Journal - Dental Ethics: California Dental Association
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Journal
J U LY 2 0 1 3
What Does It Mean to Be Ethical?
Ethics of Social Media in Dental
Practice
Care Versus Commerce:
A Challenge to Professional
Integrity?
Dental Ethics:
PROFESSIONAL CHALLENGES IN A CHANGING WORLD
~ JAMES D. STEPHENS, DDS
You are not a statistic.
You are also not a sales goal or a benchmark or a market segment.
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TDIC. More than 30 years ago, the small group of CDA dentists
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you’re a dentist first, last and always.
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July 13 c da j o u r n a l , vo l 4 1 , n º 7
de pa rt m e nts
466 The Editor/Happy Birthday JCDA
469 Letter
471 Impressions
479 CDA Presents 4 71
533 Classifieds
544 Advertiser Index
546 Dr. Bob/The Beginning
f e at u r e s
490 D ENTAL ETH IC S : P R O FES S I O NA L CH A L L E N GE S I N A CH A N GI N G W O RL D
An introduction to the issue.
James D. Stephens, DDS
493 W O U LD S O M EO NE P LEAS E EX P L A I N W H AT I T ME A N S TO B E E T H I CA L ?
Confusion remains over the meaning of terms such as ethics and legality, charity, professionalism and
morality. The purpose of this paper is to present a summary of what has been learned about the various
parts of dental ethics.
David W. Chambers, PhD
499 TH E ETH I C S O F S O C I AL M ED I A I N D E N TA L P RACT I CE : CH A L L E N GE S
This essay reviews ethical and legal implications of the use of websites, Facebook, review sites, email
and other digital innovations in dental practice.
Bruce Peltier, PhD, MBA, and Arthur Curley, JD
507 TH E ETH I C S O F S O C I AL M ED I A I N D E N TA L P RACT I CE : E T H I CA L TO O L S A N D
P R O FES S I O NAL R ES P O NS ES
This essay provides ethical tools for analysis, illuminates areas of ethical concern in today’s practice
environment and offers recommendations for future practice.
Bruce Peltier, PhD, MBA, and Arthur Curley, JD
515 CAR E VER S U S C O M M ER C E: A CH A L L E N GE TO P RO F E S S I O N A L I N T E GRI T Y ?
The dentist’s ethical integrity calls for him or her to objectively present treatment options without regard
to potential financial gain. Absent this integrity, the potential for financial conflicts of interest to enter
into the discussion will present itself.
Phyllis L. Beemsterboer, MS, EdD, FACD, and Gary T. Chiodo, DMD, FACD
continu es on 4 65
j u ly 2 0 1 3 463
c da j o u r n a l , vo l 4 1 , n º 7
Journal
CDA Journal
Volume 41, Number 7
cda.org/journal
j u ly 2 01 3
Submitting Stay Connected
a manuscript
Visit cda.org
to the Journal? Journal of the California
Dental Association
Advertising
Corey Gerhard
Reader Guide:
There’s a site published by the
advertising manager
Jenaé Gruchow
Upcoming Topics
august: Children's Care
september: Americans
Manuscript Submissions
www.editorialmanager.com/
jcaldentassoc
California Dental
for that. Association
1201 K St., 14th Floor
project/traffic
administrator
With Disabilities Act
october: Dental-Medical Subscriptions
Sacramento, CA 95814 Collaboration Subscriptions are available
Erin Jernigan only to active members of
800.232.7645
assistant coordinator Classified Advertising the Association. The
cda.org
cda.org/classifieds subscription rate is $18 and
Production is included in membership
Management/Editorial
Val. B. Mina Display Advertising dues. Nonmembers can
Kerry K. Carney, DDS, CDE
senior graphic Corey Gerhard view the publication online
EM
editor-in-chief
designer advertising manager at cda.org/journal.
Kerry.Carney@cda.org
Corey.Gerhard@cda.org
Randi Taylor 916.554.5304 Change of Address
Ruchi K. Sahota, DDS, CDE
senior graphic Manage your subscription
associate editor
designer Letters to the Editor online: go to cda.org, log in
www.editorialmanager.com/ and update any changes to
Brian K. Shue, DDS, CDE
Ann Davis jcaldentassoc your mailing information.
associate editor
graphic designer/ Email questions or other
In fact, from letters to the Peter A. DuBois
production artist Permission and Reprints changes to membership@
Andrea LaMattina cda.org.
executive director
editor to reviews, the new California Dental publications specialist
Association Andrea.LaMattina@cda.org
Jennifer George
site is now the only way chief marketing officer
Lindsey A. Robinson, DDS 916.554.5950
president
to submit anything to the Cathy Mudge
president@cda.org
vice president,
Journal of the California community affairs
James D. Stephens, DDS
president-elect Journal of the California Dental Association (issn
Dental Association. Alicia Malaby
presidentelect@cda.org 1043-2256) is published monthly by the California Dental
Association, 1201 K St., 16th Floor, Sacramento, CA 95814,
communications
Upload your content, director
Walter G. Weber, DDS 916-554-5950. Periodicals postage paid at Sacramento,
vice president Calif. Postmaster: Send address changes to Journal
receive automatic status Andrea LaMattina
vicepresident@cda.org of the California Dental Association, P.O. Box 13749,
Sacramento, CA 95853.
publications specialist
updates, even track Kenneth G. Wallis, DDS
secretary The Journal of the California Dental Association is
Robert E. Horseman, DDS
progress anytime day or contributing editor
secretary@cda.org published under the supervision of CDA’s editorial staff.
Neither the editorial staff, the editor, nor the association are
night. See for yourself at James D. Stephens, DDS
Clelan G. Ehrler, DDS responsible for any expression of opinion or statement of
treasurer fact, all of which are published solely on the authority of the
guest editor
www.editorialmanager.com/ treasurer@cda.org author whose name is indicated. The association reserves
the right to illustrate, reduce, revise or reject any manuscript
Blake Ellington
jcaldentassoc Alan L. Felsenfeld, DDS submitted. Articles are considered for publication on
staff writer
speaker of the house condition that they are contributed solely to the Journal.
speaker@cda.org
Courtney Grant
Copyright 2013 by the California Dental Association.
communications
Daniel G. Davidson, DMD
specialist
immediate past
president
Jack F. Conley, DDS
pastpresident@cda.org
editor emeritus
46 4 j u ly 2 0 1 3
j u ly 1 3 contents
c da j o u r n a l , vo l 4 1 , n º 7
c o n ten ts, c o n tin ued f ro m 46 3
519 O U R NEX T G ENER ATI O N: D ENTA L ST U D E N T E T H I CS A N D I T S P OT E N T I A L
I NFLU ENC E O N TH E P R O FES S I O N
This article shares how today’s students, faced with a rapidly changing environment that impacts the
behavior of many in the profession, are responding to the perceived problems in the profession.
