Photos: Steve McClelland Photography
Fresh Concepts in
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-
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.
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
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
cost for non-members is $20
For more information, visit: April 27-May 2 American Academy of Cosmetic Dentistry’s 20th annual Scientific Session,
Vancouver, British Columbia, www.aacd.com.
June 24-26 ADA 18th annual New Dentist Conference, San Diego, (312) 440-2779,
w.ada.org/goto/jada and click
the hyperlink “JADA CE
Sept. 8-11 International Federation of Endodontic Association’s sixth Endodontic World
Congress, Brisbane, Queensland, Australia, www.ifea2004.im.com.au.
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,
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
370 CDA . JOURNAL . VOL . 32 . NO . 5 . MAY . 2004