fewer hassles than ever before.

For information about a Direct Reimbursement plan deSigned to

meet the company needs you

DIRECT REIMBURSEMENT

speCify. just call 1-800-552-3886

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VDA NEWS [II

INTERNATIONAL COLLEGE OF DENTISTS CLASS OF 1998

The new Fellows of the International College of Dentists, Class of 1998 were inducted into the College at its annual meeting at the Hilton Towers Hotel, San Francisco, California on October 23, 1998.

Pictured: (front row) Ralph L. Howell, Jr., R. Leroy Howell, Sr., Guy G. Levy, Robert L. O'Neill. (back row) French H. Moore, Jr., Neil J. Small, Jay S. Lipman, Harold ~1. Neal, Jr. (not pictured) T. Wayne Mostiler, Augustus A. Petticolas, Jr., Frank R. Portell.

THE ALTON D. BRASHEAR POSTGRADUATE COURSE IN HEAD &NECK ANATOMY

A four-day course entitled "The Alton D. Brashear Postgraduate Course in Head and Neck Anatomy" will be held at Virginia Commonwealth University, School of Medicine, Department of Anatomy, March 8-11, 1999. The course is approved for 44 credit hours by the Academy of General Dentistry.

The course is open to any individual who holds one of the following degrees: MD., DD.S., PhD., or equivalent. The class size will be limited to 36. All applications will be processed in the order in which they were received.

Contact Dr. Hugo R. Seibel, VCU, Department of Anatomy, for an application (804) 828-9791.

SCHOLARSHIPS AVAILABLE

Dental auxiliary and student loan funds are available through the Virginia Dental Association. Scholarships up to $500 are available to Dental Assisting Students and loans up to $1000 are available to Dental Hygiene Students. If you are interested in an appliation or wish to learn more about the availabilty of these funds, please call the Virginia Dental Association Central Office (804) 358-4927 orfax (804) 353-7342.

IMPORTANT INFORMATION ABOUT YOUR 1999 MEMBERSHIP DUES STATEMENT

The ADA has advised that, based on guidance given from the IRS, a revised estimate of the non-deductible portion of ADA dues for 1999 is 8.9%, which is a change from the 9.2% figure shown on your VDA dues statement.

Only that portion of an association member's dues not attributable to lobbying activities is deductible as an ordinary and necessary business expense. 7% of VDA dues and 0% of component society dues is allocable to lobbying activities and therefore, nondeductible as a business expense.

\t' ~

Looking for info on upcoming CE courses?

What's happening at the VDA?

Want to learn more about Direct Reimbursement?

Visit the VDA's website for answers to these questions... and much, much more.

www.vadental.org


ALLIANCE NEWS [II I~ Jocelyn Lance of Richmond was installed as Treasurer of the Alliance of the American Dental Association during the organization's recent convention in San Francisco, California.

Mrs. Lance is a former Associate Membership Chair, Public Relations Chair and Legislative Chair and has held various elected and appointed leadership positions in local and state dental alliances. She is a Thelma J. Neff Award recipient, a distinguished service award for alliance members making outstanding contributions to their components. She currently participates in "The Woman's Club", "The Tuckahoe Woman's Club", and "Colonial Dames of America, Virginia Chapter".

Jocelyn is married to Dr. James Lance, an Endodontist in Richmond. They are the parents of three children, Brian, Stephanie and Christopher.

The Alliance of the American Dental Association (AADA), a national organization for spouses of dentists, promotes dental health through community involvement and legislative activities.

ASSISTANT NEWS ~I ~]

GLORIA CRIST RECEIVES NATIONAL AWARD

One of the highlights of each year's American Dental Assistants Association Annual Conference is the presentation of awards in various categories of achievement including the recently inaugurated American Dental Assistants Association/Sullivan-Schein Awards of Excellence. The award may be presented to as many as 12 ADAA members- one from each district- and from this pool of recipients a national winner is selected. This year, seven district awards were in addition to the national award.