Alvin Rosenblum, DDS
524 C DA J U D IC I AL C O U NC I L: BLEND I N G I D E A L I S M A N D P RACT I CA L I T Y
This article explains the responsibilities of the California Dental Association Judicial Council.
Robert D. Kiger, DDS
529 R OAD S I G NS O N TH E R OAD O F L I F E
An excerpt from Dr. Dugoni’s Student Professionalism and Ethics presentation.
Arthur A. Dugoni, DDS, MSD
Print, meet digital.
Delivered to your mobile device
each month, the ePub Journal
includes dynamic interactivity, such
as embedded videos and one-click
web and email links for more
information, as well as the ability
to “clip” an article or photo and
share it through social media or
email. Available for iPad, iPhone,
Android and Amazon’s Kindle Fire.
Check it out at cda.org/mobile
j u ly 2 0 1 3 465
Editor c da j o u r n a l , vo l 4 1 , n º 7
Happy Birthday, JCDA
kerry k. carney, dds, cde
V
olume 1, Number 1, July 1973,
that was the beginning of the For 40 years, it has been the monthly
Journal of the California Dental
Association. Leafing through publication that we rely on for information
that issue transports one
back 40 years. about the science and art of dentistry.
The Journal was the tangible evidence
of the successful merger of California’s
two dental associations.
The California Dental Association you.” Dr. Yuen’s message foreshadowed our advise on the acceptance of new treatment,
(CDA) represented dentists in Northern motto: Moving Forward, Together. techniques and materials. The chair, Sidney
California (it was known as California Page 6 shows the “New Mod Styling” R. Francis, DDS, and the associate director
State Dental Association until Jan. 1, 1961). for a dental chair that incorporated of dental care, Gary Radine, sign it.
The Southern California Dental Association electric yellow or neon orange with a In “A Goliath Emerges,” G. Robert
(SCDA) represented dentists in the selection of mod plaids. (Some fashions Rogers, DDS, describes the first House of
southern part of the state. are simply painful to look at.) Delegates of the new CDA. It was held in
After their unification in May, the In the “Feedback” section, a letter San Mateo on May 12, 1973. (The CDA office
very first issue of the Journal of the from Jay W. Friedman, DDS, and John at that time was located in the Tishman
new California Dental Association was I. Ingle, DDS, takes issue with a report Airport Center in Los Angeles.) Photos of
published in July. For 40 years, it has been by the CDA/SCDA Study Committee on the event captured the excitement of the
the monthly publication that we rely on for the “Delivery of Dental Services in New first meeting. The men’s hairstyles included
information about the science and art of Zealand and California.” sideburns reminiscent of Elvis and at least
dentistry, as well as the issues that affect In the “Composite News and Views,” one mullet was visible. The few women in
oral health care today and the challenges R. Earl Robinson, DMD, writes about “The the photos were identified as family or staff.
that face organized dentistry tomorrow. Loss Leader” and concludes they should be Among the resolutions approved by
That first issue provides a snap shot “thrown out. The public should learn that the first House were the following:
of what was important to dentistry and in the long run, good dentistry is probably ■ Directs the Board of Trustees
dentists of the time. The cover photo is of the best health care bargain today.” to appoint a task force to define the
Burton H. Press, DDS, the first president There is a critical appraisal of “Health standards of quality of dental care.
of the new state association. Care, Human Rights and Government ■ Makes continuing education (28
According to the editor, Stephen S. Yuen, Intervention,” which warns against the hours every two years) a requirement for
DDS, the new Journal was “… to combine the trend toward socialized medicine. maintenance of membership, beginning
best features of the former CDA Composite; An opinion piece entitled “Triple Threat Jan. 1, 1974.
Journal, California Dental Association; SCDA to High Quality Dental Care” concludes that ■ Supports registration of dental
Newsletter and Journal, Southern California “dentistry must take a strong and aggressive laboratory technicians.
Dental Association.” Dr. Yuen described the position of leadership on a national and ■ Adopts the Code of Ethics of the
organization and the goals of the Journal. state level in the formation of health care “old” California Dental Association as that
“CDA is comprised of people; people are programs, to see to it that the patient gets of the new CDA.
diverse in activities and opinions; we want quality care and the dentist’s position is ■ Directs the Council on Legislation
to reflect all your concerns … We hope that properly presented to the lawmakers.” to study the feasibility of amending the
the reading of this and future issues will help The “Council on Dental Care Dental Practice Act to prohibit advertising
you gain a greater measure of what your new Newsletter” suggests how to navigate by dentists.
California Dental Association is all about. Read the paper claim maze. It reviewed Closed ■ Approves a $1.76 million budget for
us for awhile; let us know what you think. The Panel guidelines and related that California the fiscal year 1973-74.
real responsibility to your profession rests with Dental Society (CDS, Delta’s precursor) had ■ Discourages formation of any new
you. We look forward to the future … with established a Dental Policy Committee to separate organizations, specifically unions,
46 6 j u ly 2 0 1 3
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j u ly 1 3 editor
c da j o u r n a l , vo l 4 1 , n º 7
to replace authorized agencies of CDA. The fashions and hairstyles are different. download through the iTunes Store, Google
■ Recommends CDS reduce the The advertisements are different (many ads Play and the Amazon App Store.
withhold to 3 percent by Jan. 1, 1974 and for dentures and partials). However, the Subscribe for free and the latest
to zero as quickly as possible. commitment of those engaged in leadership issue will show up on your mobile device
Dr. Press charged the new officers and then is the same now. The dedication to every month. This is not a simple, lifeless
delegates to “prove that the California communicate with membership and the call shadow of the print version of the
Dental Association is indeed a unified for members to engage is unchanged. Journal. We have parlayed the features
organization with the interests of the The Journal of the California Dental that make the Journal great through the
patients (the public) at heart.” Association is your tangible connection to functionalities of the medium into an
In his president’s message, Dr. Press your association. Every month you receive enhanced member experience.
discussed “Why should dentistry have an an award-winning, high-quality, peer- It is not just more portable, it
association? Why should you belong to reviewed scientific journal. provides depth and connection.
it?” He underscored the most important From the very first issue of the Journal, Easily click through to resources and
and immediate issue for dentists, “The we have continued to seek better ways to references. Watch embedded video.
burning problem for our association today communicate, engage and connect with our Learn and engage. It makes me wonder
is the survival of private practice in some members. CDA launched a digital version what the Journal experience will be like
recognizable form!” of the Journal in May 2013. It is available for in another 40 years.
