A PUBLICATION OF THE IOWA ACADEMY OF GENERAL …€¦ · Academy of Orofacial Pain, the American...

A P U B L I C A T I O N O F T H E I O W A A C A D E M Y O F G E N E R A L D E N T I S T R Y

DENTISTRY...in general

D E N T I S T R Y … I N G E N E R A L • S U M M E R | F A L L 2 0 1 7 1

Summer | Fall 2017

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2017 IAGD/NAGD Fall Joint Meeting . . . . . . . . . . . . . . . .1, 3, 5

IAGD Senior Dental Student Award . . . . .2President’s Message . . . . . . . . . . . . . . . . . . . .2Officers and Board of Directors . . . . . . . . .2Legislative Chair Report:

IBDE Meeting . . . . . . . . . . . . . . . . . . . . . . .4Editors Report: Oral Scanning . . . . . .6 & 72017 IAGD Fall Meeting . . . . . . . . . . .8 & 9What is QSEHRA? . . . . . . . . . . . . . . . . . . .10Tell Me About HYDRIM Please . . . . . . . .10Executive Director’s Update . . . . . . . . . . . .11

Julie Berger, Executive Director 2244 Stockwell Street • Lincoln, NE 68502

(O/F) 402 .438 .2321 julieberger50@gmail .com

Continued on page 3

NEBRASKA ACADEMY OF GENERAL DENTISTRY& IOWA ACADEMY OF GENERAL DENTISTRY

October 27 – 292017 Fall Mastertrack Weekend

“Triaging the Facial Pain Patient: From Diagnosis to Management Strategies”

“Anesthesia, Pain Management, Sedation and Pharmacology”

DR. STEVEN D. BENDER earned his Doctorate of Dental Surgery degree from Baylor College of Dentistry in 1986 and practiced general restorative dentistry for 14 years .

He then studied orofacial pain and temporomandibular disorders at the Parker E Mahan Facial Pain Center at the University Of Florida College Of Dentistry under the mentorship of Doctors Henry Gremillion and Parker Mahan .

From 2000-2015, Dr . Bender maintained a private practice devoted to pain management of the head and face, as well as sleep medicine . Beginning in 2016, he transitioned to a full

time faculty member of Texas A&M College of Dentistry and assumed the role of director of facial pain and sleep medicine . He has earned Fellowship in the American Academy of Orofacial Pain, the American Headache Society, the International Academy of Oral Oncology and the American College of Dentists . He is a past presi-dent of the American Academy of Orofacial Pain as well as the Fourth District Dental Society of Texas and the Dallas Academy of General Dentistry . In addition, he serves as a consultant for the United States Army .

DR. J. BRUCE BAVITZ, graduated from the University of Pennsylvania School of Dental Medicine in 1984 and com-pleted his Oral/Maxillofacial Surgery (OMFS) Residency in Pittsburgh in 1988 . He is currently the Merritt C . Pederson Professor and Chair of the Department of Surgical Specialties at the University of Nebraska College of Dentistry, and has given multiple CE courses to dentists both nationally and internationally . He is past president of the Nebraska Society of OMFS, the Lincoln District Dental Society, and the Nebraska Chapter of the American College of Dentists and

is a Diplomate of the American Board of OMFS . He has a United States patent on a dental implant aligning device, is a member of the Oral Surgery/Pain Control test

Dr. J. Bruce Bavitz

Dr. Steven D. Bender

GENERAL INFORMATIONAll 3 days will be held at the Doubletree Hotel, 3650 S . 72nd St ., Omaha, NE 68124 . Schedule for all 3 days October 27, 28 & 29, 20177:15 a .m . . . . . . . . . . Registration/Breakfast8 a .m . . . . . . . . . . . . . Course Begins12 noon – 1 p .m . . . Lunch Hour1 p .m . . . . . . . . . . . . . Course resumes5 p .m . . . . . . . . . . . . . Course adjourns** Breakfast, Coffee breaks and lunch will be provided each day

This course will fulfill the requirements for the 2 new disciplines for Mastership. By attending the entire 3 days, you will receive 12 hours lecture credit in Orofacial Pain (code 200) and 12 hours participation credit in Anesthesia, Pain Management, Sedation & Pharmacology (code 340)Due to the popularity of this course, we encourage you to register early and take advantage of the member discounts. Space is limited!!!

The entire 3 day event is for doctors only .

