GDA Action February/March 2016

February/March 2016 Journal of the Georgia Dental Association

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February/March 2016 3

GDACONTENTS

SEMI-ANNUAL REPORTTO GDA MEMBERSExecutive Director Frank Capaldo on finances, services, and future initiatives.

GDA CONVENTIONGet the scoop on this yearsCE and special events.

ANTIBIOTIC REFRESHERWhen and when not to pre-medicate a patient, completewith a wallet card to share.

SEEN & HEARDMembers making news and news for GDA members.

THE PRACTICETools and tips to help youmanage your business.

FINDING SUCCESSHelping you achieve personaland professional growth.

GDA CalendarGDA Benefits Plus+Contact GDA StaffEditorialDirectors CommentaryClassifiedsPractice Outreach

Dentists Take Part in GDA LAW DaysAttending a GDA Legislative AWareness (LAW) Day provides a unique opportunity to learn about political issues impacting dentistry and dental patients in the state. Dentist, GDA Alliance, and dental student attendees enjoy breakfast and a full issues orientation, then walk to the State Capitol (like Dr. Bruce Camp, at left above, and Dr. Darryal Donerlson-McCullough did on the February 10 LAW Day) and talk to legislators about those issues. Thank you to all of this years attendees for volunteering their time to speak up for patients and dentistry!

february/march 2016 volume 35, no. 2

features

departments

in every issue

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15

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Cover: Dr. Amy Loden and Dr. Michael Loden of Central District research information about legislators during a GDA LAW Day at the State Capitol. Look for a legislative wrap up and list of LAW Day attendees in a future GDA Action. (Photo: Sheila Watson.)

4 February/March 2016

GDA ACTION (ISSN 0273-5989; USPS PE-590290) The official Journal of the Georgia Dental Association is published 10 times per year.

POSTMASTER: Send address changes to GDA Action, 7000 Peachtree Dunwoody Road N.E., Suite 200, Building 17, Atlanta, GA 30328.

Dr. David BradberryGDA Editor1070 Woodlawn Drive NESuite 250Marietta, GA [email protected]

Dr. Tom BroderickGDA President500 Eisenhower DriveSavannah, GA [email protected]

Mr. Frank Capaldo Executive DirectorGeorgia Dental Association7000 Peachtree Dunwoody Road NESuite 200 Building 17Atlanta, GA [email protected]

______________________________

GDA ACTION seeks to be an issues-driven journal focusing on current matters affecting Georgia dentists and patients accomplished by disseminating information and providing a forum for commentary.

Closing date for all editorial and advertising materials: First of the month preceding the publication month.

Subscriptions: $17 of GDA membership dues is for the journal; all others, $75 per year. Periodicals postage paid at Atlanta, GA.

Copyright 2016 by the Georgia Dental Association. All rights reserved. No part of this publication may be reproduced without written permission. Publication of any article or advertisement should not be deemed an endorsement of the opinions expressed or products advertised. The GDA expressly reserves the right to refuse publication of any article, photograph, or advertisement, and illustrate, reduce, or revise any article submitted.

GDAEVENTS

April 7-9: ADA Recruitment & Retention Conference, Chicago.

Fri, April 22: GDA Expanded Duties Course, Columbus Tech.

Apr 24-May 1: GDA Presidents Trip: Danube River Cruise.

___________________________________________________________

May 2-4: Washington Leadership Conference, DC.

Mon, May 16: Northern District Executive Council, GDA Office.

Fri, May 20: Southwestern District CE Event: Dr. Howard Farran.

Sat, May 21: Special Smiles Dental Screening Event, Emory Campus.

Sat, May 21: Leadership GDA Workshop, GDA Office.

___________________________________________________________

Mon, July 4: GDA Office Closed for Independence Day Holiday.

Mon, July 11: Northern District Executive Council, GDA Office.

Wed, July 13: GDA Board of Trustees Meeting, Amelia Island, Florida.

Thur, July 14: GDA House of Delegates Meeting, Amelia Island, Florida.

July 14-17: GDA Convention & Expo, Amelia Island, Florida.

Fri, July 22: ACD White Coat Ceremony, The Dental College of Georgia.

Sat, July 30: NEW DATE: Northern District Gala for Smiles, Park Tavern.

___________________________________________________________

Wed, August 24: Welcome Back Event, The Dental College of Georgia.

Sat, August 27: Special Smiles Dental Screening Event, Warner Robins.

___________________________________________________________

Mon, Sept 5: GDA Office Closed for Labor Day Holiday.

Sat, Sept 10: GDA Board of Trustees Meeting, Atlanta.

___________________________________________________________

Oct 13-15: ADA Fifth District Caucus, Birmingham, AL

Oct 20-25: ADA Annual Session, Denver, Colorado

Oct 20-23 Continuing Education

Oct 20-22 Exhibit Hall

Oct 21-25 House of Delegates


REACHUSGDA EXECUTIVE OFFICE7000 Peachtree Dunwoody Road NESuite 200 Building 17Atlanta GA 30328-1655(800) 432-4357 or (404) 636-7553GDA Fax: (404) 633-3943GDIS Fax: (404) 634-6099

EXECUTIVE DIRECTORFrank J. [email protected]

EXECUTIVE STAFFEmail staff at [email protected] Dial the persons extention when calling

Michele Amatulli, x-127Business Insurance Department Manager

Christy Biddy, x-113Health Insurance Department Manager

Catrece Brown, MAFM, x-106Assistant Controller

Carol Galbreath, x-119Senior Director of Public Relations & Marketing

Kitty Giffin, x-109Assistant to Georgia Dental Holding Co.

Delaine Hall, x-104Senior Director of Communications

Anne Jamison, x-116Membership & Advertising Assistant

Laura Kuechenmeister, x-190Communications Specialist

Courtney Layfield, x-209Director of Outreach & Development, GDA Foundation for Oral Health

Scott Lofranco, x-103General Counsel and Director of Government Relations

Stephanie Lotti, x-108Senior Director of Health Policy

Denise Moya, x-129Business Insurance Sales Representative

Torin Nickens, x-107Business Insurance Sales Representative

Katherine Torbush, x-191Member Relations Manager

Lisa VanZandt, x-105Chief Operating Officer, GDHC & GDIS

Sheila Watson, x-189Governmental Affairs Assistant

Patrice Williams, x-125Assistant to the Executive Director

MERCEDES-BENZ PROGRAM: (866) 628-7232 or www.gadental.org

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DR. DAVID BRADBERRYGDA EditorPhone (770) [email protected]

On my mind most often lately is what I call the state of the profession. In government, education, and business arenas every year the leader typically addresses the rank and file with a speech summarizing where the entity is at that time and where they intend to go. A thought, bringing up the question for our professionwhere are we and where do we intend to go?

I have posited many thoughts to you over the last few years and tried to provoke thought and awareness. We have lived in a bubble for some time and been relatively unaffected until recently. In the last few years our little bubble we call dental practice has been stretched, poked, prodded, and at times attacked. The view we have known, the view that has been taught in our schools, and the overall premise of how we do what we do is, I believe, not only under assault but in the throes of changing and evolving.

In my last few writings I let everyone know that change is always with us and has many benefits. Failure to change leads to stagnation and the possibility of being discarded to the dust bins of history. State after state is falling to the rosier image of scope of expansion for different members of the dental team. The pressures to change politically and economically are tremendous. As in other professions there are promises that the cost of care will decrease and access to care will increase. But I ask you, with all this change in other professions, has your ability to access appointments and save cost improved? For me and my family the answer is a resounding NO.