Get your CDA email precisely
the way you want it.
We recently changed our email preferences to
give you greater control. Now, you can opt in
to the content you want to receive or opt out
of the content you don’t.
So if you only want to learn about advocacy,
we can do that. Want more practice support
or education? We can do that, too. It is really
all about you. Customized content. We’re
hoping it makes you reconsider opting back
in to emails from CDA.
Customize yours today at cda.org/emailpref
46 8 j u ly 2 0 1 3
Letter c da j o u r n a l , vo l 4 1 , n º 7
Digital Radiography During Implant Osteotomy
T
his letter is in regard to a valid option to prevent implant
Journal
J A N UA RY 2 0 1 3
the article “The Effect of misplacement. Digital radiography or Dental Anatomy in
Asian Populations
Angulation Sensors on radiovisiography results in minimal Metallic Halation of Titanium
Implants
Angulation Sensors and
Implant Placement
Implant Placement” authored radiation exposure to the patient and
by Goodacre et al., in the eliminates the need for processing
January 2013 issue of the Journal of the and developing of X-ray films. For
California Dental Association. a beginner who is placing dental
Implant placement for a beginner implants, digital radiography with the
can be a daunting task and errors may drill placed in the osteotomy site after
occur in initial efforts. One possible every subsequent drill provides the
error is the placement of the implant at beginner with the option of correcting
the wrong angulation. Although this the angulations of the osteotomy. YOUNG
INVESTIGATORS
may not hamper the osseointegration Even if minor errors in angulation AND
TRANSLATIONAL
process, it may compromise the safety of are seen in the digital radiograph, RESEARCH
RICHARD T. KAO
DDS, PhD
adjacent teeth and structures. In they can be corrected during further
addition, once the “angled” implant is osteotomy. This will result in implants
loaded, forces which otherwise would placed in the optimal direction and
have been compressive may become angulations, thus improving the overall The Journal of the California Dental
detrimental in nature. Even the accuracy success rate of dental implants. Association welcomes letters.
of impressions can be adversely affected We reserve the right to edit all
when improperly aligned implants are srinivas sulugodu ramachandra, mds communications and require that all letters
present.1 Checking with paralleling pins ritu rana, post-graduate student
be signed. Letters should discuss an item
after every subsequent drill, and the use jithendra kd, mds
Mathura, Uttar Pradesh, India published in the Journal within the past two
of guided surgical templates, are options months or matters of general interest to our
available to prevent misplacement of the readership. Letters must be no more than 500
implant.2 Paralleling pins are useful references
1. Sorrentino R, Gherlone E, Calesini G. Effect of Implant words and cite no more than five references.
instruments to know the angulation; Angulation, Connection Length, and Impression Material on No illustrations will be accepted. Letters
however, if the angulation of the drill is the Dimensional Accuracy of Implant Impressions: An In Vitro
may be submitted at editorialmanager.com/
deviated at the apical portions, it would Comparative Study. Clin Implant Dent Relat Res 2010; 12 Suppl
1:e63-76. jcaldentassoc. By sending the letter to the
not be clearly visible. Guided surgical 2. Naitoh M, Ariji E, Okumura S, Ohsaki C, Kurita K, Ishigami Journal, the author certifies that neither the
templates increase the chance that T. Can Implants Be Correctly Angulated Based on Surgical
letter nor one with substantially similar content
implants are placed at the correct Templates Used for Osseointegrated Dental Implants? Clin
Oral Implants Res 2000; 11:409-14. under the writer’s authorship has been published
angulation. However, the templates used 3. Goodacre B, Mashni J, Yankee J, Goodacre C, Lozada J, Won or is being considered for publication elsewhere,
to guide the surgical placement require J. The Effect of Angulation Sensors on Implant Placement. J
and the author acknowledges and agrees that
substantial planning and training. They Calif Dent Assoc 2013; 41:47-50.
the letter and all rights of the author with
also increase the cost of the procedure.2 regard to the letter become the property of the
A recently published study explored the California Dental Association.
use of an angulation sensor for implant
placement in correct angulation.3
The use of radiovisiography after
every subsequent drill with the drill
placed in the osteotomy site is also
j u ly 2 0 1 3 469
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Terms and conditions apply Provider ID# 316714Impressions c da j o u r n a l , vo l 4 1 , n º 7
Writing About the Other Guy
by david w. chambers, phd
I have come to expect that
editorials will be about other
people doing something they
should not have done or failing
to do those things that would
make our lives easier. A staple in the
genre is the ethics editorial. A little
preaching to the choir never lost any
preacher his or her job.
Scholars say the oldest writings (not
the oldest events) covered in the Old
Testament are in the Book of Amos.
Actually, they are transcriptions of the
chants the prophet sang in the gates of
the cities of Israel. They are among the
most powerful poetry I know. “Thus saith
the Lord: For three transgressions of
Damascus, and for four, I will not turn
away the punishment thereof.” This follows
cont i n ue s on 4 73
Correction Law Incorporates Dentists in Emergency Response Plans
In the June 2013 issue of the Journal, President Obama recently signed into law language incorporating dentists into
part of the introduction and several emergency response plans. The president’s action brings to a close a two-year effort by
references in the article “Salt Fluoridation: the American Dental Association to include the language in the Pandemic and All-Hazards
A Review” by Howard F. Pollick, BDS, MPH, Preparedness Reauthorization Act (PAHPA), according to a news release from the ADA.
were inadvertently omitted or misnumbered. The law clarifies that dentists may be considered disaster response public health
A full, corrected version of the article is responders to disasters or other public health emergencies, and states that dental schools
available online at cda.org/journal. We are eligible to receive federal funds to train public health and medical response workers.
apologize for the error. The reauthorization will ensure that programs created almost 10 years ago to help
the government manage medical responses to natural disasters and other emergencies
will remain in place. The reauthorizing law contains language that includes dentistry in
the response framework, taking advantage of dentists’ extensive education, training and
professionalism, according to the ADA.
