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CDA Journal - May 2004



                                                                                                                         Photos: Steve McClelland Photography
               Fresh Concepts in
                 Dental Design
  today,                     ecently celebrating its one-     the center that delivers dental care to
                             year anniversary, the USC        approximately 150 patients a day.
yesterday.”   R              School of Dentistry Oral
                             Health Center serves as a
                             model facility designed to
              attract quality faculty, increase student
                                                                  According to USC Dean Harold Slavkin,
                                                              DDS, the 12,500 square-foot facility “looks
                                                              like today, not yesterday.”
                                                                  Slavkin came to USC with a grand design
              enrollment and take the anxiety out of          to recruit and retain top faculty by providing
              going to the dentist.                           a private-practice environment offering high-
                  A waterfall, stylish wood paneling, indi-   quality care focused on restorative and cos-
              rect lighting and concierge greet visitors to   metic dentistry. An equal goal was to create a
                                                                      MAY . 2004 . VOL . 32 . NO . 5 . CDA . JOURNAL   365
                                                model center for the highest                                        which reinterprets the cam-
                                                level of care and make it                                           pus’ traditional design in a
                                                accessible to the surround-                                         modernist way favoring
                                                ing community as well as                                            exploration of new materi-
       directive was                            the university community.                                           als, ample space, fresh color
                                                    According to Slavkin,                                           pallets and seamless integra-
          to “design                                                                                                tion of technology and beau-
                                                there has been a conceptu-
         a state-of-                            al shift in the way dentistry is practiced        ty. To create an optimal patient experience,
                                                today. In the past, dentists were trained to      the designers dedicated special attention to
      the-art faculty                           diagnose quickly and spend significant time       creating inviting visual elements, soft light-
      dental practice                           on treatment. Now, an ounce of prevention         ing, acoustics and visual privacy.
                                                goes a long way.                                      A large concern was to alleviate patient
            with the                                “We take a very careful, detailed             fear that can be aggravated by shrill noises
                                                approach to health promotion, risk assess-        and pungent odors. Care was given to low-
       ambiance and
                                                ment, disease prevention, diagnostics, treat-     ering patient anxiety through design ele-
       service of a                             ment and therapeutics, and outcomes               ments such as strategically placed foun-
                                                assessments,” Slavkin said. The 21st century      tains, vaulted ceilings, soft lighting and tex-
       Ritz-Carlton                             is about health outcomes. To ensure the best      tured walls.
             Hotel.”                            outcomes, facilities need state-of-the-art            Directing the new center is former CDA
                                                equipment, optimal patient experience and         President Jack Broussard, DDS. Former CDA
                                                proper technology to support administrative       Speaker of the House Sig Abelson, DDS, is
                                                         management.                              practice administrator. These individuals
                                                            To support a vision of this scale,    bring more than 60 years of combined prac-
                                                         the school of dentistry needed a         tice management experience and leadership
                                                         more appropriate venue to house          skills to the center.
                                                         both a group faculty practice and             “Our patients are in awe of the beauty
                                                         an Advanced Education in General         of the center,” Broussard said. “Our faculty,
                                                         Dentistry teaching clinic under one      residents and staff are committed to becom-
                                                         roof. What’s more, the center would      ing a valued asset to our community and to
                                                         function in concert with the current     our university.”
                                                         teaching and leaning agenda of               The center includes features such as dig-
                                                the school of dentistry, which includes           ital imaging equipment, digital radiogra-
                                                health promotion, risk assessment and dis-        phy, microscopes and intra-oral cameras.
                                                ease prevention.                                  Current data on caries prevention and
                                                    The challenge was to turn an ordinary         strategic design focused on patient relax-
                                                space into an aesthetically beautiful and         ation are all touches expected to help attract
                                                nurturing environment, yet make it func-          quality faculty as well as increase student
                                                tional enough to house 24 operatories, diag-      enrollment and enhance the equity of the
                                                nostic equipment and a planned Center for         downtown Los Angeles area.
                                                Dental Technology.                                    “In just one year, the center has
                                                    Slavkin’s directive was to “design a state-   increased its practicing faculty from 13 to 27
                                                of-the-art faculty dental practice with the       individuals.” Abelson said. “Some of the
                                                ambiance and service of a Ritz-Carlton Hotel.”    finest clinicians in the world have joined our
                                                    The Neiman Group, a Los Angeles-based         faculty practitioners.”
                                                architectural firm, was selected to bring             The center opened its doors in January
                                                Slavkin’s vision to life. The firm’s influence    2003 and has successfully integrated into
                                                led the university down a new stylistic path,     the Los Angeles health-care community.