From my own perspective, the trend that I am seeing is that patients are finding more difficulty, not less, in accessing medical care. The cost of delivering and receiving care is exploding at a rate faster than ever. People think they have insurance and therefore access when the truth is that is often a phantom. The deductibles are causing many to be unable to receive the care they need, so on paper they have coverage but reality is something different.

We in organized dentistry are working harder to find ways to break down barriers for people to receive the care they deserve

Meanwhile, our ability to care for patients, the numbers of dentists we have [...], and our overall means to provide the best and greatest oral health care is the best it has ever been.

EDITORIAL: STATE OF THE UNION

By Dr. David BradberryGDA Editor

and desire. But the plain fact is the harder we work, the more those who provide coverage for care, no matter what the type, actually seem to put up more barriers.

The more efficiency we create in the system, the more reasons seem to be given for lower reimbursements. If the numbers of people we care for increase, the more the coverage entities seem to view there must be a problem.

Meanwhile, our ability to care for patients, the numbers of dentists we have available, and our overall means to provide the best and greatest oral health care is the best it has ever been. Each person in the dental team is appropriately trained, motivated, and has the biggest heart ever. In spite of this, we have entities, including those in the coverage sector, who want to change that. I believe that changing scopes of practice for members of the dental team will not break down barriers and impact access. Patients need total care, not just stop-gap measures that I believe will eventually lead to increased costs and inefficiencies in care delivery that will push away the people who need help.

At the end of the day it appears to me that a wall is continually being built between patients and doctors. Every time we fight to knock out a brick, three more appear in its place. We have to tear down this wall and we must recognize that time is short. We have to see that our profession is under serious pressure and cracks are forming. We as dentists and the teams that magnificently help us to deliver care every day are strong. But many forces, including the monetary coverage entities that have not only gained a foothold, but are dangerously close to having a level of control that we cannot recover from, grow stronger every day.

So ladies and gentlemen, the state of the profession is cloudy with a possibility for showers or sunshine. Its up to you. If you have not joined your association for 2016, the one fighting for us every single day, it is time.


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FRANK J. CAPALDOExecutive DirectorPhone (404) [email protected]

To sit back hoping that someday, some way, someone will make things right is to go on feeding the crocodile, hoping he will eat you lastbut eat you he will. Ronald Reagan

Folks, we have a lot to be proud of as a team when we look at our accomplishments over the last six months. We have faced some serious challenges but none of us has sat back. As a result, we have made a lot of things right.

I want to give you a phrase: Right-sized. We have welcomed a number of talented staff members in the past few months, and we are at last approaching an association that is right-sized for the products and services we currently offer and plan to roll out. When a member reaches out, there will be a staff member there to provide answers. Christy Biddy, in addition to her position as Health Insurance Department Manager, is bringing her years of human resources experience into play and is giving all of our new staff members the materials they need to be productive starting their first day. Every staff member is introduced immediately to the idea that if it matters to a GDA member, it matters to us.

Further, in a two-year process we have turned around our financial picture with positive trends during the fourth quarter of 2015 and the first quarter of 2016 and are on our way to solid financial health.

I want to give you one more phrase: Strategic Plan. Your House of Delegates has approved the goals and strategies for your associations Strategic Plan. Going forward, the staff and leadership will use this plan to help determine what products, services, and operational structures are the ones that truly move this association forward toward our mission of Helping Georgia Member Dentists Succeed. Already, under Dr. Marshall Mann, the Governance Task Force is undertaking the monumental job of reviewing each standing committee and our governance structure to see if any changes need to be made.

Further, in a two-year process we have turned around our financial picture with positive trends during the fourth quarter of 2015 and the first quarter of 2016 and are on our way to solid financial health.

EXECUTIVE DIRECTOR SEMI-ANNUAL REPORT

By Frank J. CapaldoGDA Executive Director

There is excellent news to report in our Four Cornerstones: Legislation and Policy, Public Relations and Communications, Member Practice Services and Education, and Business Services and Non-Dues Revenue. I am happy to report our semi-annual progress in each area.

LEGISLATION & POLICY

2016 Legislative Session: Our governmental affairs team traveled the state attending legislative receptions last fall. Dr. Tom Broderick, our president; Stephanie Lotti, our Senior Director of Health Policy; and I visited every district to talk about the legislation we expected to see when the session opened in January.

In the meantime, our team, headed by Governmental Affairs Committee Chair Dr. Bruce Camp and Contact Dentist Program Liaison Dr. Troy Schulman, worked to recruit contact dentists for every Georgia legislator so we had a reliable system that we could activate instantly. We also hired Scott Lofranco as our chief lobbyist and director of government relations as of January 1 and retained Mo Thrash as a contract lobbyist to represent the interests of dentists and patients at the Capitol. He brings 40 years of lobbying experience and a deep appreciation of the value of dentistry to his work.

As soon as the session opened, bills were introduced in the House and Senate to reduce supervision of dental hygienists performing their duties in approved safety net settings and for the Medicaid and Medicare patients of a supervising dentist. The GDA worked with the advocates of House Bill 684 to try and identify ways to ensure that the proposed legislation adequately addressed patient safety. At the

EXECUTIVE DIRECTOR Continued on page 30


SEEN&HEARDEmail GDA Staff Members at [email protected] can email staff members at the GDA executive office in Atlanta in a new way. Instead of emailing to an address comprised of the last name of the staff member @gadental.org, please use the first name of the staff member @gadental.org. To access a full list of all GDA and Georgia Dental Insurance Services staff members, please visit the GDA website or the staff contact page of this journal.

You can still reach staff members at their [email protected] emails for a short while, but members are encouraged to begin emailing the new way as soon as possible.

Best Wishes to Staff Member Skip JonesMarch 4 was the last day for GDA Director of Membership & Business Services Skip Jones. Skip has worn a number of hats during his 10 years of GDA service, including in the areas of debt recovery with PDRS, insurance sales, insurance marketing, GDA convention exhibit hall booth sales, and planning for the GDA convention family fun night event. Please join the GDA leadership in wishing Skip all the best in his future endeavors.

Members Featured in PressDr. Tom Broderick, Dr. Richard A. Smith, and Executive Director Frank Capaldo were featured in a Georgia Trend article called Filling in the Gaps. They spoke about the value of regular dental care and the importance of finding a dental home. Kudos to these dental spokesperson champions for conveying the good news about dentistry!

Are You In? GDA Group Buying Program Gets Underway June 1 The board of the GDA Integrity Dental Buyers Group (IDBG) recently met with senior management from Premier, our Group Purchasing Organization (GPO). The IDBG board selected Premier, an outstanding GPO in the medical supply arena that is already doing business with well-known dental supply and distribution companies, after a lengthy Request for Proposal process. IDBG Chair Dr. Jim Hall is pleased to announce that the first buy for products will take place on or before June 1. Dentists who are already committed to IDBG will begin to receive their participation fee invoices in March. For dentists who have already remitted a check or credit card, those will be processed by the end of March.

Our commitment to the GPO was to obtain commitments from 350 Georgia dental practices. We have that now, after an extensive member education process, and in fact the number of committed practices is growing. We have also been required to form a legal entity and perform all of the work that goes along with setting up that legal entity correctly. The entity to house the GDA GPO is a Limited Liability Corporation called Integrity Dental Buyers Group, LLC, or IDBG. A board of directors was recently formed of your peers and they held the initial Incorporators board meeting on February 12, 2016, in Macon. Visit www.dentalbuyersgroup.com for more details. Members are invited to get on board with this cost-saving benefit. Email [email protected] for additional information.