A statement from the White House press secretary said the law “revises authorities for
activities to improve public health and bioterrorism emergency planning, preparedness and
response; streamlines authorities within the Department of Health and Human
Services to improve coordination and eliminate inefficiencies; and
strengthens the role of the Food and Drug Administration to bring
prevention treatment products, known as ‘countermeasures,’
emergency use.”
to market for em
more information, see the ADA news story
For mo
ada.org/news/8365.aspx.
at ada
j u ly 2 0 1 3 47 1j u ly 1 3 impressions
c da j o u r n a l , vo l 4 1 , n º 7
Researchers Digitally Analyze Modern “The computer simulation of chewing
Human Teeth Using Finite Element forces creates high tensile stresses
Analysis exactly in the cervical areas where we
Scientists from the Max Planck Institute frequently find tooth lesions in our teeth,”
and the Senckenberg Research Institute said Stefano Benazzi of the Max Planck
digitally analyzed modern human teeth Institute. To investigate changes in stress
using a finite element method to evaluate pattern in the same tooth crowns with
the biomechanical behavior of teeth under varying tooth wear ages, two premolars
realistic loading, according to a news release. were artificially abraded in the laboratory,
The study showed very widespread loss of based on their individual data of occlusal
dental material at the base of the crown movement — making it possible to
could be linked to the reduction of tooth calculate changes in stress pattern,
wear in our industrialized societies. depending on wear stage.
Dental tissue and supporting structures of the “Over the last century, humans from Stress in the teeth with advanced
second premolar of the right mandible after industrialized societies have witnessed a wear shows far better distribution of
segmentation. radical increase in some dental diseases. A the loads over the whole tooth crown,
© Max Planck Institute for Evolutionary Anthropology
severe problem concerns the loss of dental reducing tensile stresses. The extension
materials (enamel and dentine) at the buccal of the lifespan and the quick changes
cervical region of the tooth,” authors wrote. in our lifestyle with a remarkable
“Based on the results of our simulations reduction in tooth wear present a major
of chewing loads, we assume that much of challenge for modern dentistry, the
the enamel failure we find today frequently researchers concluded.
in tooth crowns is probably caused by For more information, see the study in
cyclic tensile stresses during chewing,” the journal PLoS ONE, 8(4): e62263 or see
Ottmar Kullmer of the Senckenberg the news release at senckenberg.de/root/
Research Institute said in the news release. index.php?page_id=5210&kid=2&id=2711.
Researchers Develop Implant Coating for People With Bone Deficit
Spanish researchers have developed an implant coating with a novel biodegradable material that is targeted at
patients with bone deficits. According to the researchers, the new implant material will also increase the overall success
rate of implants through an enhanced biocompatibility and reduced time of osseointegration or bone integration.
Elderly people or those with osteoporosis, smokers, diabetics orr people who have had cancer are sometimes not
ctly integrate the new
eligible to receive dental implants as their bones are unable to correctly
prostheses, according to a news release from the Asociación RUVID,, via ScienceDaily.com.
th a biodegradable
The recent development “consists of covering the implant with
is degradation
coating that, upon contact with the bone, dissolves and during this
process is able to release silicon compounds and other bioactive molecules which
induce bone generation,” said Julio José Suay, coordinator of the research group of
Polymers and Advanced Materials, in the news release.
nnovative,” as the
Called Soldent, researchers say this research line is “totally innovative,
ss of implants to allow
systems used thus far have consisted of increasing the roughness
for integration into the bone.
rials, they
After in vitro testing with cell cultures of the different biomaterials,
pe with the
proceeded to the live animal evaluation, until achieving the prototype
cedaily.com/
best results. For more information, see the news release at sciencedaily.com/
releases/2013/04/130429094941.htm.
472 j u ly 2 0 1 3c da j o u r n a l , vo l 4 1 , n º 7
FDA Says There’s No Guarantee of “Latex Free”
The U.S. Food and Drug Administration recently issued new draft guidance for the labeling of medical
products recommending manufacturers of FDA-regulated medical products stop using statements on labels
such as “latex-free” or “does not contain latex.”
According to FDA.gov, the organization issued this guidance in order to avoid giving a false sense of
security to people who are allergic to natural rubber latex, saying, “The problem with that language is that FDA
is aware of no tests that can show a medical product is completely without the natural rubber latex proteins
that can cause allergic reactions.”
The FDA said it wants to promote scientifically accurate labeling and suggests manufacturers who want to
indicate that natural rubber latex was not used as a material instead use the more accurate language “not made
with natural rubber latex.” While this recommended language communicates that natural rubber latex was not used
as a material in the finished product or as a material in the container, it also
does not make the unsupportable claim that the medical product is
“free” of or “does not contain” natural rubber latex.
Natural rubber latex made from plant sources is used in
numerous medical products, including medical gloves, adhesive
bandages and blood-pressure monitoring cuffs, among others.
Repeated exposure can result in sensitivity to natural rubber latex
tching to
proteins, with symptoms ranging from skin redness, rash, hives or itching
difficulty breathing and wheezing and, rarely, shock and death.
/ucm342641.htm.