2 D E N T I S T R Y … I N G E N E R A L • S U M M E R | F A L L 2 0 1 7

2017-2018 IAGD Officers and Board of DirectorsPresident Chad A . Johnson, DDS, FAGD 915 10th Avenue Pl SE Altoona, IA 50009-2560 515-967-4292 (F) 515-266-3597 chaddds@gmail .com

President-Elect Dona W . Prince, DDS, MAGD 4220 Sergeant Rd, Ste 100 Sioux City, IA 51106-4648 712-274-2228 drprince@drdonaprince .com

Vice President Roberto A . Moreno, DDS, FAGD 1205 N Columbus St West Liberty, IA 52776-9601 319-627-2612 robertomoreno .dds@gmail .com

Immediate Past President/Public Information Officer Kelly Huston, DDS 1630 SW White Birch Cir Ankeny, IA 50023 515-965-4470 kmhuston@gmail .com

Treasurer Ryan Hussong, DDS 1010 S . 3rd St, Ste 2A Polk, IA 50226 515-984-6001 ryanhussong@gmail .com

Editor/Webmaster Jon L . Hardinger, DDS, MAGD 1339 6th St SW Mason City, IA 50401 641-423-6172 (F) 641-423-6248 jlhdds@netconx .net

Continuing Education Chairperson Craig Driver, DDS, MAGD 3308 Kimball Ave Waterloo, IA 50702-5758 319-232-6804 (F) 319-232-8396 cwdriver@mchsi .com

Legislative Chairperson Stephen R . Thies, DDS 7506 Hickman Rd Des Moines, IA 50324 515-276-0202 (F) 515-276-8074 srthis@qwestoffice .net

Mastertrack Chairperson Debra Oldham, DDS, FAGD 702 W Main St Anamosa, IA 52205-1636 319-462-2531 (F) 319-467-7914 d4hawks@gmail .com

Membership & Student Membership Chairperson Carol Moreno, DDS, MAGD 1205 N Columbus St West Liberty, IA 52776-9601 319-627-2153 cleam@lcom .net

Constitution & Bylaws Communications Chair John J . Arend, DDS, FAGD 206 3rd Ave NE Independence, IA 50644-1950 319-334-3342 jarend@indytel .com

Dental Care Chairperson Philip Andersen, DDS 907 Bank Ct Center Point, IA 52213 319-849-1171 (F) 319-849-2453 philipnandersen@gmail .com

Member-At-Large Carlin Lawhead, DDS, FAGD 315 Sycamore St Muscatine, IA 52761 563-263-8034 cclawhead@machlink .com

Member-At-Large Patricia Meredith, DDS, MAGD 51371 PFP UIHC Iowa City, IA 52240 319-384-7282 patricia-meredith@uiowa .edu

Member-At-Large Eric R . Recker, DDS, FAGD 2114 Washington St Pella, IA 50219-7880 641-628-1604 tridocrecker@gmail .com

At-large Board Member Richard D . Nelson, DDS 2430 Tech Dr Ste A Bettendorf, IA 52722-3258 563-332-0415 (F) 563-332-2979 rnelson49@gmail .com

At-large Board Member Chadwin J . Wagener, DDS, MAGD 340 SE Delaware Ave Ankeny, IA 50021-9346 515-964-5482 (F) 515-964-1956 drwagener@aadsmiles .com

National Trustee, Region 10 Mark Malterud, DDS, MAGD 770 Mount Curve Blvd Saint Paul, MN 55116 651-699-2822 (F) 651-699-3009 mark@drmalterud .com

Regional Director Kevin C . Low, DDS PO Box 468 246 Vincent Ave Chappell, NE 69129-0468 308 .874 .2910 lenny2351_69129@yahoo .com

Executive Director Julie Berger 2244 Stockwell St Lincoln, NE 68502 402-438-2321 julieberger50@gmail .com

President’s Message

I can just imagine your summer has been just as busy and fast as mine has been . My last message to this group was 6 months ago!I want to reiterate that our fall course is October 13-15 in

Des Moines, with Mastership requirements being fulfilled in the orthodontic and pediatric categories . This will be the end of this current IAGD Mastertrack series, but you can join at any time . It is definitely a benefit to Iowa dentists to have the speakers and coursework that the Iowa AGD provides within our own state,

and on a regular basis . Our executive director, Julie Berger, is who you would contact to sign up for the Mastertrack series: 402 .438 .2321, or julieberger50@gmail .com

That said, I want to congratulate our colleagues that are finishing the Mastertrack, which is a well-rounded CE coursework that allows for you to earn your Mastership within 6 years, all done within the state . They have met twice annually to receive hands-on training, lectures, and do case presentations among the group, to sharpen their skills and become more well rounded in all areas within general dentistry .

Speaking of case presentations, in a more informal manner—I want to showcase our Facebook page, "Iowa Academy of General Dentistry," which is a closed group only for Iowa AGD member to present cases online without the hassle of scheduling time to meet with one another regarding any particular case discussion or topical discussion in general .

Is there any way that I can be of service to you? If so, feel free to contact me .

Chad Johnson, DDS, FAGD

(Left to right); Dr. Patty Meredith, Greg Daniels (2017 IAGD Student Award Winner) and Dr. Mike Murrell.

IAGD Senior Dental Student Award


construction section for the National Dental Board, and has performed office inspections for the State of Nebraska for dentist’s seeking advanced anesthesia permits . He is currently the coordinat-ing editor for Practical Reviews in Oral and Maxillofacial Surgery, and serves as a reviewer for multiple implant and oral surgery journals . His primary area of research and publishing involves the surgical anatomy of the jaws and alveolar bone reconstruction .