Welcome Benefits+ Partner iMedicorThe GDA welcomes iMedicor to the Benefits+ Program. Did you know that dentists are breaking the law when they transmit patient records and x-rays through their personal email even if encrypted? The GDA endorsed the iMedicor HIPAA-compliant messaging system to help members comply with federal regulations. GDA members get a discounted rate of $22.50 per month. There is a competitor that tells you they only cost $10.00 a month, but their fee doesnt include services like HIPAA-required file storage. After the extra charges for these requirements, their cost will soar past $22.50. Visit the endorsed services section on www.gadental.org for more details.


In Memoriam The GDA expresses sympathy to the families and colleagues of the following dentists:

Dr. Carl Carter Edge Jr.March 3, 2016GDA Honorable FellowADA Life MemberNorthwestern District

Dr. Donald M. FelkerFebruary 25, 2016GDA Honorable FellowADA Life MemberNorthwestern District

Dr. Marian Sprinkle GravesFebruary 12, 2016ADA Life MemberNorthern District

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Deadline Extended for Dentists to Decide Whether to Opt In or Out as Medicare ProvidersThe ADA News reports that the Centers for Medicare & Medicaid Services (CMS) has extended the deadline for dentists to either enroll as a Medicare Part D ordering/referring provider or opt out of the program. The deadline was June 1, 2016, but is now February 1, 2017. According to The ADA News, CMS encourages prescribers of Part D drugs to submit their Medicare enrollment applications or opt-out affidavits to their Medicare Administrative Contractors before August 1, 2016

The GDA has updated its Medicare Opt In/Opt Out Decision Guide for members and posted it at www.gadental.org. Use this free guide to determine if opting in or out of Medicare is the best decision for your particular dental practice.

Dr. Jay Harrington, GDA member of the ADA Council on Governmental Affairs, mentions that a dentist can enroll as a Medicare Provider, a Medicare Ordering and Referring Provider, or can Opt Out with an affidavit. If a dentist has, or might have, patients with a Medicare Advantage Plan, Dr. Harrington notes that the dentist might not want to opt out because the dentist wont get reimbursed. He also notes that the Ordering and Referring Provider enrollment form is simpler to fill out, and it will work for the Medicare Advantage Plan.


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Disability insurance replaces a portion of a dentists income in the event a dentist is unable to work due to an illness or injury without using valuable assets set aside for retirement. You are your most valuable practice asset. If your income stops because of a disability, what will replace the income? Here are some tips about choosing disability coverage that best protects you and your family.

What to Look for in a Disability Plan

Waiting period. Once you become disabled, there is a waiting period before your benefits begin paying, usually 30, 60, or 90 days. One way to reduce policy cost is to select a longer waiting period. A policy with a 30-day waiting period can cost 2-3 times more than one with a 90-day waiting period. If you have significant other income, you can purchase longer waiting periods than 90 days. However, you will be self-insuring short-term disabilities.

Length of Benefits. The benefit period starts right after the waiting period ends. It represents the maximum length of time during which benefits are paid. A policy may offer benefits for two years, five years, to age 65, or for lifetime. Premiums for policies with longer benefit periods are more expensive. As a rule of thumb, if possible, purchase a policy with lifelong benefits. If you suffer a disability, it will be financially catastrophic if benefits end prematurely.

Definition of Disability. Your policys definition of total disability is crucial because it determines the circumstances that entitle you to your benefits.

Imagine you have had a serious illness. Your disability makes a rigorous patient load impractical; so after you have partially recovered, you resign your practice and start teaching at a local university. Or, you sell your practice and start a career in another field. Can you still collect on your disability insurance? Yes. Good policies provide full disability benefits, regardless of what you now earn. Inferior policies will reduce your benefits because you are still employed. The worst policies will terminate your

THE PRACTICEbenefits completely once you go back to work, with no compensation for your drop in income.

Look for a policy that finds you totally disabled when a condition prevents you from performing the substantial and material duties of your regular occupation. This definition, often referred to as the your occupation or own-occ definition is a liberal one. You collect benefits although you may practice another occupation or facet of your profession.

Another definition states that you are totally disabled when an illness or accident prevents you from performing the important duties of your regular occupation or any other occupation for which you are suited as a result of education, training, and experience. This definition is less expansive than your occupation but is workable.

Because many dentists return to part-time practice after a disability, the insurance industry has introduced partial coverage that pays reduced or residual benefits. Make sure that your policy includes a clause of this type so that you receive benefits even if you decide to work part time. However, many policies pay residual benefits only after a period of total disabilitysometimes as long as 12 months. In addition, many policies restrict benefits if partial disability occurs after age 55. Other insurers will pay benefits for only 18 to 24 months. Because your risk of disability is greatest after age 55, choose a policy that covers you up to age 65.

Plan Renewability TipsAfter you buy a policy, the two worst things that can happen are having your premiums raised or your coverage cancelled. Some inexpensive policies allow the carrier to do both. An important feature of your disability income policy is its continuance provisionthe clause that spells out your rights to renewal. There are three types:

Disability Coverage: If Your Income Stops, What Replaces It?By Michele Amatulli, CISR, GDIS Business Insurance Department Manager

Find tools and tips for managing your business in this column and on The Practice page at www.gadental.org.

THE PRACTICE Continued on page 29


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Center for TMJ Therapy

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disorders.


FINDING SUCCESSWhat role should spouses play in a small business, particularly a dental practice? There are as many answers to that question as there are dental practices. Some spouses choose not to be involved in the practice at all and some are full practicing partners. Most spouses fall somewhere in between, playing a supporting role in the practice. While many spouses are employed by the practice as dental hygienists or dental assistants, the majority of spouses are employed in administrative support roles. There is variability even in those roles, from full time management of the office to coming in one day a week to handle payroll and accounts payable.

What is crucial to spouses working successfully together is not the actual roles, but clearly defining those roles. As with any member of the team, spouses need clear roles that enable them to work toward common goals, adhere to healthy boundaries, and communicate roles, goals, and boundaries to other employees, patients, and family members.

Unique Challenges for Dental SpousesIts amazing how many spouses start working in the dental practice on a temporary basis to help out. What starts as a temporary job becomes a permanent one. What starts as a part time job becomes a full time one. Consequently, there is little if any of the normal discussion that you would have when hiring a new employee. Not only does this important discussion need to happen now, it needs to happen on a regular ongoing basis. Spouses, more than any other family members working in a family business, need to have clearly defined roles, work toward clearly defined goals, and adhere to healthy boundaries.

Spouses have unique challenges not faced by other family members. Working in the practice is more than a job for them. They have more of a vested interest in the success of the practice since it may determine their only or at least their main source of income. However, unlike a furniture store or a restaurant, the spouse who is not a dentist can never own the practice. Spouses may put their heart and soul into building the practice only to be left with very little due to death or divorce. And spouses may not feel that they can leave to find another job because that would mean emotionally abandoning their spouse.

Another challenge is the unique relationship between spouses. Other employees, including other family members, are not going home and sleeping with the boss. Or at least I hope not! The employees, patients, and other family members recognize that power imbalance and the best way to handle this it to acknowledge it. Spouses are never fully employees and never the boss. The relationship is unique in the workplace and the challenge is for spouses not to abuse this unique power.