366   CDA . JOURNAL . VOL . 32 . NO . 5 . MAY . 2004
Managing the Amelogenesis Imperfecta Patient
    A rare developmental abnormality of         enamel thickness and degree of mineraliza-
the tooth enamel, amelogenesis imperfecta       tion, and the ability of restorations to bond
(AI) patient occurs in about 1:4,000 to         sufficiently to the affected enamel; as well as
1:14,000 people in the Western populace.        the strength of attachment of the enamel to
Dental features associated with the condi-      dentin and dentin quality.
tion range from pulpal calcification, tau-          The article further notes that children
rodontism and root malformations, quan-         and young teens can display the gen-
titative and qualitative enamel deficien-       eral features of AI, but may not be
cies, failed tooth eruption and impaction       similar in young adults where caries
of permanent teeth, congenitally missing        and noticeable sensitivity may result
teeth, anterior and posterior open-bite         from widespread exposed dentin in
occlusions, as well as progressive root and     permanent teeth.
crown resorption.
    In an article in The International                                                              G
Journal of Prosthodontics, managing                                       e                                             h
AI patients can be complex. That is                        c
why authors suggest that those in
the prosthodontic profession can
have a major role in the rehabili-
tation of rare disorders.                       B
    Among the recommendations is
that treatment of AI patients should
begin with early diagnosis and inter-

                                                                                                                                                   Illustration: Matt Mullin
vention to prevent later restorative                             d
problems. The authors acknowledge
some patients might not seek treat-
ment until later when advanced
tooth wear and the associated tooth
sensitivity, functional and esthetic
problems have already occurred, lead-
ing to numerous years of complex
restorative treatments.
    Authors noted that poor oral hygiene
                                                    Tax Credit Available for Disabled Access
associated with gingivitis and gingival                 Dental practices, like all small commercial enterprises, are entitled to a non-
hyperplasia may be factors adversely                refundable disabled access federal income tax credit for expenses incurred in
affecting restoration management. Poor              making a business accessible to the disabled, according to consultant Milt Zall
oral hygiene may stem from tooth hyper-             in the January/February 2004 issue of Chicago Dental Society Review.
sensitivity and the presence of an anterior             The credit is half the amount of eligible access expenses for a year that
open-bite associated with breathing
                                                    exceeds $250 but under $10,250. An eligible small business is one that claims the
through one’s mouth.
                                                    disabled access credit and during the preceding tax year had either gross receipts
    When performing restorative work on AI
                                                    (minus allowances and returns) of $1 million or less or no more than 30 full-time
patients, aspects to contemplate include loss
of occlusal vertical dimension and degree of        employees.
dentoalveolar compensation; size of the pulp            Qualified expenses include the cost of removing architectural, transporta-
chambers and amount of occlusal and inter-          tion or communication obstacles preventing disabled individuals from access-
proximal tooth wear; number, color, form,           ing or using a business.
sensitivity of the affected permanent teeth;