“Triaging the Facial Pain Patient: From Diagnosis to Management Strategies” with Dr. Steven Bender Friday, October 27 • 8 a.m. – 5 p.m. Saturday, October 28 • 8 a.m. – 12 noon

By far, the most common reason patients seek care in a medical or dental setting is for pain . At least 22% of the population has suffered from facial pain more than once in the past 6 months with the highest prevalence in the 18- to 25-year-old age group . Oral and facial pains may be due to disease of the orofacial structures, musculoskeletal system, peripheral or central nervous system, or possibly, the manifestation of psychosocial disorders . These pain conditions can be primary in presentation or secondary due to referral from other sources such as cervical or intracranial structures . The diversity of these numerous structures and their complex innervations are potentially responsible for the sometimes-puzzling symptomatology these patients present with . In order to effectively treat the facial pain patient; a systematic approach to examination must be a part of the diagnostic process . This course will provide the clinician with a cursory background of pain definitions, classifications and presentations commonly seen in the head, face and oral cavity regions . The second portion of this course will discuss management strategies of some of the most frequently encountered facial pain presentations . This activity will be enhanced with real

The AGD-Iowa is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing education programs of this program provider are accepted by AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry. The current term of approval extends from 6/1/2017 to 5/31/2021. ID# 219301

FAGD/MAGD

Approved6/1/2017 to 5/31/2021

Continued from page 1

October 27 – 29 2017 Fall Mastertrak Weekend

patient case presentations designed to encourage discussion . It is encouraged for the participants to bring some of their most challenging cases for group discussion. At the conclusion of this course, the clinician should feel comfortable with the process necessary to adequately screen, treat or refer this often-misdiagnosed group of patients .

LEARNING OBJECTIVES• Learn the classifications of pain• Recognize pain presentations in the

oral and facial region and common referral patterns

• Establish diagnostic procedures and office protocols for patients with chronic facial pain

• Review evidence-based treatment protocols for different chronic facial pain conditions

• Know when and how to work with other specialties and when it’s best to refer

COURSE OUTLINE• Introduction: what is orofacial pain • Epidemiology of orofacial pain• Classifications of pain• Introduction to assessment strategies• Orofacial pain presentations: Musculoskeletal Neuropathic Burning mouth syndrome Primary headache disorders “the red flags”• Management strategies for orofacial

pain conditions with case studies

“Anesthesia, Pain Management, Sedation and Pharmacology” with Dr. J. Bruce BavitzSaturday, October 28 • 1 – 5 p.m. Sunday, October 29 • 8 a.m. – 5 p.m.

ANESTHESIA• What’s new in local anesthesia• Intranasal administration• Buffering• Reversal• Pediatric dosing review

PAIN MANAGEMENT• Acute versus Chronic• Central versus peripherally acting

agents• Nation’s opioid epidemic• Contemporary narcotic prescription

guidelines

SEDATION• Rationale, why sedate?• New ADA Guidelines and NE state

laws, why the drama• Minimal, moderate and deep sedation

definition review• Capnography• Review of overdose cases…what went

wrong?

PHARMACOLOGY• Review of drug classes and best agents

from each class• Future breakthroughs?• Advantages and disadvantages of each

route of drug administration• FDA approval process• Antibiotic review, both topical and

systemic

PRODUCT TRAINING• Kovanaze intranasal local

• Emergency epinephrine options glass ampules versus Epipens

• Mock challenging case scenarios . . .can’t get numb, anxious and pregnant, medication related osteonecrosis, novel oral anticoagulants, respiratory depression during sedation, allergic to local

Registration Form on page 5


Legislative Chair Report

The Iowa Dental Board meeting was held on Thursday, April 27, 2017 . As always there

were attendees from the Iowa Dental Association, Iowa Dental Hygiene

Association, and the Iowa Public Health Department . Also, there were representatives from the SmileLabs business and DSO, Dental Support Organization .

Board member changes were

announced . Public board member, Diane Meier, has completed her 9 year term . This was her last meeting . Dr . Steve Fuller will no longer be a board member . This was his last meeting .

The American Association of Dental Boards, AADB, gave a presentation involving Assessment Services Program . The AADB is an association of all state dental boards . It serves as a forum for information exchange and a resource for dental board services . The presentation explained the specific services involved in dental licensee issues . The association can provide expert review assessment for cases of complaints . The association has established programs at 4 dental universities for dentist professional review . The dentist professional review involves an evaluation of the dentist clinical skills and personal problems . At the dental universities there are established programs to provide remediation and rehabilitation of dental clinical skills . The remediation and rehabilitation programs provide an assessment of the dentist for the referring

dental board . The dentist participant bears the cost of the expert review, assessment, and remediation programs . The cost can be substantial .

A new communication system will be implemented by the board for communication with licensees and the public . The system was demonstrated . It will be user friendly and comprehensive .