National recipient for the ADAA/Sullivan-Schein Award of Excellence was Gloria Crist of Concord, VA. Ms. Crist was recognized in part for her leadership in the area of identifying continuing education professionals in the Lynchburg, Virginia area. She is the second national award winner. She was concurrently named winner of the District award for the ADAA's 3rd District which includes Delaware, District of Columbia, Maryland, Ohio, Virginia, and West Virginia. The national winner is chosen from among the winners of each ADAA:s twelve districts comprising over 15,000 members.

DR. JAMES WATKINS NAMED AS DANS DIRECTOR

The Dental Assisting National Board's Board accepted the American Dental Association (ADA) nomination of James D. Watkins, D.D.S., from Hampton, Virginia, to serve as a DANB director. Dr. Watkins is a general practitioner in Virginia and is a past-president of the Virginia Board of Dentistry. He also served on the ADA Commission on Dental Accreditation and the Council on Dental Education and Licensure. Dr. Watkins will serve a three-year term, ending at the conclusion of the 2001 annual meeting.

DANB's board of directors consists of nine members representing the American Dental Assistants Association (3), the American Dental Association (2), the American Association of Dental Schools (1), the American Association of Dental Examiners (1), At-Large Population of DANB Certificants (1), and the Public (1).


wanted to be heard from. I sent an e the next time we meet as to dates and ( COMPONENT NEWS ) mail to my congressman the day be location.

Component I Tidewater

Dr. Barry Einhorn, Editor

Happy New Year from Tidewater. Our component is looking forward to 1999 with great anticipation. Our program committee has prepared a very interesting series of continuing education programs, beginning on February 5th with Dr. Dean Elledge. His topic will be "Restorative Magic". On April 9th we will present Dr. Dick Barnes whose topic will be "Practice Management". These are two outstanding clinicians and we invite attendance from all VDA members. For further information please call Ginnie Donne at 757-491-4626.

Dr. Pam Morgan, chairperson for Children's Dental Health Month has scheduled an exciting series of events for the month. The highlight of the month's celebration will be a Fair to be held at the Virginia Marine Science Museum on Saturday, February 6th from 11 :OOam - 1pm.

VDA President-Elect Bud Zimmer has mounted a campaign to influence the state legislature to pass the assignment of benefits bill that will be coming up in this year's session. This is a patients' rights issue which we feel strongly about. I hope by the time this article is read we will be able to say our efforts bore fruit.

As I am writing this article the sun is shining and the temperature is 60°. It is hard to get the feel of winter under these conditions, but I know that the cold wind will blow soon, if not today. Unfortunately there is likely to be some frigid goings on in our nation's capital in the next few months. Let us pray that whatever the outcome, it will cause little disruption in all our lives. Perhaps that is part of the genius of our country, that we can weather political storms and move on to better days. Regarding the impeachment issue, I guess a lot of folks


fore the vote and his line was so busy that the message could not be delivered.

Have a great winter, we look forward to greeting you all in the spring.

Component II Peninsula

Dr. A.J. Booker, Editor

I don't know about you folks out there but I'd like to start something different. You see the holidays come at the same time of year that I'm suddenly too busy tying up loose business ends or cementing that forty unit bridge at the stroke of midnight. I say let's move all these festivities to the middle of January. At least it will liven up an otherwise dark and dismal month for us sailors!

However, there is a light at the end of the tunnel. And that light will be carried down interstate 64 by none other than Dr. John Svirsky on Friday, March 12 at the Newport News Omni Hotel. Dr. Svirsky's programson oral pathologyare always both informative and great fun. Anyone who misses the fliers on this course can obtain all the information necessary by calling the PDS office at (757)259-0594 or on the web at www.blackhairytongue.com.

Our Caribbean/Legislators night seems to have been another success this year. Especially for Dr.Jim Watkins who was the winner of a color TV donated by Benco Dental. It has been quite interesting to watch the communication grow between membership and our legislators.