                                                                                                MAY . 2004 . VOL . 32 . NO . 5 . CDA . JOURNAL   367
                                               Successfully Terminating the Dentist-Patient Relationship
                                                   Ending a dentist-patient relationship car-   ter one week before the scheduled treatment.
                                               ries the same cautions about refusing treat-         In the letter, the dentist also must offer to
                                               ment to a new patient. In either case, the       provide emergency care for a “reasonable
           The dentist,                        dentist must be careful to avoid potential       period” such as 30 to 90 days following the
                                               legal claims, said Keith                                               notice of termination,
             in ending                         Kerns,    Ohio     Dental                                               and inform the patient
                                               Association director of                                                 they have the right to
       the relationship,                       Legislative and Legal                                                    view or obtain a copy of
                                               Services, in January’s                                                   dental records includ-
      must not abandon                         issue of ODA Today.                                                      ing impressions and X-
                                                   The dentist, in end-                                                 rays. Additionally, the
            the patient.                       ing the relationship, must not abandon             dentist should offer to forward the docu-
                                               the patient. If they do so, the dentist can be   ments, upon the patient’s written request and
                                               held liable for abandonment by their failure     authorization, to the new dentist.
                                               to give adequate notice to the patient and           It is helpful, Kern said, to recommend
                                               refusal to provide treatment proximately         the patient contact the local dental soci-
                                               causes injury.                                   ety in obtaining a referral to another
                                                   Kern recommended not terminating the         dentist. The letter should be sent via cer-
                                               relationship during the patient’s course of      tified mail. Following these simple guide-
                                               treatment and giving them plenty of notice.      lines, Kerns said, can reduce the dentist’s
                                               For example, do not send a termination let-      exposure to liability.

368   CDA . JOURNAL . VOL . 32 . NO . 5 . MAY . 2004
Bridging the Billing Gap for
    A technique has been developed in
Michigan that may help dentists
meet their patients’ request to bill
part of a bridge in the last months of
one year and for the remainder in
January of the following year.
    In the Kalamazoo Valley District
Dental Society’s Gutta Percha Clarion, Keith
Konvalinka, DDS, suggested that in placing a
three-unit bridge instead of preparing both teeth, a dentist
might prep one and send it off. Rather than having the usual crown
made, the lab can create a bridge abutment with the female portion of an MS attachment.
The dentist may then request the lab fill the slot with acrylic so in the interim it doesn’t
become a food trap. The dentist can cement it in, bill it as an abutment with precision
attachment and be finished for the year.
    At the beginning of the next year, the other abutment can be prepped. This time, an
impression should be taken with attention to capturing the entire cavity of the female
attachment by syringing impression material into the slot fully. Or, if the lab prefers,
using an abutment, pontic and the male end of the MS attachment.
    Insurance annual maximums often times do not cover the price of a full bridge. This
leaves patients seeking to eliminate or reduce their portion of the cost. Dentists typically
are forced to explain that bridgework has to be billed to insurance as one unit. By utiliz-
ing this technique, Konvalinka said, a dentist can successfully bill two halves of a bridge
in two insurance cycles.

Pacific Awarded Recruiting Grant
    The W.K. Kellogg Foundation and                  Not only will the Access to Dental
American Dental Education Association            Careers grant make available low-cost
Access to Dental Careers grant of $100,000       loans to select students and enhance
has been awarded to the University of the        Pacific’s recruiting activities including
Pacific School of Dentistry to assist with the   identifying and recruiting
recruitment of under-represented minority        applicants at colleges and
and low-income students.                         universities with popula-
    “This award is a great complement to the     tions of pre-dental, under-
applicant recruitment, community educa-          represented      and    low-
tion and curriculum enhancement aspects of       income students, it will
Pacific’s Pipeline program,” said Paul           provide counseling to
Glassman, DDS, associate dean for informa-       applicants with the hope
tion and educational technology and princi-      of improving their qualifications either in
ple investigator for the Pipeline program        the pre-dental stage or at the start of the
and Access to Dental Careers grant.              application process.
    The award enhances Pacific’s current $1          Pacific is committed to addressing the
million grant project, the California            shortage of dentists from underserved and
Initiative Dental Pipeline program, which        low-income populations, a major issue fac-
in addition to recruiting under-represented      ing California as well as throughout the
and low-income students also strives to pro-     U.S. By recruiting more students from these
vide dental students and residents in com-       communities and helping them succeed
munity clinics with more experiences in          will benefit the diverse areas within the
helping underserved populations.                 state as well as across the country.