The anesthesia committee is developing guidelines regarding capnography . The guidelines will probably be similar to the ADA guidelines . They will be submitted at a future meeting for discussion and a notice of intended action .

The Iowa legislature passed legislation allowing dental hygienists to provide oral education without dentist supervision .

Of special interest the issue of dental practice ownership by a dental hygienist was discussed . Current regulations prevent ownership of a dental practice by a dental hygienist . If a dental hygienist wants to own a dental practice, then the dental board must grant a waiver . There was a request from a dental hygienist to own a practice . The dental hygienist must practice under the supervision of a dentist . However, the dental hygienist may own the practice if a waiver of rule is given . The dental hygienist’s reason for the waiver request was a lack of employment in the area . By having ownership of the dental practice she could remain employed in the area . Again, she must practice under the supervision of a dentist . The waiver was approved by the board . This is the second waiver of practice ownership allowing a dental hygienist to own a dental practice .

Dental assistant and dental hygienist renewals will begin in July and August of this year . There will be 8,000 renewals .

The board requests that all renewals be done online at the dental board website . Paper renewals are work intensive for the board, slow the renewal process, and are costly . Please renew registrations and licenses online for the board’s benefit .

The board passed rules regarding dentist transition or retirement . A dentist who is transitioning from a location or retiring must notify patients treated within the past 2 years of the transition or retirement, inform patients of the location of their patient records, and provide options for continued care .

Regarding continuing education, dentists will be required to have 1 hour continuing education in jurisprudence and 1 hour continuing education in infection control . Continuing education credit at the dental convention will be changed . There will be credit of 1 ½ hr for one day attendance and another 1 ½ hr credit for a second day of attendance . The requirements will apply at the next renewal period in 2018 .

There is concern about teeth whitening by unlicensed individuals in violation of the illegal practice of dentistry . Multiple teeth whitening business have opened . A letter explaining the rule regarding the practice of dentistry will be sent to the teeth whitening business .

The next dental board meeting will be July 13-14, 2017 . To all practicing Iowa dentists, please consider attending the meetings . The board appreciates dentist attendance and involvement .

Steve Thies, DDS IAGD Legislative Chair

Dr. Thies

Iowa Dental Board Report


Course Registration Form

Name

Staff

Address City State Zip

Phone Fax

E-mail (required)

AGD # Non-Member: Yes

PAYMENT METHOD

Check (made payable to the Nebraska AGD) Credit Card Credit Card Type

Credit Card # Expiration Date Code on back

Credit Card Address (if different from above)

Credit Card City, State & Zip (if different from above)

Phone (if different from above) Fax (if different from above)

Signature Date

2017 Fall Mastertrack Weekend (This weekend will consist of the 2 new disciplines required for Mastership)“Triaging the Facial Pain Patient: From Diagnosis to Management Strategies” with Dr . Steven Bender“Anesthesia, Pain Management, Sedation and Pharmacology” with Dr . J . Bruce Bavitz

October 27, 28 & 29, 2017A block of sleeping rooms have been reserved at the Doubletree Hotel until August 31, 2017 . Ask for the Nebraska Academy of General Dentistry (NAD) rate of $89 . To make reservations call the hotel directly at 402 .905 .9414 .

COURSE FEES AGD Dentists: Entire 3 day Event $1,950 Register by August 1, 2017 and receive a $200 member only discount. Includes materials, meals and handouts. Lodging not included.

Non-AGD Dentist Entire 3 day Event $2,600 Includes materials, meals and handouts. Lodging not included.

Total

Please mail registration form and payment to: NAGD, 2244 Stockwell Street Lincoln, NE 68502. Registration can be taken over the phone with a credit card. Register by September 26th to avoid a $45 late fee! A $85 processing fee will be applied to all person requesting a refund before September 26th. No refunds will be issued after that date. You will receive an email confirmation when your registration is processed. The course has been submitted to the IDBE for CE credits and approval is pending.


If there is one reason above all else why I decided to implement oral scanning in my dental practice, it was because

I knew I could see my work better . Now that I am 64 years old and have 38 years

of dental practice experience, it seems the right time to make it easier on myself in evaluating the quality of my crown preps and impressions .

Contemplative DaysIn 2011, I shopped for the Chairside

Oral Scanner (COS) by 3M, and had an office demonstration . I balked at the uploading charge to central processing, and a charge to create the model . There also was a fee for directing this model to the lab of my choice . The unit was about $30K, and Iowa Dental Supply was proud to be showing tomorrow’s dentistry . Following this, the Iowa Dental Association Annual Session featured Dr . Lou Graham who also spoke on digital oral scanning with the iTero and others . In 2014, Dr . Brian Schroeder gave a presentation to the North Iowa Dental Seminars (NIDS) and explained how he incorporated the COS into his practice . About that time, I became aware that my colleagues from Trachsel Dental Studio in Rochester printed models from oral scanning . Then, in May this year Dr . Brian Schroeder gave a second presentation on the COS to NIDS . By then I had decided to proceed based on my office needs .