Take one good idea - a picnic. Stir in lots of good food. Then top it off with a theme park and you have all the necessary ingredients for a spring outing the PDS is planning for its members and guests. Will keep everyone informed

Component II would like to welcome three new members to it's midst. Dr. Ed Owens, Dr.Brian Frandsen,andfrom the "Land of Lincoln", Dr. Raymond Flanders.

It's time to close for now with the wish for smooth sledding to all you skiers and snowboarders out there. For me, I'll just sit here with brandy in hand trying to figure out how to get around the course without hitting the buoys this year. I sure hope the power stays on - it's a long walk in the dark for a second brandy!

Component III Southside

Dr. Reed Boyd, Editor

I am writing these notes shortly after Christmas and before New Year's. We are recovering from an ice storm, supposedly the worst in five years. It started the Wednesday before Christmas. Power, phones, cable TV and heat were lost at midnight the Wednesday before Christmas and were restored to my home the Monday after Christmas. Some parts of Petersburg, including my office, do not have power yet, and do not expect power back until New Year's. Talk about the "Southside Shuffle", the temperature in my house got to 37 degrees, so we become homeless and started moving from motel to motel, all the while praying for power to be restored.

The first day or so camping out in the house was fun, cooking on the fire, sleeping in front of it, but after three days it did get old. Memories of times and days gone by...

Anyway, the Southside Dental Society continues to move on and stay active with many interesting and exciting programs and activities scheduled for

the next year. January will bring our annual Spouses' Night. This year we will have as our speaker Alexander Wise, the current Director of the Virginia Department of Historic Resources to talk to us about "Why Virginia's Historic Resources Matter to You". Should be interesting.

February 6 brings our National Children's DentalHealthMonth Celebration. Dr. Samuel Galstan is heading that up again this year and it will be a most successful event involving our Alliance members, the Component members, the Dental Division of the Public Health Department and of course, the MCV Dental School's van and students. Later in February on the 26th, we will have our annual OSHA and CPR Update and Recertification day. This has been a successful project from the beginning and a great membership recruitmentand retention tool. If the Component member's dues are paid in full by January 15, the OSHA Update course is free to them and their office staff. Then on March 24th, we will hold our Component Business Meeting. Nominations will be presented for next year's Component officers, as well as other business will be taken care of, I am sure that officers for statewide offices will join us as well.

We have scheduled several continuing education courses. On April 30,1999, we will present Suzanne Boswell who will talk on "Unmasking Your Mystery Patients". She will give her presentation at the Holiday Inn Koger Center in Richmond.

Then in June, Dr. Joe Tregaskes will be our speaker at our annual continuing education course held in conjunction with the Emporia Pork Festival. That is scheduled for June 9, 1999. Our final continuing education course scheduled for this year is to be held on November 5, 1999 at the Country Club of Petersburg. "Contemporary Concepts in Aesthetic Dentistry" will be presented by Dr. Doug Lambert. Please mark your calendars now and watch for information in the mail about these opportunities to join us to learn, have some fun and fellowship.

We in Southside Virginia hope that all of you had a happy, safe and joyous holiday season. In the throes of winter, be careful on the slopes and the highways. Here's hoping that everyone is enjoying a prosperous and great 1999. Get yourself ready for the new millennium. Be Y2K compliant, whatever that means and involves! Get more active in organized dentistry; take a role in the development of legislationaffecting dentistry. Make dentistry better for us as dentists and our patients, those we serve, the citizens of Virginia. Contact your legislators on the issues that affect dentistry and let them know how you and organized dentistry feel! Call Lisa Finnerty at the VDA office in Richmond for any information that you might need.

Hope to see you soon!

Component IV Richmond

Dr.Jack Dunlevy, Editor

New Year's greeting from your colleagues in Central Virginia. Component IV has begun 1999 with numerous program activities.

Our January monthly membershipmeeting featured Mr. John Fitzpatrick, attorney, who spoke about "Pitfalls of Documentation and Malpractice - Is Each Patient a Potential Lawsuit?" On February 5, Dr. Charles Blair presented a day longcourseentitled"ImprovingPractice Profitability."