                                                                                           MAY . 2004 . VOL . 32 . NO . 5 . CDA . JOURNAL   369
                                                Ross Award Nominations Due by June 1
                                                    The deadline to nominate a dentist for                    explicitly describe
                                                their strides in periodontics, orthodontics,                  the influence of
                                                oral pathology, oral and maxillofacial                        the research on
                                                surgery as well as other clinical research                    clinical    den-
                                                areas is June 1.                                              tistry. A curricu-
                                                    The Norton M. Ross Award for Excellence                   lum vitae with a
                                                in Clinical Research recognizes those who                     list of published
                                                have notably improved the diagnosis, treat-                   articles must be
 C.E. Credits Online                            ment and/or prevention of craniofacial-oral-                  included. Send
      The University of Colorado                dental diseases.                                              the nomina-
                                                    Last    year’s    winner,   periodontal                   tion to Marcia
School of Dentistry, in partner-
                                                researcher Robert Genco, DDS, PhD, won for                    Greenberg, American
ship with the Journal of the                    his work on the link between oral disease                     Dental Association, 211 E. Chicago
American Dental Association,                    and cardiovascular diseases.                                  Ave., Chicago, Ill., 60611. For more infor-
has developed an online con-                        Selection is based upon the scope of                      mation, call the ADA at (800) 621-8099,
                                                research completed with its impact on clini-                  Ext. 2535.
tinuing education module.
                                                cal dentistry, and the nominee’s publica-                          The Ross award is sponsored by the
      The module, which will                    tions in refereed journals. The winning                       American Dental Association through the
offer up to two CE credits each                 researcher receives a plaque and $5,000 dur-                  ADA Foundation, with support from Pfizer
month, provides complete                        ing an ADA Board of Trustees dinner in                        Consumer Healthcare. It is awarded in
                                                August in Chicago.                                            memory of Norton M. Ross, a dentist and
online testing, submission,
                                                    Nominations must include a letter                         pharmacologist who contributed significant-
grading and secure payment
                                                describing the nominee’s accomplishments                      ly to oral medicine and dental clinical
for the program. Members of                     in the context of the award objectives and                    research.
ADA will receive a discounted
rate of $15 per submission. The
                                                        Upcoming Meetings
cost for non-members is $20
per submission.
      For more information, visit:                      April 27-May 2      American Academy of Cosmetic Dentistry’s 20th annual Scientific Session,
                                                                            Vancouver, British Columbia,
                                                        June 24-26          ADA 18th annual New Dentist Conference, San Diego, (312) 440-2779, and click
the hyperlink “JADA CE
                                                        Sept. 8-11          International Federation of Endodontic Association’s sixth Endodontic World
                                                                            Congress, Brisbane, Queensland, Australia,
                                                        Sept. 10-12         CDA Fall Scientific Session, San Francisco, (866) CDA-MEMBER (232-6362).
                                                        Sept. 30-Oct. 3     ADA Annual Session, Orlando, Fla., (312) 440-2500.

                                                        April 6-9           Academy of Laser Dentistry 12th annual Conference and Exhibition, New Orleans,
                                                                            (954) 346-3776.
                                                        To have an event included on this list of nonprofit association meetings, please send the information to
                                                        Upcoming Meetings, CDA Journal, P.O. Box 13749, Sacramento, CA 95853 or fax the information to
                                                        (916) 554-5962.

370    CDA . JOURNAL . VOL . 32 . NO . 5 . MAY . 2004

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