The TRIOS3 scanner by 3 Shape was my choice, primarily because my dental lab supported it . It cost me about $42K, and there were no extra charges per model, and I paid an additional maintenance fee for the next three years . The practical side of getting an oral scanner for me was for quality, and I have not been disappointed . Oral Scanning overall has not yet saved me time compared to analog, but I expect to save time once I am familiar with the process . Perhaps my readers will benefit from my experience and I can help others who are making the transition into digital dentistry .

Hydrocolloid DaysSince moving to Mason City and assuming the dental practice of Dr . Denny Buffington in 1989, I have used the Van R Hydrocolloid impression system for crowns . On hearing that I used hydrocolloid, Dr . Schroeder reassured me that he still knew of excellent dentists who continue using hydrocolloid in Texas . This technique is familiar to my staff, and involves the softening and maintenance of the impression material in heated baths . During an impression, special water-cooled trays are hooked up to water carrying hoses that flow inside the tray . This cools the impression material and sets in 5 minutes . In this technique, the material is dead soft and doesn’t rely on chain reaction polymerization . The material can push water/fluids away from the crown prep so that moisture is not a problem at the time of the impression . This benign and chemical free material doesn’t have an odor, and it is well digested if swallowed . In the past couple of years, I stopped using retraction cord . I found that the retraction cord distorted the delicate facial margin and caused recession . I used a soft clay-like substance called 3M Retraction Paste . This got rinsed and ultrasonically cleaned off just before splashing on the hydrocolloid . When it was set in 5 minutes, the hydrocolloid was removed and poured and the die inspected before sending this to the lab . It took two days to reach the lab . My crown preps had chamfer margins and no buildups were ever pulled out with hydrocolloid . The bottom line is seeing the die before sending it out . We spent many evenings dropping cases off at the post office before 6 pm and scheduling the patient two weeks out .

Model Storage DaysThe storage of study models is a medical-legal concern, and I reduced this exposure by taking a JPG digital image with my dental camera then editing and filing this image into a patient’s folder . This does sound like a lot of extra work, but it does crop the image, add the patient’s name, my name, date and any pertinent information to the image . I actually was encouraged by others who appreciated this attention to detail affirming my image storage work . Further, I took photos of the finished crowns or removable appliances . (I have a black background box and lighting)

Now, this is laborious and could be delegated, but it was one of my interests and I kept doing this to satisfy the Iowa Dental Board’s requirements of patient records and also to communicate to my lab about the case . After I set up the oral scanner, it occurred to me that it would already have a record of all of the models, and this would save me a lot of time and storage . If I were an oral scanner sales representative I would promote this aspect to my doctors, but they don’t naturally see that side of the work we do to document our work in their promotion of the product . Anyway, my sales people left me to discover this myself .

Scanning and Learning Abstractly, I anticipated the scanner showing me the die before sending it to the lab . In real life, not only does it see the margin, the scanner interprets the draw and the occlusal clearance . So now this device tests me on the draw, reduction, and prep surface irregularities . All of this sounds incredibly cool and helpful, but then I realized the difference between what I was doing and what I was learning to do . The first thing that became apparent was the difference in tooth preparation .

Editor’s Article

Dr. Jon L. Hardinger

Continued on page 7

Oral Scanning


I decided to practice a shoulder preparation with my conventional hydrocolloid, and the first thing I encountered was the shelf left at the margin which naturally creates an undercut . You are already telling me what I now know, that my temporaries will get caught on this- and they did- and parts of the temporary left behind messed up my impression . I am just saying the transition from chamfer to shoulder preparation was hard for me . Further, I had to learn how to make a shoulder without the sombrero effect . I anticipated eliminating the curved-up lip and I ordered an end cutting diamond bur from Komet . I am confident using the .5 mm circle cutting end to flatten that shoulder . The bur is smooth on the vertical side, so that adjacent tissue is not disturbed . When Dr . Brian Schroeder spoke, he explained how a larger diameter diamond bur has a lower angle of cutting the surface and makes it

support the back end of my scanning device so when I get past a certain point in the arch I can re-grasp . Further, like any software there are extra steps that are possible, and I am learning that some cases are straight forward and do not require these extra steps . A patient who is only getting a crown build-up, I can pre-scan both arches so that when a patient returns for their prep the software is programmed to allow a fresh scan of the prepared tooth and proceed to the occlusion .

I am told about 25% of dentists are using an oral scanner, and I expect this will only increase as the product is accepted . I have purposely not promoted it as a solution to messy impressions, because I took pride in my impression work . However, patients do like the digital method better, and it can only build the practice .

Jon L. Hardinger, DDS, MAGD IAGD Editor

easier to cut smoothly . This works for me on the buccal, but it is too large for reduction interproximal .

Lately, I have used Kerr’s Vertise Flow to fill in wavy undercuts, and this works nicely and by the time I do this; I finish the prep with a 3M Coarse Black Disc, and polish the contacts to make sure the oral scanner can see to draw up from the margins under the contacts . All of this can be seen in magnification on the flat screen monitor, and I learn after the scan what needs to be improved . To review, I can check the draw, margins, undercuts in the preparation, and see what the TRIOS3 says for color mapping .