February is Children's Dental Health Month and the Dental Alliance of the RDS is again assisting the Dental Health, Public Information and Community Involvement Committee in several programs. Component dentists assisted in a puppet show at the Science Museum of Virginia on February 20, a "Toothbrush Swap" at the Children's Museum and toothbrushes were do

nated to the Red Cross. The Component is appreciative of the combined efforts of Drs. Shari Ball, Charlie Thomas, co-chairs of the Committee, and Ms. Caroline Sweeney, President of the local Dental Alliance.

The March monthly meeting will feature Dr.James Soderquist, discussing "Orthodontics to Enhance Your Esthetic Dentistry." Another day long course is scheduled for March 20, when Dr. Dan Fisher, President of Ultradent Products, will be speaking on "Everyday Adhesive Dentistry." The April monthly membership meeting will feature two Component IV dentists, Drs. Jim Schroeder and AI Stenger who will discuss "Successful Associateships."

The Component expresses appreciation to the Alliance of the RDS, as well as to Drs. Anne Adams and Charlie Cuttino. The Alliance sponsored a dessert for Senate Majority Leader Walter Stosch at Anne and Charlie's home. We congratulate Dr. Monroe Harris, an Oral and Maxillofacial Surgeon, selected by Inside Business magazine as one of Richmond's "Top40 Under Forty,"for his various community activities. We also congratulate Russ and Rebecca Mosher on the birth of their daughter, Riley, on November 6.

Component V Piedmont

Dr. Barry Cutright, Editor

Begin your New Year by marking April 30 - May 1. 1999 aside for the Piedmont Dental Society Spring Meeting. Dr. Daniel E. Becker will be our guest speaker at The Homestead in Hot Springs, Virginia. His topic an "Update in Pharmacology for the Dentist," like computer technology, is a must know for us to evolve as practicing dentists.


Our society met on October 30, in Lynchburg,and Dr. David Feltonwas the guest speaker. Dr. Felton was an unusually effective prosthodontic lecturer. He didn't ramble. He could address succinctly yet thoroughly any prosthetic procedure from a scientific, materials, or clinical point of view. If you were unable to attend, make it a point to attend one of his lectures in the future.

A welcome to the following new members of the Piedmont Component:

Dr. John Carter Dr. Christine Mayhew Enright Dr. David Foley Dr. Richard Golden Dr. Paul Kiser Dr. Christine Roberts

Also, we welcome two new practicing dentists in Lynchburg, Dr. Jason Crist and Dr. Brad Sorenson.

During our fall business meeting Dr. Bill Martin was nominated for presidentelect in 1998-1999. Dr. Doug Price was nominated to serve on the executive council to represent Danville. Likewise, Committee Assignments include Dr. Dan Grabeel who was appointed to the Ethics and Judicial Affairs Committee. Dr. Grabeel will also serve on the VDA Foundation. Dr. Frank Crist will represent the Piedmont Dental Society on the Annual Meeting Committee.

Finally let's remember the contributions of three fellow dentistswho passedaway in the previous year, Dr. Doug Handy, Dr. Andy Lipford, and Dr. George Vaughn.

Correction to Component V news in the October-November-December issue: The names of Dr. Arthur Silvers, Dr. Norm Prillaman, and Dr. Denby Lewis were misspelled. This error was of no fault to the Piedmont Editor. The news should have read as follows:

Practicetransrtions-- Dr.Norm Prillaman has joined Dr. Richard Zechini in Lynchburg in the practice of Orthodontics. Dr. Pamela Baker has joind Dr. Arthur "Skip" Silvers in the practice of General Dentistry. Dr. Baker graduated

from MCV this past spring.

Welcome back to work Dr. Denby Lewis. Your dedication to dentistry and excellence continues to be an example for your colleagues.

Component VI Southwest

Dr. Robert G. Schuster, Editor

Winter has finally arrived in Southwest Virginia. A beautiful, mild fall season transformed itself with a smattering of ice and snow on Christmas Eve. The mesmerizing appearance of a crystalline landscapewould cause the onlooker to appreciate the beauty and peace of the season.