Establishing Boundaries and Practice GoalsWhile its important for spouses not to abuse the relationship power with others, its equally important for the dentist not to abuse the relationship power. The dentist may have expectations of a spouse working in the practice that they would never have of other employees. Many dentists will take advantage of a caretaking spouse and expect the spouse to put the dentists and practices needs ahead of their own. If the dentist is uncomfortable with confrontation, he or she may use a peace-making spouse to handle unpleasant situations with employees, patients, or extended family members, situations that are more appropriately handled by the dentist. Cheerleading spouses may find that more and more discussions revolve around the practice and its problems and finding balance both at home and at work becomes difficult.

This overlap between home life and work life becomes evident in determining the practices goals and how they fit into the familys goals or vice versa. Honest and ongoing conversations need to take place. During these discussions, both dentist and spouse have equal say and this is unique to the spouse/employee and spouse/dentist relationship. While the dentist would want to consult employees and have consensus on the practices goals, he or she is ultimately going to set the goals. With spouses as employees, more than consulting and consensus need to take place. Real negotiation needs to happen to ensure that the practices goals and the familys goals mesh and can be supported by both partners. If an

Got Marriage? How to Succeed in Dentistry Working with Your Spouse By Wendy Cassidy

Find guidance in achieving personal and professional growth in this column and at www.gadental.org.

SUCCESSContinued on page 34


WELCOMEThere is something for everyone at the GDA Convention & Expo in beautiful Amelia Island, Florida, at The Ritz-Carlton Amelia Island. The event is July 14-17, 2016, and registration is open.

The convention features top quality continuing education courses, nationally known speakers, networking and social events, childrens programs, a spouse educational track, and an exhibit hall not to be missed!

Our kickoff speaker is noted political commentator and media personality James Carville. The Ragin Cajun is Americas best-known political consultant. His long list of electoral successes evidences a knack for steering overlooked campaigns to unexpected landslide victories and for re-making political underdogs into upset winners. He is going to knock your socks off with his insight into the current state of American presidential politics.

Value-added inclusive pricing is back this year, with one GDA member dentist registration fee gaining you access to all continuing education, our kickoff session with Mr. Carville, our opening night reception in the Exhibit Hall, and entry into the Saturday family fun night event. Register your spouse at no additional charge and they can attend all of these events as well.

You may add children, dental staff, and other guests to your main registration for additional fees. Each category can also attend multiple special events at no additional charge once registered.

We also have inclusive registration pricing for Life Members, Retired Members, and our first time attendees. Current GDA members who have never before attended a GDA convention receive a special 50% registration discount. There is value in attending the convention wherever you are in your dental professional career.

New this year! Register for the convention AND your room at The Ritz-Carlton Amelia Island via our secure, easy to use online system located at www.GDAconvention.com. Rooms will go fast! Register early to reserve your spot. Early bird pricing for the convention ends on June 15; rooms at The Ritz-Carlton are available on a first come, first served basis.

Please note that you are not required to reserve accommodations at The Ritz-Carlton to register for the meeting, but if you do want a room at the Ritz, you must obtain one via the GDA convention registration system.

Our planning committee is excited about the value this convention offers to our members. I want to thank them for their hard work leading up to the meeting, and on behalf of President Tom Broderick, we all look forward to seeing you and your family in Florida this July.

Alliance Liaison: Julie Vaughn and Linda BroderickAwards & Installation Breakfast: Dr. Matt MazzawiChildrens Program: Dr. Eric GladdenClinical Program: Dr. Byron DavisDoor Prizes: Dr. Celia Dunn and Dr. Annette RaingeExhibit Hall: Dr. Julie Ann RouthierFishing: Dr. Ron SmileyGolf Tournament: Dr. Donald NelsonKickoff Event: Dr. Byron ColleyMemories Presentation: Dr. Jim HallNew Dentist Program: Dr. Katie Garvin and Dr. Erin PickwickRegistration: Dr. Christopher DeLeonSaturday Family Event: Dr. Mark DusekTennis Round Robin: Dr. Will FaulkTours & Events: Dr. Matt RosenthalVolunteers Party: Dr. Jay McCaslin

By Mark Dusek, DDSGeneral Chairman2016 Convention & Expo

Register before June 15 at www.GDAconvention.com to enjoy Early Bird pricing! New this year: You may only obtain accommodations at The Ritz-Carlton Amelia Island through the link at GDAconvention.com. You cannot call the resort directly for GDA rooms. Once again we listened to you and scheduled more free time for you and your family to enjoy!


WEDNESDAY, JULY 131-4PM: Board of Trustees Meeting.

THURSDAY, JULY 148:30 AM-1 PM: House of Delegates and GDA Business Meeting

10AM-NOON: CE: Dental Estate Planning. (CE included with registration.)

2-3:30 PM: CE: Future of Dentistry. (CE included with registration.)

3:30-5:30 PM: CE: 2016 Legal Trends. (CE included with registration.)

6:00-8:00 PM: Welcome Reception/Exhibit Hall Opens.

FRIDAY, JULY 157:30-8:30 AM: GADPAC Power Breakfast with James Carville.(Special separate ticketed event and GADPAC fundraiser.)

8:30 AM-2PM: Exhibit Hall Opens.

9:00-11:00 AM: Kickoff Event: James Carville Looks at the Race for the White House. (Included with your registration fee.)

9:00-11:00 AM: Children's Kickoff Breakfast. (5-12 years old only; included with childrens registration fee.)

1-5:00 PM: CE: Peri-Implants. (CE included with registration.)

3-5:00 PM: Salt Infusion & Wine Tasting Event. (Special separate ticketed event.)

6:30-7:30 PM: New Dentist and Alliance Social (by invitation).

SATURDAY, JULY 167:30 AM-Noon: Golf Tournament. (Special separate ticketed event.)

8:00 AM-Noon: Inshore Fishing. (Special separate ticketed event.)

8:00 AM-Noon: Deep Sea Fishing. (Special separate ticketed event.)

8:00 AM-1PM: Exhibit Hall Opens.

8:30 AM-12:30 PM: CE: Contemporary Treatment Options for Edentulous Patients. (CE included with registration.)

9:00-11:00 AM: Tennis Round Robin. (Special separate ticketed event.)

10:00 AM-Noon: Alliance Brunch. (Special separate ticketed event.)

1:30-3:30 PM: CE: Dental Implants. (CE included with registration.)

4:00-5:00 PM: CE: The Quality of Life. (CE included with registration.)

6:00-10:00 PM: Family Fun Night. (Fun night included with dentist, guest, and child registration fees.)

SUNDAY, JULY 178:00-10:00 AM: Awards & Installation Breakfast.(Special separate ticketed event.)

8:00-10:00 AM: Children's Farewell Breakfast (5-12 years old only; included with childrens registration fee.)

EVENT SCHEDULE

KICKOFF SPEAKERKickoff Breakfast Event with Guest Speaker James CarvilleFriday, July 15 9-11 a.m. (Included with registration)James "The Ragin' Cajun" Carville is Americas best-known political consultant. His long list of electoral successes evidences a knack for steering overlooked campaigns to unexpected landslide victories and for re-making political underdogs into big-time upset winners.