My first case scanning was a case without posterior teeth 29-31, and that is a difficult scan for learning and building confidence . When the case came back it was high in the bite . This case taught me the importance of posterior recording of teeth and I could have left the patient’s partial denture in to help with this . I also have my office staff lightly


Oral Scanning


Registration Form on page 9

Dr . Josh Wren received

his Doctor of Dental Medicine degree from the University of Mississippi School of Dentistry in 2005 . He then completed the Pediatric Dentistry

residency program at the University of Kentucky in 2007, where he obtained his Specialty Certificate in Pediatric Dentistry . After residency, Dr . Wren established Wren Pediatric Dentistry in Brandon, Mississippi . He is a diplomate of the American Board of Pediatric Dentistry and Mississippi representative to the Southeastern Society of Pediatric Dentistry . Dr . Wren is an online and live speaker for www .dentaltown .com and serves as the moderator of the pediatric dental forum . In 2013, he founded Pediatric Dental Seminars to educate practitioners on pediatric dental topics .

LECTURE

“Pediatric Dental Pearls”Friday, October 13, 2017(8 hours AGD Pedo Lecture Credit) (IDBE pending final approval)

This course is designed to give the participants a clear understanding and comfort level

working with children while learning modern techniques and materials in all aspects of pediatric dentistry . There have been many changes in the materials used in pediatric dentistry over the past few years . By using specific cases from his office, Dr . Wren will review his choices of materials and methods for performing various pediatric dental procedures .

October 13 – 152017 IAGD FALL MEETING

“Pediatric Dental Pearls”

Dr. Josh Wren

While this presentation is case based, Dr . Wren will briefly review the science and literature behind the materials that he uses . At the conclusion of the course, the participant will know how to confidently treat the pediatric patient and get predictable treatment results .

LEARNING OBJECTIVES • Learn “modern day” behavior guidance

methods• Understand emerging trends in caries

control and treatment that is based on caries risk assessment

• Understand the differences and treatment decisions of glass ionomer vs . bioactive vs . resin based composites

• Learn when full coverage restorations are needed and how to perform these procedures (resin crowns vs . class III restorations in the anterior primary teeth, stainless steel crowns vs . large amalgams/resins)

• Learn when/how to perform various pulp therapy procedures (indirect pulp therapy, therapeutic pulptotomies, pulpectomies) and the materials that are proven to be the most successful

• Learn the ultimate painless local anesthetic technique when treating all primary teeth

HANDS ON TRAINING

Pedo/Ortho lecture and OrthoOctober 14 & 15, 2017Saturday & Sunday

If you attend the entire 3 days, you will receive 12 hours AGD Pedo Participation Credit and 12 hours

AGD Ortho Participation Credit—IDBE pending final approval . While you only need 12 hours participation in ortho and 12 hours participation credit in pedo to fulfill the AGD Mastership requirements, 24 additional hours of participation credit (12 in pedo/12 in ortho) may be earned by presenting a clinical homework

assignment after the course and presenting in March of 2018 . There is an additional fee .

Learning Objectives for the Pediatric Hands on Training • Learn how to prepare, crimp and seat

stainless steel crowns• Learn how to prepare and seat anterior resin

crowns• Learn how to prepare and seat anterior and

posterior zirconia crowns• Learn how to use and implement Activa

restorative composite in the class II restoration

• Learn the indications for lingual and labial frenectomies

• Learn the difference between a scalpel frenectomy and a laser frenectomy

ORTHO LECTURE

“Interceptive Orthodontics: From growth and development to treating common malocclusions”Learning Objectives for the Orthodontic Lecture• Understand an abbreviated cephalometric

analysis• Learn how to treat common malocclusions

in the mixed dentition—posterior crossbites, anterior crossbities, transient crowding

• Learn when to refer patients for an orthodontic evaluation

• Learn when to look for what on your panoramic evaluations

• Learn when to place what space maintainers when dealing with premature loss of primary teeth

• Learn how to treat hypocalcified first permanent molars (should I extract, should I seal, should I restore with full coverage)


Learning Objective for the Hands on Orthodontics Training • Learn how to fabricate the various space

maintainers—band and loop, lower lingual arch, wire nance

• Learn how to fabricate and quad helix for expansion

• Learn how to fabricate a Nance button + Z-Summer for anterior crossbite correction


2017 IAGD Fall Meeting “Pediatric Dental Pearls”

The AGD-Iowa is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing education programs of this program provider are accepted by AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry. The current term of approval extends from 6/1/2017 to 5/31/2021. ID# 219301

FAGD/MAGD

Approved6/1/2017 to 5/31/2021

Course Registration Form

Name

Staff

Address City State Zip

Phone Fax

E-mail (required)

AGD # Non-Member: Yes

PAYMENT METHOD

Check (made payable to the Iowa AGD) Credit Card Credit Card Type

Credit Card # Expiration Date Code on back

Credit Card Address (if different from above)

Credit Card City, State & Zip (if different from above)

Phone (if different from above) Fax (if different from above)

Signature Date

2017 IAGD Fall Meeting“Pediatric Dental Pearls” with Dr . Josh WrenOctober 13, 14 & 15, 2017A block of sleeping rooms have been reserved at the Hilton Garden Inn for $109 until September 20, 2017 . Ask for the “Iowa AGD” rate . To make reservations, call 515 .270 .8890 .