As the New Year of 1999 unfolds, we are reminded of achievements of the past year, and goals for a New Year. Our component is currently preparing for the winter committee meetings in Richmond, VA.

The first component meeting of 1999 will be held at the Van Dyke Center, in Emory, VA, on March 12. The featured speaker will be Dr. Jeffrey Hutter. His topic will be "Facial Space infections of Dental Origin and Traumatic Injury Update."

Our spring meeting will be held at Pipestem State Park and Resort in West Virginia on May 14-16. The featured speaker is Dr. David Chance. His topic will be "Crownand Bridge."This is a family weekend event which features a golf tournament, an old-fashioned barbecue, and the many amenities and activities offered by Pipestem Resort State Park.

Best wishes to all for a Happy New Year that will hopefully bring new challenges and aspirations.

Component VII Shenandoah Valley

Dr. Carolyn Herring, Editor

All are encouraged to attend the continuing education course "Sticking to the Principles of Esthetic Adhesive Dentistry" presented by Dr. David Sarrett, which will be on March 19, 1999, at the Holiday Inn in Winchester.

Look forward to seeing you there!

Component VIII Northern Virginia

Dr. Melanie Love, Editor

Happy New Year from Component 8! I hope the Holidays were healthy and happy for everyone. Northern Virginia has had a few bouts with some slick weather, but no blizzard yet!

We would like to welcome the following new members into the Dental Society: Dr. Deidre J. Maull, Dr. Shavaprasanna Rai, and Dr. Edward J. Strittmatter.

On a very sad note, we suffered the loss of two of our members. Dr. Zachary T. Gray, III, passed away on October 4 after a battle with leukemia. Also suffering from leukemia, we lost Dr. Sameh K. Hanna on December 22. We know they will both be missed.

Component 8 has a busy winter schedule with New Member orientation on January 20; an ali-day meeting with Dr. Gerard Chiche on January 29, speaking on "Recipes for Predictable Anterior Esthetics"; and Dr. George Blakey presenting an evening meeting on "Dental Emergencies/Pharmacology." The NVDS VDA Fellows will host a dinner for new members on February 8. Kathleen Todd, Esq., Director of the ADA Council on Ethics, Bylaws and Judicial Affairs is the featured speaker.


The Committee on the New Dentist will host an evening with Dr. Dave Whiston for current members and non-members on February 24. An appreciation party for Dr. Whiston is being planned.

VAO NOTES (~--'"') Dr. Robert Miller, Past President

As winter falls fast upon us, final arrangements are being made for the annual winter seminar this January in Big Sky Montana. The featured speakers have planned a variety of topics that will interest both the dentist and orthodontist alike. I would encourage everyone to consider this CE opportunity next year which will likely return to Colorado!

Plans are also well underway for the upcoming annual meeting for the VAO annual meeting this summer at Kingsmill Resort in Williamsburg. The dates to mark on your calendars are June 26-30th . This years meeting will be "family friendly" with lots to do for everyone. Many thanks to Alan Bagden, VAO President, who has planned both the location and the events. Also thanks to Rod Klima for arranging our speaker, Dr. Wick Alexander, an orthodontist known worldwide. His discussion topic for 2 days is "Practice Pearls and Secrets to Ultimately Finishing Cases". Rod reports Dr. Alexander cancelled a speaking engagement in Japan over the favored Kingsmill, Williamsburg location! Complementing Dr. Alexander will be Mr. Lou Walensky, a financial expert and friend of Dr. Bagden. His topic includes how to achieve and maintain wealth. Along with these great speakers, our traditional golf tournament will occur at Kingsmill's famous River Course. Also, an evening of "dine around" in Williamsburg followed by a ghost tour of Colonial Williamsburg will highlight the social portion of this meeting. Free shuttles will be provided to Colonial Williamsburg and Bush Gardens in conjunction with the opening reception and great fellowship with other member's promises to make this more

than just another VAO meeting! If you are a "regular" at the VAO meetings or a newcomer, plan now to attend. These meetings have been the highlight of being a VAO member for me personally over the last 10 years.