His winning streak began in 1986, when he managed the gubernatorial victory of Robert Casey in Pennsylvania. In 1987, Carville helped guide Wallace Wilkinson to the governors seat in Kentucky. Carville continued his winning streak with wins in New Jersey, when Frank Lautenberg was elected to the U.S. Senate. He next managed the successful 1990 gubernatorial campaign of Georgia's Lieutenant Governor Zell Miller, including a tough primary victory over Atlanta mayor Andrew Young. But his most prominent victory was in 1992 when he helped William Jefferson Clinton win the Presidency.

In recent years, Carville has not been a paid political consultant for any domestic politicians or candidates for office, instead focusing on campaigns in more than 20 countries around the globe, including leading Ehud Barak to victory in his campaign to become the Prime Minister of Israel in 1999. Carville is also a best-selling author, actor, producer, talk-show host, speaker, and restauranteur.

Along with pollster Stanley Greenberg, Carville founded Democracy Corps, an independent, non-profit polling organization dedicated to making government more responsive to the American people. Democracy Corps has conducted over 200 national, congressional, and local surveys, interviewing over 220,000 American voters during the past 10 years.

Carville can be seen on news networks worldwide. He is a columnist for The Hill newspaper which publishes daily when Congress is in session and serves as a Professor of Practice at Tulane University in New Orleans, where he lives with wife Mary Matalin and their two daughters.

Value-added inclusive pricing is back this year, with one GDA member registration fee gaining you access to all continuing education, our kickoff session with Mr. Carville, our opening night reception in the exhibit hall, and entry into the family night event.

Register your spouse at no additional charge and they can attend all of these events as well.

You may add children, dental staff, and other guests to your main registration for additional charges. Each category can also attend multiple special events once registered.

We also have inclusive registration pricing for Life Members, Retired Members, and our first time attendees. There is value in attending wherever you are in your dental professional career.

Visit www.GDAconvention.com to register! Act quickly. Early bird registration ends June 15.



THURSDAY, JULY 1410 a.m.-Noon: Dental Practice Estate Planning: How to Handle the Unexpected Death of a Practice Owner (2 CEUs). Stuart Oberman, JD.Attendees will learn why every dental practice owner must be prepared for an unexpected death, and what happens to a dental practice when an owner passes away. Learning objectives: Learn how simple estate planning can prevent enormous complications and financial devastation if an owner passes away; how to handle the complex probate process; what happens if there is no will; steps to consider in the sale of a dental practice; how to avoid losing 25-35 percent value per month; and Georgia Board of Dentistry requirements when a practice owner passes away.

2-3:30 p.m. The Future of Dentistry (1.5 CEUs). Dr. Mark Causey, Dr. Jim Lopez, Dr. Colin Richman, and Dr. Mark Stevens.Dentistry, like all health disciplines, continues to see advances in technology, technique, and materials. The future of dentistry is bright and part of an ever-changing landscape in health care delivery. Join specialty dental leaders as they discuss cutting edge developments in their specialty. There will be a Q&A session following the presentations. Learning objectives: Attendees will learn about new technology, techniques, and materials in four specialty areas of dentistry.

Mark Causey, DMD, is a board-certified orthodontist from Gainesville, Georgia, who received his dental degree and orthodontic certificate from the Medical College of Georgia. He is the current president of the Georgia Orthodontists Foundation.James Lopez, DDS, graduated from the University of Tennessee Center for Health Sciences with his DDS degree and went on to earn degrees in Pedodontics and Orthodontics from UT. He is a Trustee to the GDA Board of Trustees and the 2016 President of the Georgia Academy of Pediatric Dentistry. He maintains an orthodontic and pediatric practice in Columbus, Georgia.Colin Richman, DDS, completed his residency in Periodontics at the University of Connecticut. He maintains a private Periodontics and Implant Dentistry practice in Atlanta, Georgia. Dr. Richman is an assistant professor in the Department of Periodontics at The Dental College of Georgia at Augusta University and a Diplomate of the American Board of Periodontology. Mark Stevens, DDS, is Professor and Chairman of Oral and Maxillofacial Surgery at The Dental College of Georgia at Augusta University. Dr. Stevens is boarded and a diplomate of the American Association of Oral and Maxillofacial Surgeons. He served on the American Board of Oral and Maxillofacial Surgeons as a board examiner for seven years. Dr. Stevens is widely recognized in the field of cranio-maxillary fracture repair and is an Association for the Study of Internal Rigid Fixation faculty member.

3:30-5:30 p.m. 2016 Legal Trends and Updates: What Every Practice Owner Must Know (2 CEUs). Stuart Oberman, JD.This course is designed to provide attendees a broad overview of common legal issues that every practice owner must know. Topics will include: employee embezzlement and warning signs, dental practice management, intellectual property protection, OSHA whistleblower statutes, U.S. Department of Labor audits and how to be prepared in the event you find your office involved in one, basics of dental office employment law, guidelines for risk management, cyber security risks and breaches, arbitration agreements, HIPAA compliance, and dental board complaints. There will be a Q&A session following the presentation. Learning objectives: Attendees will learn how to best prepare and protect their office, their employees, and themselves in the event of any legal issues.

Stuart Oberman is the founder and president of Oberman Law Firm. Mr. Oberman received his law degree from John Marshall Law School and has practiced law for more than 22 years. He represents dental clients through the United States in a wide range of areas, including mergers and acquisitions, partnership agreements, commercial real estate, entity formation, employment law, commercial leasing, intellectual property, and HIPAA/OSHA compliance.

The GDA is an American Dental Association (ADA)

Continuing Education Recognized Provider (CERP) and

expects its presenters to be in compliance with ADA

CERP standards. ADA CERP is a service of the American

Dental Association to assist dental professionals in

identifying quality providers of continuing dental

education. ADA CERP does not approve or endorse

individual courses or instructors, nor does it imply

acceptance of credit hours by boards of dentistry. As

a national CE accreditation system, CERP recognized

providers are approved providers of dental continuing

education, and are recognized as approved CE

providers by the dental licensing boards of most states,

the licensing agencies of most health-related fields,

and certification requirements of most health-related

fields. Concerns or complaints about a CE provider may

be directed to the provider or to ADA CERP at www.

ada.org/cerp.


CONTINUING EDUCATION

Dr. Mark Causey

Mr. Stuart Oberman

Mr. Harris Gignilliat

Dr. George Priest

Dr. James Lopez

Dr. Mark Stevens

Mr. Patrick Carroll

Dr. Samuel Norris

FRIDAY, JULY 151-5 p.m. Part 1: Shaping Peri-Implant Soft Tissue for Long Term Esthetics and Health (4 CEUs). Dr. George Priest. Esthetic implant restorations require a sound understanding of peri-implant profiles and a technical foundation of appropriate implant components. As a critical member of the implant team, the restorative dentist or prosthodontist is primarily seen as the clinician providing the definitive implant restoration. That role, however, extends far beyond hard tissue esthetics and includes a significant responsibility in soft tissue development which is necessary for optimal esthetic outcomes. This session will include a discussion on immediate placement and aesthetic restoration of implants in appropriate situations. Dr. Priest will examine restorative dentist/oral surgeon collaboration to achieve optimal peri-implant profiles primarily with anatomically contoured provisional restorations and definitive abutment and crown contours that maintain long-term soft tissue stability. The use of digital dentistry to facilitate procedures will be explored. Step-by-step clinical examples and videos demonstrate provisional restoration techniques. Results are examined from initial treatment to long-term follow-up for periods of over 20 years. Learning objectives: attendees of this course will learn how to adopt surgical and restorative protocols that maximize soft tissue potential of single and multiple implants; create esthetic chairside

implant provisional restorations; optimize implant sulcular profiles in the esthetic zone; develop anatomical peri-implant esthetics for single and multiple edentulous spaces and completely edentulous patients; and communicate tissue contours to the laboratory via accurate impression and scanning techniques.