COURSE FEES: AGD Dentists: Friday Lecture Only . . . . . .$ 350 (Register by 8-1-17 and receive a $50 member only discount)Non-AGD Dentists: Friday Lecture Only . . . . . .$ 600 AGD Dentists: Entire 3 day Event . . . . . . . . $1,850 (Register by 8-1-17 and receive a $200 member only discount) Includes materials, meals and handouts. Lodging not included.

Non-AGD Dentist: Entire 3 day Event . . . . . . . .$2,500 Includes materials, meals and handouts. Lodging not included.

Staff Member/Assistants/Hygienists (Friday only lecture) . . . . . . .$ 100 Dental Students (Friday only lecture) . . . . . . .$ 35 Lab Techs (Friday only lecture) . . . . . . .$ 175

Total Amount Paid

Please mail registration form and payment to: IAGD, 2244 Stockwell Street Lincoln, NE 68502 . Registration can be taken over the phone with a credit card . Register by September 26th to avoid a $45 late fee! A $40 processing fee will be applied to all persons request-ing a refund (lecture only) or $85 processing fee will be applied to all person requesting a refund (3 days) before September 26th . No refunds will be issued after that date . You will receive an email confirmation when your registration is processed . The course has been submitted to the IDBE for CE credits and approval is pending .

GENERAL INFORMATIONFriday, October 13, 2017Lecture will be held at Hilton Garden Inn8600 Northpark Drive, Johnston, IA515 .270 .8890

7:15 a .m . . . . . . . . . . . . . . . Registration8 a .m . . . . . . . . . . . . . . . . . . Course BeginsNoon – 1 p .m . . . . . . . . . . Lunch Hour1 p .m . . . . . . . . . . . . . . . . . . Course resumes5 p .m . . . . . . . . . . . . . . . . . . Course adjourns** Coffee breaks and lunch will be provided

HANDS-ON COURSE(Please note schedule change for weekend)Friday will conclude at 5 p.m.Saturday, October 14: 8 a.m. – 8 p.m.Sunday, October 15: 8 a.m. – 1 p.m.

Limited Space Available . The hands on portion will be held at Patterson Dental Supply, 955 SE 28th Street, Grimes, IA

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Editor’s Articles

Q ualified Small Employer Health Reimbursement Arrangement (QSEHRA) is a rather long

anacronym and it stands for a health reimbursement arrangement allowed since January 1, 2017 . This plan was allowed because many small businesses had stopped participating in their employee medical insurance benefit . Rather than actually buy it as an employer, the QSEHRA takes the qualified plan the employee owns already and reimburses insurance premiums, co-pays, deductibles and any other qualified medical expense . This reimbursement is funded by the employee and the employer can also fund all or a portion of the qualified expenses up to $4960 per employee . This may seem like a lot as it would allow $412 per month in reimbursement to them . However, it must have a cap otherwise employers would over fund to escape employer taxes of 7 .65% . Take the employee who has an Affordable

Care Act Silver Plan that costs $500 per month, and they get a $150 subsidy, so it costs the employee $350 per month . Enter an employer who wishes to create a benefit package including medical reimbursement, the employee can be reimbursed $412 .50 and the balance of $87 .50 is paid by them . Of course, the benefit package is a whole figure, and most employers don’t wish to add to employee cost, but if it were figured into their whole package it is possible to see both sides benefit . The employer benefits by an employee cost that spends down their gross so that there is a 31-dollar savings (412 .5 X 7 .65%) of employer taxes . Further, if a retirement plan is in place, the reimbursement is taken out before this is figured saving another percent of whatever the employer gives toward that expense .

Some bullet points to keep in mind:

• The employer decides the benefit amount up to $4950 per year for single and $10,000 for families .

• An administrator needs to be contracted who collects and disburses the qualified funds, and their costs are paid by the employer .

• Employees submit documented health care expenses to the administrator under IRC Section 213(d)

• There is no prefunding required .

I was told about an administrator called BASE® in Adel, Iowa by my accountant many years ago, and after Affordable Care Act was implemented I decided to let the medical insurance benefit go . Now with this 2017 law I am going to get back in the business with the help of an administrator . Lastly, but very important, It will help retain good employees who seek a benefits package .


What is a QSEHRA?