Special congratulations go to Orin Clifton, who very deservedly was awarded the Southern Association of Orthodontists Citizenship Award this past fall in Asheville, NC. This is awarded to the orthodontist in the southern region who has contributed greatly to their community in the good name of orthodontics. At the same meeting, Bill Wallert was awarded the SAO's highest honor as he was bestowed with the Orin Oliver Distinguished Service Award (the first ever from Virginia), recognizing his many years of contributions to the society. Knowing both of these men professionally and socially, I can think of no two other Orthodontists in the Commonwealth more deserving for these high honors. I want to personally congratulate them and their families for representing Virginia!

I would also like to thank Dr. Alan Helwig for Leading the SAO last year as president. Also many thanks to Steve Garrett, who continues to serve us so well as Director to the SAO. Also, Eddie Ross who is always present at both Board of Director meetings and UVA football games, but more importantly serving as our Delegate to the AAO.

Dr. Michael E. Miller, President

As I write this note I feel quite fortunate to have the electrical power to do so, knowing many of my colleagues in Virginia may not be so lucky due to the blanketing of ice that has recently plagued our commonwealth. For those who spent some of the holidays under candlelight and kerosene heaters, I'm sure the coming of Spring will be a welcome sight indeed.

The VSOMS Executive Committee convened on November 11, 1998, where a number of pertinent issues were addressed. Communication with the VDA Legislative Committee led to the prudent deferral of the definition of dentistry issue to the 2000 Legislative Agenda. A seminar on implant dentistry sponsored by the VSOMS and presented to the MCV third and fourth year dental students will be held at an MCV campus site, featuring Drs. James Nelson and Harlan Schufeldt. The final date is pending at the time of this publication, but this will likely occur in March 1999. The combined VDNVSOMS Meeting being held in Reston, Virginia, September 15 -19, 1999, is expected to showcase Dr. Dan Sullivan discussing a variety of aspects of implant dentistry, as well as G.L. Johnson, a well-received lecturer on practice management with regards to implant dentistry. The highlight of the Executive Committee Meeting was undoubtedly a speakerphone conversation with Dr. Jim Priest, who continues to exemplify courage and stamina in his steady recovery from paralysis as the result of Guillain-Barre Syndrome.

In the "Thanks for your knowledge, diligence, and watchful eye" department, the VSOMS recognizes Dr. Charles Cuttino for his attendance as ADA liaison dentist at last years (1998) American Medical Association meeting. Dr. Cuttino's experience and educated input on issues such as anesthesia and bottled water (a fluoride issue) became instrumental in AMA decision-making on these topics of concern to the dental community as well.

On a somber note, the VSOMS has recently lost two of its members. Dr. Harry J. Dennis of Virginia Beach died December 12, 1998; he was a retired Life Member of the VDA and had practiced both in the U.S. Navy and in l\lewport News. Dr. Sameh Hanna, who practiced in Sterling and Leesburg, Virginia, died on December 22, 1998 from complications of leukemia. Our condolences to their families and friends.


VSOP NOTES ('----') RICHMOND PERIODONTIST

RECEIVES HIGHEST HONOR FROM THEAMER~ANACADEMYOF

PERIODONTOLOGY

J. Gary Maynard, Jr., D.D.S., a periodontist from Richmond, VA, is the 1998 recipient of the American Academy of Periodontology (AAP) Gold Medal Award, the highest honor bestowed by the Academy.

The Gold Medal is given annually in recognition of outstanding contributions to the field of periodontics. Maynard received the award, funded by the John O. Butler Company at the AAP's 84th

Annual Meeting in Boston.