For more, visit www.fda.gov/ForConsumers/ConsumerUpdates/ucm342641.htm.
t he ot h e r g u y, c o n t i n u ed f ro m 47 1
with some specifics about these other guys’ I talked about the ethical of professional ethics, there are about
poor behavior and the punishment they responsibilities of advising one’s eight in medicine, several each in
will endure. The same formula is repeated colleagues how to practice. The nursing, law, business and other fields;
for Gaza,, Tyrus,
y Edom, Ammon, Moab and conference organizers thanked me but none in dentistry. The writing I am
other local bad actors.
a That is good stuff if politely but suggested they had had in awe of is where people stand up and
you are into schadenfreude.
sch something else in mind. They wanted say, “This is what I am prepared to do to
Several years
year ago, I was asked to me to make a case that it would be make the profession better.”
speak on ethics at a conference where unethical for dentists not to follow their Amos cautions against pointing the
evidence-based methodology was being guidelines. My personal view is that if moral finger. But you will have to look at
used to develop guidelines for dentists in they had wanted to engage practitioners verse 6 of his passage to find out why.
a treatment arearea. If you Google “practice they would have invited them to the The nub:
guidelines” you will find about 10,000 meeting. Only the people in the room 1 Stop talking about what others
such position papers
p from various get to say what counts; we cannot do it should do.
organizations ttelling practitioners in on behalf of others. 2 Search for deep understanding of
various health professions how they I find four types of written pieces how people actually behave morally.
should do their jobs. This was to be about ethics in dentistry. “Others 3 Declare what you are willing to do
another. ThThee lit
little research that has been are doing something wrong” and for dentistry.
done on such gguidelines shows that “our problems would be relieved if David W. Chambers, PhD, is professor
somewhat less than half of practitioners others did what they should” are the of dental education, Arthur A. Dugoni
in any area are aware of the guidelines two most common. Scholarly work School of Dentistry, San Francisco, and
that exist, and a small proportion of designed to explain how people behave editor of the Journal of the American
those who know
kno follow them. ethically is scarce. Of the 18 journals College of Dentists.
j u ly 2 0 1 3 47 3Practice Support
Cutting Costs
I’ve cut my overhead
already. Why are
costs still eating
away at my profits ?
Answers to all of your practice management questions
XJMMCFeasier to find on the new CDA Compass,
launching August 15, 2013.j u ly 1 3 impressions
c da j o u r n a l , vo l 4 1 , n º 7
Study Shows Alarming Rise in CRE people who get severe infections from them.”
Infections in Past Decade Additionally, CRE are known to pass on their
According to a recent Vital Signs antibiotic-fighting abilities to other kinds of
report, antibiotics are being overpowered germs, which means in the near future more
by lethal germs called carbapenem- bacteria will become immune to treatment.
resistant Enterobacteriaceae (CRE). “Stopping CRE will take a rapid,
In their usual forms, germs from the coordinated, and aggressive ‘Detect and
Enterobacteriaceae family (e.g., E. coli) Protect’ action that includes intense
are a normal part of the human digestive infection prevention work and antibiotic
system. However, some of these germs prescribing changes,” according to
ontrol have developed defenses to fight off all CDC’s website. CDC released a CRE
ce for C esistant
Guidan -r
ap e n e m
of Carb teriaceae (CR
E) or almost all antibiotics available today, prevention toolkit in 2012 reiterating
ac
Enterob according to CDC. practical CRE prevention and control
kit
RE Tool
2012 C CDC has warned about CRE for more steps and recommends leadership and
than a decade but says new information medical staff in hospitals, long-term
shows that these germs are now becoming acute care hospitals, nursing homes,
ases
tious Dise
notic Infec
g and Zoo
Emergin n
Center for Promotio
National re Quality
of Healthca
Division
more common, noting on its website that health departments and even outpatient
there has been a seven-fold increase in the practices work together to implement
spread of the most common type of CRE these recommendations to protect
during the past 10 years. patients from CRE.
CDC stated that although these For more information, see the report
infections are not common, “their rise is at cdc.gov/features/vitalsigns/hai/cre/
alarming because they kill up to half of index.html.
Fluoride Found to Lower Adhesion Force of Bacteria
Researchers recently discovered new evidence that fluoride affects the adhesion force of the cavity-causing
bacteria that stick to teeth.
Despite more than 50 years of scientific research, controversy still exists over exactly how fluoride compounds
reduce the risk of tooth decay, according to a news release from the American Chemical Society. Research
established long ago that fluoride helps to harden the enamel coating that protects teeth from the acid produced by
decay-causing bacteria, and newer studies have found that fluoride penetrates into and hardens a much thinner layer
of enamel than previously believed, lending credibility to other theories about how fluoride works.
For the new study, published in the ACS journal Langmuir, in order to characterize adhesion on fluoridated
samples on a single bacterial level, researchers used force spectroscopy with bacterial probes to measure
adhesion forces directly. The researchers “tested the adhesion of Streptococcus mutans, Streptococcus
oralis, and Staphylococcus carnosus on smooth, high-density hydroxyapatite surfaces, pristine and after
treatment with fluoride solution.” Authors reported finding that all
bacteria species exhibited lower adhesion forces after fluoride
treatment of the surfaces.
These findings suggest that the decrease of adhesion properties
is a further key factor for the cariostatic effect of fluoride besides the
decrease of demineralization, authors concluded.
For more information, see the study in Langmuir, 2013, 29 (18), pp.
5528–5533.
Mona Lisa Production / Science Source
476 j u ly 2 0 1 3c da j o u r n a l , vo l 4 1 , n º 7
Throwing Out a Toothbrush After Strep May Be Unnecessary
A recent study has found that it may not be necessary to replace children’s toothbrushes after having strep
throat as the strep bacteria typically don’t survive.
In the study, researchers investigated whether the strep bacteria would grow on new toothbrushes used by 14
children who had strep throat, having them brush their teeth for one minute before placing the toothbrushes in a
lab for testing. The authors then compared those toothbrushes to those used by
sterile cover and taking them to a la
weren’t strep and 27 well children ages 2 to 20, according to the study.
13 patients with sore throats that w
The step bug was recovered from only one toothbrush, which had been used by a
without strep throat. The other study toothbrushes failed to grow the group A
patient wit
Streptococcus but did grow other bacteria that are common in the mouth.
Streptoco
“This study
s supports that it is probably unnecessary to throw away your toothbrush
after a diagnosis
d of strep throat,” said co-author Judith Rowen, MD, in a news release
from the
t American Academy of Pediatrics, while study co-author Lauren Shepard,
DO, noted that the study was small and larger studies with more subjects would be
needed to confirm their findings.
nee
The researchers presented their findings at the Pediatric Academic
Societies Annual Meeting in Washington, D.C., on May 4, 2013. For more
S
information, see the news release at eurekalert.org/pub_releases/2013-05/
aaop-dbq042613.php.