George Priest, DMD, maintains a private prosthodontic practice devoted to esthetic, advanced restorative and implant dentistry on Hilton Head Island, South Carolina. He lectures nationally and abroad on topics including implant dentistry, advanced restorative dentistry and esthetic excellence. He is a regular contributor to many acclaimed dental journals including The International Journal of Oral and Maxillofacial Implants, The International Journal of Periodontics and Restorative Dentistry, The Journal of Prosthodontics, The American Journal of Esthetic Dentistry and others. He is a Diplomate of the American Board of Prosthodontics and a Fellow of the American College of Prosthodontists. Dr. Priest is a former professor in graduate prosthodontics at Emory University and an innovator and teacher of implant and esthetic dentistry for more than 30 years.

SATURDAY, JULY 168:30 a.m.-12:30 p.m. Part 2: Contemporary Treatment for Edentulous Patients (4 CEUs). Dr. George Priest. Technological innovations in materials and techniques offer superior esthetics and long-term durability to prostheses for edentulous patients. Beginning with conventional dentures and progressing to removable and fixed implant prostheses, Dr. Priest will feature treatment options that demonstrate proven longevity for edentulous mandibles and maxillae. Clinical examples and video segments will demonstrate expedited and accurate prosthetically driven implant placement; CAD/CAM designed and manufactured frameworks that are precise and long-lasting; and improved resins and ceramics for stronger, more lifelike tooth replacements. The impact of these advancements on clinical practice represents a significant development in enhancing implant treatment outcomes for edentulous patients. Learning objectives: Attendees will learn contemporary treatment protocols for edentulous patients; select appropriate implant options for edentulous maxillae and mandibles; learn how to position and distribute implants optimally for overdentures and fixed complete dentures; learn impression and scanning techniques for absolute cast accuracy; learn to direct the laboratory for ideal framework fabrication and tooth arrangement; learn to place implant attachments using an accurate and expedited chairside protocol; and learn how to use CAD/CAM technology for superior framework fabrication.

CE COURSESContinued on page 22

Dr. Colin Richman


1:30-3:30 p.m. Dental Implants and the Periodontium, Peri-Implantitis, and the Maintenance of Dental Implants (2 CEUs). Dr. Samuel Norris. The tissues of the periodontium combine to form an active, dynamic group of tissues. One of the long-term risks associated with dental implants is a condition called Peri-Implantitis, an infectious disease that causes inflammation of the surrounding gum and bone of an already integrated dental implant, leading to the loss of supporting bone. Learning objectives: Attendees will learn more about the tissues that support the natural tooth and supporting implants, the etiology and diagnosis of peri-implantitis, the mucogingival aspects of dental implants, periodontal and dental implant maintenance, and how to treat an ailing or failing implant.

Samuel Norris, DMD, graduated from the University of Mississippi Medical Center with his DMD degree and received his certificate in Periodontics from the Medical College of Georgia. He is a diplomate to the American Board of Periodontology, has been published in several prominent dental journals, and practices Periodontics in Brunswick, Georgia.

4-5 p.m. The Quality of Life (1 CEU). Mr. Harris Gignilliat and Mr. Patrick Carroll.MIT AgeLab has identified three simple questions dental professionals should ask themselves to assess how prepared they are to live well in retirement. What do these questions have to do with retirement planning? A lot more than you may think. They actually uncover important factors that will determine your future quality of life or quality of life for your loved ones and serve as a starting point for planning a satisfying retirement from practicing dentistry. The questions will also shed light on issues your patients in retirement may be facing and things to consider for those who may become caretakers. When it comes to retirement planning, were inclined to focus on accumulating assets and making sure we spend our money wisely. But while our biggest fear may be outliving our wealth, theres an even greater risk of: Losing our independence due to ailing health; Being unable to access the big and small things that make us happy, and Facing a decline in the number of friends in our social network.

Learning objectives: Attendees will leave this course having learned how to live longer and better; identify ways to assess how prepared they are to live well in retirement; discover important factors that will determine future quality of life in retirement beyond financial limitations; and with a market update and 2016 financial outlook.

Harris Gignilliat, CIMA, CRPS, is Senior Vice President, Wealth Management at UBS.Harris earned his Certified Investment Management Analyst designation from the Wharton School of Business, and attained the Chartered Retirement Plans Specialist designation from the College for Financial Planning. Harris is a member of the UBS Institutional Consulting Group and works with organizations such as the GDA, Georgia Pharmacy Association, and Alabama Dental Association to provide financial benefits to members.

Patrick Carroll, CIMA, is an advisor consultant for Hartford Funds and is responsible for marketing Hartford Funds and The Hartford SMART529 in Georgia and South Carolina. Patrick supports financial advisors and their clients with educational material, client seminars, product expertise, and practice-management strategies. Patrick has earned his Certified Investment Management Analyst designation. He attended The Pennsylvania State University and lives in Atlanta, Georgia.

CE COURSESContinued from page 21EXHIBITORS

& SPONSORS 3M Oral Care

A-dec

Affinity Bank

Atlanta Dental Supply

Company

Benco Dental

BlueCross BlueShield

of Georgia

Brasseler USA

CareCredit

Colgate

DentaQuest

Georgia Dental

Insurance Services

Georgia Department of

Public Health

Georgia Rural Water

Association

Habif, Arogeti, & Wynne

Halyard Health

Henry Schein

Medical Protective

New Image Dental Laboratory

Oberman Law Firm

Patterson Dental

Pittman Dental Laboratory

Sherer Dental Lab

Sidney Lee Medical &

Scientific Gases

Straumann, USA LLC

UBS Financial Services

Ultradent Products, Inc.

Zoll Dental / Bobby Morse


NETWORKING & SOCIALTHURSDAY, JULY 14WELCOME RECEPTION 6-8 p.m. (Included with registration)All registered attendees are welcome to stop by the Exhibit Hall and visit with our exhibitors, make purchases for your office, and network and socialize at the GDA Alliance member reception and The Dental College of Georgia at Augusta University alumni reception. Sample hors doeuvres, enjoy complimentary drinks, and enter for door prizes.

FRIDAY, JULY 15PAC POWER BREAKFAST 7:30-8:30 a.m. (Tickets: 250 per person to benefit GADPAC*)Enjoy real talk with James Carville. The Georgia Dental Association Political Action Committee (GADPAC) is honored this year to have The Ragin Cajun sit in on our Power Breakfast. This is a one-of-a-kind opportunity to meet Mr. Carville face-to-face and have candid discussions with him about his experiences, insights, and points of view on presidential politics. Attendees will receive a copy of his book and a photo opportunity starting at 7:15. Limited to 35 attendees. *Donations to GADPAC are not tax-deductible.

KICKOFF EVENT 9-11 a.m. (Included with registration)Join us for a high energy opening event! Hear from GDA leaders and then welcome James The Ragin Cajun Carville, best-selling author, actor, producer, talk-show host, speaker, and restaurateur. The legendary, provocative, and always timely pundit presents his captivating views on politics, spiced with his own unique brand of optimism and humor. His talk will be followed by a Q&A session with questions from audience members. A light breakfast, coffee, and tea will be served starting at 8:30 a.m. in the Exhibit Hall, then attendees will take their seats in the Talbot Ballroom for the 9 a.m. opening session.