A past president of the AAP, Maynard is a member of the Board of Directors of The American Academy of Periodontology Foundation and, for 1997-1998, was the chairman of The American Board of Periodontology. He also has served as president of the Virginia Society of Periodontics, the Southern Academy of Periodontology, and the Richmond Dental Society. He was the recipient of the AAP Presidential Award in 1996 and the AAP Special Citation Award in 1990.

In addition to his private practice, Maynard is a clinical professor of periodontics at Virginia Commonwealth University. He has published numerous articles in professional journals and lectures extensively in the United States and abroad.

Maynard received his AB degree from Davidson College in 1958, his dental degree from the Medical College of Virginia School of Dentistry in 1962 and his certificate in periodontics from the University of Kentucky College of Dentistry in 1967. He has been in the private practice of periodontics in Richmond, Virginia since 1967.

The American Academy of Periodontology is a 7,000-member association of dentists specializing in the prevention, diagnosis and treatment of diseases affecting the gums and

supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of the eight dental specialties recognized by the American Dental Association.

( PUBLIC HEALTH NOTES)

Dr. Karen C. Day, Director Division of Dental Health

The staff of the Divisionof Dental Health, Virginia Department of Health, has been busy during 1998. The main focus of our activities continues to be the prevention of oral disease in Virginia. The water fluoridation program monitors 136 communities in Virginia that fluoridate drinking water. During 1998, the communities of Hillsville, Fries, Clarkesville, Keysville, and South Boston were assisted with upgrading fluoridation equipment to maintain optimal fluoride levels. More than 43,000 children in areas without the potential to fluoridate participated in the topical School Fluoride Mouthrinse Program. New programs were established in schools in Warren, Clarke, Nelson, Powhatan, Alleghany, Russell,Buchanan, Dickenson,Bedford, Wythe and Bland Counties. Guidelines and new educational materials for this program, including a display and brochures, were developed and distributed. Thirteen dental sealant projects funded by the Division provided nearly 13,000 sealants for 3,000 children in Virginia's schools. Finally, workshops regarding oral hygiene, nursing bottle caries, fluoride, smokeless tobacco prevention and dental sealants were provided for public and private associations. I look forward to a productive year working with members of the Virginia Dental Association in 1999.

SCHOOL OF DENTISTRY NOTES

Tom Burke, Assistant Dean

WHITE COAT CEREMONY HELD

The School of Dentistry recently established a new and significant event for first year dental students and third year dental hygiene students. This event entitled the "White Coat Ceremony" was held on January 8th at the Medical College of Virginia Alumni House. The White Coat Ceremony is an event at which entry level dental and dental hygiene students are officially presented their white clinic jackets. This presentation signifies their entrance into clinical dentistry and the treatment of patients. The event, hosted by Dean Ronald Hunt, featured a keynote presentation by Dr. W. Baxter Perkinson, Jr. Dr. Perkinson delivered a thoughtful address on the role and responsibility of the practitioner in delivering quality patient care. He welcomed the students to the profession of dentistry and suggested that they conduct themselves professionally while treating their patients with dignity and respect.

The presentation of the white clinic jackets followed Dr. Perkinson's address, Dr. Marshall Brownstein called students forward, where they were presentedwith their clinic jackets by Drs. Ronald Hunt, Betsy Hagan, James Revere, and James Hardigan. Ms. Janet Scharer presented the Dental Hygiene students who also were coated. For some students, a dentist parent presented the coat.

An important component of the event was the administration of the dental and dental hygiene oaths. Dr. Robert Strauss, administered the dental oath and Ms. Janet Scharer administered the dental hygiene oath. The oath for dentistry, was developed by faculty and students from the School of Dentistry, and has been approved by the American Dental Association as the official oath for dentistry.

A reception followed the ceremony for students, faculty, and guests in the alumni house parlors.