Patients in ICU Rooms With Copper According to the study, the proportion
Surfaces See Lower Rate of Health of patients who developed HAI and/or
Care-acquired Infections colonization with methicillin-resistant
Placement of copper objects in Staphylococcus aureus or vancomycin-
intensive care unit (ICU) hospital rooms resistant Enterococcus was significantly
showed to reduced the number of lower among patients in rooms with
health care-acquired infections (HAIs) in copper surfaces (7.1 percent) compared
patients by more than half, according to with patients in traditional rooms (12.3
a new study in the Society for Healthcare percent). The proportion of patients who
Epidemiology of America’s journal, developed HAI was significantly lower
Infection Control and Hospital Epidemiology. among those assigned to copper rooms
These infections often contaminate (3.4 percent) compared with those in “Our study demonstrated
items within hospital rooms and allow traditional rooms (8.1 percent). that placing a copper alloy
bacteria to transfer from patient to “Our study demonstrated that placing
patient. In this study, patients who a copper alloy surface onto six common, surface onto six common,
were admitted to the ICU of these highly touched objects in ICU rooms highly touched objects in
hospitals were randomly assigned to reduced the risk of HAI by more than half
receive care in a traditional patient at all study sites,” authors wrote, noting ICU rooms reduced the risk
room or in a room where items such as that “additional studies are needed to of HAI by more than half at
bed rails, tables, IV poles, and nurse’s determine the clinical effect of copper
call buttons were made solely from alloy surfaces in additional patient all study sites.”
copper-based metals. Both traditional populations and settings.”
patient rooms and rooms with copper For more information, see the study in
surfaces at each institution were Infection Control and Hospital Epidemiology,
cleaned using the same practices. vol. 34, no. 5, pp. 479-486.
j u ly 2 0 1 3 47 7j u ly 1 3 impressions
c da j o u r n a l , vo l 4 1 , n º 7
Brain Scan Patterns Discovered to Tor Wager, associate professor of
Objectively Measure Pain psychology and neuroscience at
Scientists recently discovered the CU-Boulder, in the news release.
ability to predict pain levels in people by The researchers used computer data-
looking at images of their brains, according mining techniques to comb through
to a new study led by the University of images of 114 brains that were taken when
Colorado Boulder. the subjects were exposed to multiple
The findings, published in the New levels of heat, ranging from benignly
England Journal of Medicine, may lead warm to painfully hot and found, with
to the development of reliable methods the help of the computer, a distinct
doctors can use to objectively quantify a neurologic signature for the pain.
patient’s pain, according to a news release “We found a pattern across multiple
from the university. systems in the brain that is diagnostic of
Current measures of pain intensity how much pain people feel in response to
The neurologic signature for physical pain depend on a patient’s own description, painful heat,” Wager said.
identified in a new study in the New England
which typically utilizes a one-to-10 scale, The results of the study do not yet
Journal of Medicine. Credit: Tor Wager.
but objectively measuring pain could allow physicians to quantify physical pain,
confirm patient reports and provide new the news release noted, but they lay the
clues into how the brain generates various foundation for future work that could
forms of pain. Authors of the study also produce the first objective tests of pain by
believe the new research could open the doctors and hospitals.
door for using brain scans to objectively For more information, see the
measure anxiety, depression, anger or news release at colorado.edu/news/
other emotional states. releases/2013/04/10/first-objective-
“Right now, there’s no clinically measure-pain-discovered-brain-scan-
acceptable way to measure pain and patterns-cu-boulder or see the study in
other emotions other than to ask a the New England Journal of Medicine, 2013;
person how they feel,” said lead author 368:1388-1397.
upcoming meetings
2013
July 18–20 ADA 27th New Dentist Conference, Denver, 312-440-3524 or
ada.org/newdentistconf.aspx
Aug. 15–17 CDA Presents The Art and Science of Dentistry, San Francisco, 800-CDA-SMILE
(232-7645) or cdapresents.com
Sept. 13–15 Fifth Annual Dental Motorcycle Ride, Windsor, sites.google.com/site/dentistrides
Oct. 31–
154th ADA Annual Session, New Orleans, ada.org/session
Nov. 5
Nov. 3–9 U.S. Dental Tennis Association, Big Island, Hawaii, 800-445-2524 or dentaltennis.org
Nov. 10–13 National Primary Oral Health Conference, Denver, nnoha.org/conference/
npohc.html
To have an event included on this list of nonprofit association continuing education meetings, please email
Courtney Grant at courtney.grant@cda.org.
478 j u ly 2 0 1 3Explore the new
Expl ratorium
Image by Amy Snyder © Exploratorium
The beautiful new Exploratorium on the
San Francisco Bay, a fun and creative
space to explore and play, serves as
the setting for this year’s CDA Party.
Join us for mouth-watering delicacies,
fascinating exhibits and live music.
Image courtesy of ZUM, zumllc.com
CDA’s Party BU the Exploratorium
Friday, August 16, 7-10 p.m.
Event # 050
$65 – Open to all registration types
Purchase tickets at cdapresents.com
Party where art and science collide.So many ways to be
CDA Presents The Art and Science of Dentistry is where thousands of your
peers hone their craft. It’s three days packed with world-renowned speakers,
networking opportunities and even a little fun.
Search courses
by day, topic
or speaker
and download
handouts.
Find exhibitors by
name and product
categories and
locate them on the
exhibit hall map.
Link straight to the
Whether it’s Implant Esthetics or Surgical Crown Lengthening, the C.E. website and
avoid lines at the
hands-on workshops at CDA Presents are in a class by themselves. C.E. Pavilion.The Art
inspired. and Science
of Dentistry
San Francisco, California
Thursday-Saturday
August 15-17, 2013
Save big on the exhibit floor and get a sneak peek at a
multitude of new products.
This app makes the show a snap. New International Symposia
feature four lectures with
Japanese Drs. Minami and
Download the
CDA Presents app
Watanabe as they delve into
from the App Store restorative techniques and
for iPhones or the materials currently used in
Google Play Store Japan.
for Android users.
Read about the most
successful names in t Gain insight on the ins
dentistry from around
and outs of dental benefit
the world who’ll be
speaking at CDA plans as well as social
Presents. media do’s and don’ts.
Interactive exhibit
t Beat the crowd with
hall map with on- reserved seating for
the-go wayfinding popular lectures.
technology and
meeting room maps To register, or for more
will keep you pointed information including hotel
in the right direction.
specials, be sure to visit
cdapresents.comCDA Presents Schedule-at-a-Glance
Moscone South * Repeated Course Thursday Exhibit Hall Hours
9:30 a.m.—5:30 p.m.