NEW DENTIST & ALLIANCE SOCIAL 6:30-7:30 p.m. (Included with registration; by invitation)The GDA invites all our New Dentists (those out of school 10 years or less as of 2016), our GDA Alliance members, and their dental spouses to join us at the Ritz Spa Pool for light hors doeuvres, drinks, and networking. Get to know your colleagues, Alliance members, GDA officers, and GDA staff.

NETWORK & SOCIALContinued on page 24

9-11 a.m. Children have their own Kickoff Breakfast (ages 5-12 only) Friday. They will enjoy a kid approved breakfast then join their friends in making a pirate hand print T-shirt or other fun craft. This event is included in the CHILD 5-12 registration fee. Registered children may also attend the Family Fun Night and Sunday Childrens Farewell Breakfast for the single fee.


SATURDAY, JULY 16ALLIANCE BRUNCH 10:00 a.m. - Noon (Ticketed: 50 per person with registration)The Alliance of the GDA invites current members and all interested spouses to attend this brunch and learn. Take away information about current Alliance projects, network with other members, and find a way to make an impact on the dental profession in the areas of dental health education, dental family wellbeing, and legislative advocacy. Special speakers and great door prizes! Enjoy a lovely plated breakfast as well as our awesome Bloody Mary and Mimosa bar.

FAMILY NIGHT: WINTER WONDERLAND AT THE BEACH (KIDS) AND RAT PACK PARTY/CELEBRATING SINATRA (ADULTS) 6-10 p.m. (Included with registration)Enjoy Friday night out with family and friends. Save Saturday night for a night of fun for kids of all ages! The younger set will enjoy a Winter Wonderland on the beach with games and rides, plus kid-approved food and drinks. For the 18 and over crowd, celebrate Frank Sinatras 100th Birthday Rat Pack Style! Swoon over our casino night backed by a big band sound! After youve played a few hands of blackjack or spun that roulette wheel a few times, enjoy some delicious food and drinks and dance the night away.

SUNDAY, JULY 17AWARDS & INSTALLATION BREAKFAST 8:00-10:00 a.m. (Ticketed: 50 per person)This morning is one for beginnings and honoring dentists who honorably serve their profession. We will recognize current GDA leaders and witness the installation of 2016-17 officers for the GDA, Alliance, and districts. The GDA will also recognize past GDA and Alliance presidents, GDA Honorable Fellows, GDA Community Service winners, and Dr. Carole Hanes as our GDA Award of Merit honoree.

9-11 a.m. Children have their own Farewell Breakfast (ages 5-12 only) Sunday. They will enjoy a kid approved breakfast then have fun participating in a treasure hunt or other fun activity. This event is included in the CHILD 5-12 registration fee. Registered children may also attend the Winter Wonderland Family Fun Night and Friday Childrens Kickoff Breakfast for the single fee.

NETWORK & SOCIALContinued from page 23

EARLY BIRD REGISTRATION Prices Increase June 15!

Each dentist registration fee listed below, except the CE only fee, includes entry into all CE as well as the James Carville Kickoff Event, Family Fun Night, and the Exhibit Hall Welcome Reception.

GDA Member: 285.00___________________________

First Timer: 142.50(GDA member and first time GDA convention attendee)___________________________

GDA Married: 450.00(Two GDA members married to each other)___________________________

Life/Retired Member: 145.00___________________________

CE Only: 110.00 (GDA Life or Retired Membersonly are eligible) ____________________________ ADA Member: 670.00(Non-Georgia ADA Member) ____________________________

Non-Member: 1100.00 (Not a GDA or ADA Dentist) ____________________________

Active Military: 175.00 ____________________________ ASDA Member: 25.00

OTHER CATEGORIESCOST WHEN ADDED TO A DENTIST REGISTRATION AS DETAILED ABOVE:

Spouse: NO CHARGEChild (5-12): 80.00Child (13-20): 40.00 Child (0-4): NO CHARGEFamily: 40.00Dentist Guest: 40.00 Dental Staff: 40.00

Congratulations to Carole M. Hanes, DMD, our 2016 GDA Award of Merit honoree. The Award of Merit, the highest honor the association can bestow, is only given to recognize service above all established standards. Dr. Hanes will be honored on Sunday, July 17, during the Awards & Installation Breakfast. Come out and honor her accomplishments!


SPORTS AND TOURSFRIDAY, JULY 15SALT INFUSION & WINE TASTING 3-5 p.m. (Tickets: 150 per person)Join us for an afternoon of great taste! The experienced Ritz Chefs infuse herbs, citrus, and other flavors to make their house made gourmet salts. Participants will be able to taste a diverse array of salts from all over the world and learn the secrets of cooking on a salt platter thats 250 million years old. The sommelier will share cooking tips and the health benefits of these infused salts as well as pair some of their finest wines alongside them. Tasting will include four different pre-selected sommelier-choice wines (two reds and two whites). There is a 10 person minimum for this event. If the minimum is not met, the event will be cancelled. Participants must be 21 years old to participate.

SATURDAY, JULY 16GDA/GADPAC* GOLF TOURNAMENT 7:30 a.m. - Noon (Tickets: 215 per person) Tee off to support dentistry under the Gold Dome. Have fun with your colleagues, play for a chance to win a Mercedes Benz, and raise money for the Georgia Dental Association Political Action Committee (GADPAC). The Golf Club of Amelia Island offers an exciting 18-hole championship golf course designed by Mark McCumber and Gene Littler. This challenging, yet fun layout is an avid golfers dream. The breathtaking landscape, meticulously maintained greens, strategically placed bunkers, and the ever-shifting ocean breeze ensure no two rounds are ever the same. A continental breakfast will be available for all players beginning at 6:45. *Donations to GADPAC are not tax-deductible.

FISHING EXCURSIONS/INSHORE 8 a.m. - Noon (Tickets: 200 per person)Go fishing in the calm backwaters surrounding Amelia Island. You will be fishing in two to three feet of water for redfish and spotted sea trout. You might even catch tarpon, flounder, sheepshead, or black drum. No food or beverages provided. Boats will leave the marina in Fernandina Beach at 8, so please plan accordingly. Captains will provide rods, reels, bait, tackle, ice and fishing licenses for all ticketed participants. A minimum of 4 registrants is required per boat or the charter will be cancelled.

FISHING EXCURSIONS/DEEP SEA 8 a.m. - Noon (Tickets: 200 per person)Fish for kingfish, barracudas, amberjacks, and tuna out on the Atlantic. Amelia Island also has great bottom fishing for snapper, grouper, sea bass, and African pompano. No food or beverages will be provided. Boats leave the marina in Fernandina Beach at 8, so please plan accordingly. Captains will provide rods, reels, bait, tackle, ice and fishing licenses for ticketed participants. A minimum of 6 participants is required per boat or the charter will be cancelled.

ROUND ROBIN TENNIS TOURNAMENT 9-11 a.m. (Tickets: 60 per person)The Round Robin format of play will be held on the resorts four clay tennis courts. Three new clay courts use state-of-the-art Hydro-cool technology that keeps the courts play-ready. Players of all skill levels are encouraged to join in. Courts will open at 8:30 for warm ups.