There is a new instrument cleaning device in my galley! This past spring my under the counter ultrasonic cleaner wore out from the harsh chemicals, and my dental repair guy, Mark Ritchhart, said that some

go through its cycle in 30 minutes or less . However, the instrument washer required 220V and the 110V water heater drew over 15 amps which meant electrical rewiring . A regular attendee at our IAGD sessions, Rhonda Anderson from HuFriedy, stopped by my office and discussed the role of the HYDRIM in our instrument receiving, cleaning and decontamination work flow . It did make preparation and packaging easier, followed by sterilization (monitoring) and finally storage and use . We run it about 4 times a day, and it makes a nice comforting sound which I like to hear .


practices like the instrument washer, HYDRIM . He told me that the same company that made the STATIM, made the HYDRIM, which stood for HYD Instrument Management . We tried an ultrasonic loaner while I shopped and worked on specifications for the instrument washer . If it were not for Dr . George North’s futuristic comment on instrument washers, I would not have been as interested . This new device featured placing more of my setups into cassettes, which I was happy to do . The instrument washer is quieter than the ultrasonic, reliably delivers dried cassettes which are autoclave ready . I decided to add a water heater right under the counter so that the HYDRIM would not have to spend as much time preheating the water and it can

Tell Me About HYDRIM Please

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Summer is almost over . Was I the only one that thought summer just flew by this year? Normally summer

is a time where we can slow down a little bit, catch up on things . It just seems like I

blinked and we were in August! I know you all know I’m a huge Royals fan and this summer I was fortunate enough to get to go to 5 games . My Dad and I made our annual father/daughter trek to KC a few weeks ago and even got to see

a double header that day! While I enjoy going to the games and watching them on TV, my favorite time of year is almost upon us…FALL!

And with fall, we are excited to have Dr . Josh Wren as our featured speaker for the fall Mastertrack . The dates are October 13-15th . Friday’s lecture is titled “Pediatric Dental Pearls” . This weekend brings a unique opportunity for those working on their Mastership to receive 12 hrs of participation credit in both Pedo and Ortho . Several mailings have gone out and all the information is also posted on our website at www .iowaagd .com . We still have a few spots left for the weekend! The Iowa AGD will also be holding a joint course with the Nebraska AGD on October 27-29 in Omaha . This course will fulfill the 2 new disciplines for Mastership that went into effect in January of 2017; Orofacial Pain (Subject code 200) and Anesthesia, Pain Management, Sedation and Pharmacology (subject code 340) .

By attending the entire weekend, you will receive 12 hrs . of lecture credit in Orofacial Pain and 12 hrs . of participation credit in Anesthesia . We still have a few spots left for this course too!

Also mark your calendars for March 2-4, 2018 for the IAGD Annual Meeting featuring our very own, Dr . Bob Margeas . He will be talking on Operative Dentistry . If you are interested in attending the weekend course, I strongly encourage you to register early . We have sold out every weekend since we started the Mastertrack . Don’t delay in registering…plus take advantage of huge membership discounts by registering early .

I am excited to announce that we had 2 doctors receive their Fellowship and 3 doctors received their Mastership in Las Vegas in July at the AGD Annual Meeting . Those members receiving their Fellowship were: Dr. Jeff Joiner of Orange City and Dr. Brad Richtsmeier of West Des Moines. Those receiv-ing their Mastership were: Dr. Nick Drzycimski of Fort Dodge, Dr. Chad Wagener of Ankeny and Dr. Dennis Yossi of Cedar Rapids. Congratulations to you all on these huge honors!

In 2018, we will also be holding a Regional Fellowship Review Course again . I am in the process of finalizing a few things so watch for the e-blasts in the coming weeks for the date!

At the fall meeting in October, it will mark the end of our first Mastertrack class . Their journey started out in the fall of 2012 . It’s crazy to think we started out with only 10 doctors in the initial class and today, the class has grown to 21 . The class was slated to finish next year but the

Julie Berger

Executive Director’s Update

current class decided to join the Nebraska AGD with the additional course in October and finish yet this year . It has been a honor and privilege to ride along on this journey with those graduating and I couldn’t be more proud!

The IAGD Mastertrack is one of the best benefits we offer! High quality continuing education, all laid out for you in a 6 year program…right in your back yard! And you can start at any time . If you have been considering starting the Mastertrack, give me a call and let’s chat . Come to a Friday lecture or attend the entire weekend and see what it’s all about! We’ve had some FABULOUS CE and look forward to seeing you at a meeting in the future!

I’ve said this before and I will say it again…get involved! Your input is important and valuable . You have chosen to be a part of an elite organization, one where together we CAN make a difference . If you haven’t been to a meeting in a few years, I invite you to join us! We welcome you to join us for a lecture or the weekend course! Please feel free to contact me at any time . You can reach me at 402-438-2321 or julieberger50@gmail .com .

Have a great FALL!

Julie Berger, IAGD Executive Director

2244 Stockwell St • Lincoln, NE 68502

A PUBLICATION OF THE IOWA ACADEMY OF GENERAL …€¦ · Academy of Orofacial Pain, the American...

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