NEW RESEARCH STUDIES UNDERWAYAT SCHOOL

Department of General Practice Begins Class II Composite Trial

As new product technology evolves the School of Dentistry stays on the cutting-edge by participating in the research and evaluation of these innovative products. The Department of General Practice has received a grant from the Kerr Corporation to complete a clinical trial on their new Prodigy Condensable composite material. The trial will involve placement and follow-up recall of 50 class II restorations in premolars and molars. The primary investigator on the project is Dr. David Sarrett, who will be assisted by co-investigators Dr. Carol Brooks and Dr. Jennifer Rose. This study is a result of an AD Williams research project conducted over the summer by Dr. Peter Moon, which focused on evaluating and comparing several new composite materials. The results of Dr. Moon's research will be presented at the International Association of Dental Research meeting in March.

Department of Oral Pathology Studies Effectiveness of

New Oral Rinse

The Department of Oral Pathology is also conducting a research project for 1-DENT INTERNATIONAL to evaluate a 0.07 Triclosan-based Mouth Rinse in the treatment of common oral ulcers. Although there are many topical agents on the market today for the treatment of lesions like recurrent aphthous ulcers, this project will investigate a mouth rinse which will be evaluated in a multicenter, double-blind, placebo-controlled group study. Dr. James Burns, the principal investigator, says that this study is potentially the final step in the FDA approval of a new over-the-counter drug for the treatment of common oral ulcers.

UPCOMING SCHOOL EVENTS

Donor Recognition Dinner

On March 26, the School of Dentistry will host its first Donor Recognition Dinner at the Country Club of Virginia. This recognition dinner is being planned to acknowledge and thank donors who have supported the School of Dentistry with gifts and pledges to the "Excellence Through Research-An Investment In Our Future" Campaign. It will also provide us an opportunity to thank other major benefactors of the School. A very special guest will provide the keynote address at the inaugural event. Dr. Harold C. Slavkin, Director of the National Institute of Dental and Craniofacial Research in Bethesda will be our honored guest and speaker. Dr. Slavkin is internationally known for his entertaining and knowledgeable presentations. We are indeed fortunate to have him join us on this special evening.

Homecoming 1999

The 1999 Homecoming for School of Dentistry Alumni in classes ending with a 4 or 9 will be April 23-25. The reunion activities are scheduled for the Omni Hotel in Richmond. The festivities will begin with a reception on Friday evening and continue through the week-end culminating with the reception, banquet, and dance on Saturday evening. The School of Dentistry continues to have the largest returninggroup and we would like to see this continue in1999! If you have questions concerning this year's reunion activities you may call your class captain listed below or the MCV Alumni Association offices at (804) 8283900. We look forward to seeing you in April.

Class of 1949 TBA

Class of 1954 Dr. Charles Fralin

Class of 1959 Dr. Madison Price

Class of 1964 Dr. Kenneth Copeland

Class of 1969 Dr. S. Weldon Brown III

Class of 1974 Dr. James Wallace

Class of 1979 Dr. Arden Sterling

Class of 1984 Dr. Kanyon Kenney

Class of 1989 Dr. Richard Vacca

Class of 1994 Dr. David Montgomery & Dr.Tamara Langebeck

Drs. Hunt and Revere assist freshmen students on with their clinic jackets during the White Coat Ceremony.

Freshmen Dental Students recite the Oath of Dentistry as part of the White Coat Ceremony under the watchful eye of parents and guests. The Dental Oath was developed at VCU. and is now recognized as the official oath of dentistry nationwide.


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Classified Advertising

Classified advertising rates are $30 for up to 30 words. Additional words .25 each. All advertisements must be prepaid and cannot be accepted by phone or fax. Checks should be payable to the Virginia Dental Association. The closing dates for all copy will be the 15th of December, March, June, and September. Example: March 15, at 5pm is the closing date for the April-May-June Journal issue. After the deadline closes, the Journal can accept no ads nor can it alter or cancel previously ordered ads. This deadline is firm.

As a membership service, ads are restricted to VDA and ADA members and are restricted to non-commercial copy. Advertising copy must be typewritten and sent to: Journal Classified Department, Virginia Dental Association, P.O. Box 6906, Richmond, VA 23230-0906.

The Virginia Dental Association reserves the right to edit copy and

does not assume liability for the contents of classified advertising.

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