Thursday, August 15, 2013
InterContinental
Dugoni School
> Continued Course
Required Courses — Ticket Required
7 AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM
California Dental Infection Control
Practice Act Molinari, MS 103
Oromchian, MS 103
The Spot — Debuting the Smart Dentist Series, Free Lectures in the Educational Theater
Office Handling Charac- Employ- Dealing Health
Policies & Insurance teristics ment Law: With Pa- Reform
Procedures Refund of Ethical How to tients Who for Small
Thomason Requests Dental Pro- Stay Com- Won’t Pay Businesses
Cheese- fessionals pliant in Their Bill? Catalano
brough Kozak 2013 Fornelli
Oromchian
Workshops — Ticket Required
Surgical Crown Lengthening > > Surgical Crown Lengthening
Kohner, MS 232/234 Kohner, MS 232/234
Implant Esthetics Workshop * Implant Esthetics Workshop *
Higginbottom, MS 228/230 Higginbottom, MS 228/230
Suturing for the General Practitioner Atraumatic Extraction & Socket
Silverstein, MS 220/222 Grafting for the General Practitioner
Silverstein, MS 220/222
Pitfalls to Avoid When Starting or
Purchasing a New Practice
Hoover, et al., IC Grand Ballroom C
TDIC Risk Management * TDIC Risk Management *
Jansen, Weiss, IC Grand Ballroom A Jansen, Weiss, IC Grand Ballroom A
Site Preservation for Implant Site Preservation for Implant
Placement * Placement *
Ehsan, MS 236 Ehsan, MS 236
Implants & Attachments * Implants & Attachments *
Bambara, MS 224/226 Bambara, MS 224/226
Are Your Pictures Perfect? * Are Your Pictures Perfect? *
Parks, Williamson, MS Exhibit Hall, Parks, Williamson, MS Exhibit Hall,
Booth 302 Booth 302
Review of the Medical Emergency Kit
Lenhart, MS 270/272
New International Symposia of Dental Learning
Multidisciplinary Treatment Clinical Applications of
Approaches Orthodontic Treatment in the
Watanabe, MS 301 Esthetic Zone
Watanabe, MS 301
Express Lectures — Speakers New to the Podium
The Medical Management of Dentalveolar Update in
Management Dental Trauma Surgery Tips Endodontics
of Caries Horst, MS 309 & Tricks Peters, MS 309
Duffin, MS 309 Nattestad, MS 309
Lectures
Medical Emergencies in the
Dental Office
Lenhart, MS 303
Occlusion in Everyday Leadership, Vision & Commu-
Dentistry nication for Dental Teams
Murphy, MS 200-212 Murphy, MS 200-212
7 AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PMCDA Presents Schedule-at-a-Glance
Lectures (continued)
7 AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM
Fixed Prosthodontics & New Materials & Technologies
Esthetics Nathanson, MS 102
Nathanson, MS 102
Restorative Materials > Restorative Materials
Update 2013 > Update 2013
Brucia, MS 104 Brucia, MS 104
Direct Resin Bonding > > Direct Resin Bonding
Mopper, MS 307 Mopper, MS 307
Treatment Planning for > Treatment Planning for
Success > Success
Perry, MS 305 Perry, MS 305
Rock Your Communication Take My Breath Away
Turchetta, MS 308 Turchetta, MS 308
Transition From Practice to The Right Associateship
Retirement van Dyk, MS 302
van Dyk, MS 302
The Plaque Monologues > > The Plaque Monologues
Novy, MS 306 Novy, MS 306
Drugs, Bugs & Dental Drugs, Bugs & Over-the-
Products: Prescription Drugs Counter Dental Products
Jacobsen, MS 103 Jacobsen, MS 103
Technology in Your Practice > > Technology in Your Practice
Feuerstein, Flucke, Jablow, Feuerstein, Flucke, Jablow,
MS 101 MS 101
Cone Beam CT: Acquisition, Cone Beam CT: Perception,
Reconstruction, Artifacts Cognition, Interpretations
Khademi, MS 105 Khademi, MS 105
Early Interceptive Diagnosis & Treatment of TMD
Orthodontic Treatment Mahony, MS 304
Mahony, MS 304
Dental Sleep Medicine Dental Sleep Medicine —
Essentials Contemporary & Advanced
Simmons, MS 310 Simmons, MS 310
Demystifying Root Minimizing the Heartbreak of
Resorption Root Fractures
Tittle, MS 100 Tittle, MS 100
SM4D – Social Media for SM4D – Social Media for
Dentists * Dentists *
Newman, MS 303 Newman, MS 303
Maximize the Value
of Your Most Powerful
Asset
Brubaker, MS 200-212
7 AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PMCDA Presents Schedule-at-a-Glance
Moscone South * Repeated Course Friday Exhibit Hall Hours
9:30 a.m.—5:30 p.m.
Friday, August 16, 2013
InterContinental
Dugoni School
> Continued Course
Required Courses — Ticket Required
7 AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM
Infection Control California Dental
Molinari, MS 103 Practice Act
Canham, MS 103
The Spot — Debuting the Smart Dentist Series, Free Lectures in the Educational Theater
Paycheck Addressing Managing CBCT in Wine FUN-
Protection Negative Patient Private damentals
Nelle Online Conflicts Practice (Ticket Required)
Reviews Alvi Khademi Langer
Corum
Workshops — Ticket Required
Clinical Excellence With > Clinical Excellence With
Esthetic Posterior Restorations > Esthetic Posterior Restorations
Brucia, MS 228/230 Brucia, MS 228/230
The Art of Endodontics * The Art of Endodontics *
Buchanan, MS 236 Buchanan, MS 236
Don’t Let Your Provisionals Don’t Let Your Provisionals
Look Temporary * Look Temporary *
Henson, MS 220/222 Henson, MS 220/222
Art & Science = Creativity * Art & Science = Creativity *
Mopper, MS 232/234 Mopper, MS 232/234
TDIC Risk Management * TDIC Risk Management *
Jansen, Weiss, IC Grand Ballroom A Jansen, Weiss, IC Grand Ballroom A
Instrument Sharpening
Andrews, MS 224/226
Radiographs Aren’t Just In-office Digital Impressions &
X-rays Anymore Laboratory C"%/CAM
Feuerstein, Flucke, Jablow, Feuerstein, Flucke, Jablow,
MS Exhibit Hall, Booth 302 MS Exhibit Hall, Booth 302
Employee Embezzlement Employee Embezzlement
& Fraud * & Fraud *
Lewis, MS 270/272 Lewis, MS 270/272
Lectures
Occlusion in Everyday Improving Case Acceptance
Dentistry Murphy, MS 307
Murphy, MS 307
Radiology Boot Camp Panoramic Radiography
Parks, Williamson, MS 301 Parks, Williamson, MS 301
Treating Trauma Without > Treating Trauma Without
Drama > Drama
Tittle, MS 100 Tittle, MS 100
Digital Implant Dentistry Current Concepts in Implant
Higginbottom, MS 200-212 Dentistry
Higginbottom, MS 200-212
Women’s Health & Common Oral Lesions
Periodontal Concerns Plemons, MS 100
Plemons, MS 105
Adult & Pediatric Oral >Adult & Pediatric Oral
Sedation Review > Sedation Review
Lenhart, MS 303 Lenhart, MS 303
7 AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PMCDA Presents Schedule-at-a-Glance
Lectures (continued)
7AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM
What Good Is a Dead Patient 32 Teeth & 100 Birthdays
With Perfect Teeth? Meinz, MS 104
Meinz, MS 104
Clinical Treatment Planning Perio-restorative Interface
Lowe, MS 306 Lowe, MS 303
The Impact Dental Insurance
Has on Your Practice
Perry, IC Grand Ballroom B
Peer Review
Hansen, MS 274-276
The Agony of the Code Successful Systems for A/R &
Duncan, MS 304 Insurance Management
Duncan, MS 304
Direct Restoration Tips Indirect Restoration Placement
for RDAs for RDAs
Howell, Troendle, MS 308 Howell, Troendle, MS 308
How Crown Lengthening Will Improving Esthetic &
Enhance Your Restorative Restorative Results/Grafting
Results, Kohner, MS 101 Kohner, MS 101
Principle-based Periodontal > Principle-based Periodontal
Therapy & Treatment Planning> Therapy & Treatment Planning
Miller, MS 305 Miller, MS 305
101 Ways to Improve > 101 Ways to Improve Your
Your Practice > Practice
Schwab, MS 310 Schwab, MS 310
Precision & Semi-precision Treatment Planning
Attachments Attachments & Implants
Bambara, MS 302 Bambara, MS 302
Prescription Drugs & Herbal Natural Product Preparations
Therapies in Dentistry
Spolarich, MS 103 Spolarich, MS 103
Oral Cancer: A Patient’s & Oral Cancer: A Patient’s &
Clinician’s Perspective * Clinician’s Perspective *
Carpenter, Grayzel, MS 309 Carpenter, Grayzel, MS 309
Dental Implant Complications Anterior Implants &
& Failure Temporaries
Ehsan, MS 105 Ehsan, MS 105
The Epidemic of Cracked Teeth Direct Composite Restorations
Clark, MS 102 Clark, MS 102
Paid vs. Denied
Cheesebrough, Milar,
IC Grand Ballroom B
Early Caries, Diagnosis, > Early Caries, Diagnosis,
Prevention & Intervention > Prevention & Intervention
Donly, MS 306 Donly, MS 306
Dental Benefits
Perry, Weber
MS 301
Ergonomics
Andrews, MS 307
National Health
Care Reform
Short, MS 104
7 AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PMCDA Presents Schedule-at-a-Glance
Moscone South * Repeated Course Saturday Exhibit Hall Hours
9:30 a.m.—4:30 p.m.
Saturday, August 17, 2013
InterContinental
Dugoni School
> Continued Course
Required Courses — Ticket Required
7AM 8 AM 9 AM 10 AM 11 AM Noon 1 PM 2 PM 3 PM 4 PM 5 PM 6 PM
California Dental Infection Control
Practice Act Andrews, MS 103
Canham, MS 103
The Spot — Debuting the Smart Dentist Series, Free Lectures in the Educational Theater
Office Handling Patient HPV & the PPO
Policies & Insurance Records/ Mouth Re- Mastery
Procedures Refund Access & lationship Straine
Thomason Requests Rules Plemons
Cheese- Pichay
brough
Workshops — Ticket Required
Invisalign Clear Essentials II > > Invisalign Clear Essentials II
Brandt, IC Grand Ballroom A Brandt, IC Grand Ballroom A
Mini Dental Implants/GP * Mini Dental Implants/GP *
Choi, MS 228/230 Choi, MS 228/230
Better, Faster, Prettier Minimally Invasive Anterior
Composite Dentistry Composite Dentistry
Clark, MS 220/222 Clark, MS 220/222
Live Patient Denture Treatment > > Live Patient Denture Treatment
LaBarre, Dugoni School LaBarre, Dugoni School
Oral Lesions: Detection Oral Lesions: Detection
& Diagnosis,* Asadi, & Diagnosis,* Asadi,
Carpenter, Dugoni School Carpenter, Dugoni School
Hands-on Participation with Implant Hands-on Participation with Implant
Components & Chairside Techniques * Components & Chairside Techniques *
Sadowsky, Hoover, MS 232/234 Sadowsky, Hoover, MS 232/234
Functional & Esthetic Crown Functional & Esthetic Crown
Lengthening * Lengthening *
Lundergan, Bruce, Martinez, Lundergan, Bruce, Martinez,
Dugoni School Dugoni School
Digital Exam & Treatment What’s New & What’s Coming
Planning Feuerstein, Flucke, Jablow
Feuerstein, Flucke, Jablow, MS Exhibit Hall, Booth 302
MS Exhibit Hall, Booth 302
Employee Embezzlement & Employee Embezzlement &
Fraud * Fraud *
Lewis, MS 270/272 Lewis, MS 270/272
“I Can Hear the Odontoblasts “I Can Hear the Odontoblasts
Screaming!” * Screaming!” *
Novy, MS 224/226 Novy, MS 224/226
/FXInternational Symposia of Dental Learning
Considerations for Natural Treating Cases of Occlusal
Teeth & Anterior Implant Destruction With Full Mouth
Esthetic Restoration Reconstruction
Minami, MS 301 Minami, MS 301
Lectures
Foundations of Dental
Office Management
Duncan, MS 302
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