Recommendations for antibiotic prophylaxis prior to certain dental procedures have existed historically for two groups of patients: those with heart conditions that may predispose them to infective endocarditis; and those who have a prosthetic joint(s) and may be at risk for developing hematogenous infections at the site of the prosthetic.

However, compared with prior recommendation statements, there are currently relatively few patient subpopulations for whom antibiotic prophylaxis may be indicated prior to certain dental procedures.

In 2014, the American Dental Association (ADA) Council on Scientific Affairs assembled an expert panel to update and clarify the clinical recommendations found in the 2012 evidence report and 2013 guideline, Prevention of Orthopaedic

Refresher: Recommendations for Antibiotic Prophylaxis Prior to Certain Dental Procedures

Implant Infection in Patients Undergoing Dental Procedures.1, 2 As was found in 2012, the updated systematic review undertaken in 2014 and published in 2015 found no association between dental procedures and prosthetic joint infections.3 Based on this evidence review, the 2015 ADA clinical practice guideline states,3 In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.

A co-published editorial by Meyer4 also states: The new CSA guideline clearly states that for most patients, prophylactic antibiotics are not indicated before dental procedures to prevent [prosthetic joint infections]. The guideline also takes into consideration that patients who have previous medical conditions

or complications associated with their joint replacement surgery may have specific needs calling for premedication. In medically compromised patients who are undergoing dental procedures that include gingival manipulation or mucosal inclusion, prophylactic antibiotics should be considered only after consultation with the patient and orthopedic surgeon. For patients with serious health conditions, such as immunocompromising diseases, it may be appropriate for the orthopedic surgeon to recommend an antibiotic regimen when medically indicated, as footnoted in the new chairside guide.

The ADA encourages dental professionals to review the full 2015 guideline3 and take this recommendation into account, consult with the patients orthopedic surgeon as needed, and consider

Management of patients with prosthetic joints undergoing dental procedures

Clinical Recommendation:In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.For patients with a history of complications associated with their joint replacement surgery who are undergoing dental procedures that include gingival manipulation or mucosal incision, prophylactic antibiotics should only be considered after consultation with the patient and orthopedic surgeon.* To assess a patients medical status, a complete health history is always recommended when making final decisions regarding the need for antibiotic prophylaxis.

Clinical Reasoning for the Recommendation: There is evidence that dental procedures are not associated with prosthetic joint implant infections. There is evidence that antibiotics provided before oral care do not prevent prosthetic joint implant infections. There are potential harms of antibiotics including risk for anaphylaxis, antibiotic resistance, and opportunistic infections

like Clostridium difficile. The benefits of antibiotic prophylaxis may not exceed the harms for most patients. The individual patients circumstances and preferences should be considered when deciding whether to prescribe prophylactic

antibiotics prior to dental procedures.

* In cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and when reasonable write the prescription.

Copyright 2015 American Dental Association. All rights reserved. This page may be used, copied, and distributed for non-commercial purposes without obtaining prior approval from the ADA. Any other use, copying, or distribution, whether in printed or electronic format, is strictly prohibited without the prior written consent of the ADA.

Sollecito T, Abt E, Lockhart P, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners a report of the American Dental Association Council on Scientific Affairs. JADA. 2015;146(1):11-16.


the patients specific needs and preferences when planning treatment. According to the ADA Chairside Guide, in cases where antibiotics are deemed necessary, it is most appropriate that the orthopedic surgeon recommend the appropriate antibiotic regimen and, when reasonable, write the prescription.

With input from the ADA, the American Heart Association (AHA) released guidelines for the prevention of infective endocarditis in 2007,5 which were approved by the Council on Scientific Affairs as they relate to dentistry in 2008.6

The current guidelines support infective endocarditis premedication for a smaller group of patients than previous versions. This change was based on a review of scientific evidence, which showed that the risk of adverse reactions to antibiotics generally outweigh the benefits of prophylaxis for many patients who would have been considered eligible for prophylaxis in previous versions of the guidelines. Concern about the development of drug-resistant bacteria also was a factor.

Also, the data are mixed as to whether prophylactic antibiotics taken before a dental procedure prevent infective endocarditis. The guidelines note that people who are at risk for infective endocarditis are regularly exposed to oral bacteria during basic daily activities such as brushing or flossing.

Patient SelectionThe current infective endocarditis guidelines state that use of preventive antibiotics before certain dental procedures is reasonable for patients with:

prosthetic cardiac valve or prosthetic material used for cardiac valve repair

a history of infective endocarditis

a cardiac transplant that develops cardiac valvulopathy

the following congenital (present from birth) heart disease:a unrepaired cyanotic congenital heart disease, including palliative shunts and conduits; a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedureb; any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device (that inhibit endothelialization)

a Except for the conditions listed above, antibiotic prophylaxis is no longer recommended for any other form of congenital heart disease.

b Prophylaxis is reasonable because endothelialization of a prosthetic material occurs within six months after the procedure.

Dental ProceduresProphylaxis is recommended for the patients identified in the previous section for all dental procedures that involve manipulation of gingival tissue or the periapical region of the teeth, or perforation of the oral mucosa.

Additional Considerations About Infective Endocarditis Antibiotic Prophylaxis (when indicated)Sometimes patients forget to premedicate before their appointments. The recommendation is that the antibiotic be given before the procedure. This is important because it allows the antibiotic to reach adequate blood levels. However, the guidelines to prevent infective endocarditis5, 6 state, If the dosage of antibiotic is inadvertently not administered before the procedure, the dosage may be administered up to 2 hours after the procedure.

Another concern that dentists have expressed involves patients who require prophylaxis but are already taking antibiotics for another condition. In these cases, the guidelines for infective endocarditis5, 6 recommend that the dentist select an antibiotic from a different class than the one the patient is already taking. For example, if the patient is taking amoxicillin, the dentist should select clindamycin, azithromycin, or clarithromycin for prophylaxis.

Other patient groups also may merit special consideration, which is discussed more fully in the guidelines.

In 2015, The Lancet published a study out of the United Kingdom that reported a correlation between institution of more limited antibiotic prophylaxis guidelines by the National Institute for Health and Clinical Evidence (NICE) in 2008 and an increase in cases of infective endocarditis.7 Because of the retrospective and observational nature of the study, the authors acknowledged that their data do not establish a causal association. At this time, the ADA recommends that dentists continue to use the AHA guidelines discussed above. Dental professionals should periodically visit the ADA website for updates on this issue.

References1. American Academy of Orthopaedic Surgeons/American Dental Association. Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures: Evidence-based Guideline and Evidence Report. American Academy of Orthopaedic Surgeons 2012. http://www.aaos.org/Research/guidelines/PUDP/PUDP_guideline.pdf. Accessed February 3, 2016.

2. Rethman MP, Watters W, 3rd, Abt E, et al. The American Academy of Orthopaedic Surgeons and the American Dental Association clinical practice guideline on the prevention of orthopaedic implant infection in patients undergoing dental procedures. J Bone Joint Surg Am 2013;95(8):745-7.

3. Sollecito TP, Abt E, Lockhart PB, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners--a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2015;146(1):11-16 e8.

4. Meyer DM. Providing clarity on evidence-based prophylactic guidelines for prosthetic joint infections. J Am Dent Assoc 2015;146(1):3-5.

5. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007;116(15):1736-54.

6. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. J Am Dent Assoc 2008;139 Suppl:3S-24S. 7. Dayer MJ, Jones S, Prendergast B, et al. Incidence of infective endocarditis in England, 2000-13: a secular trend, interrupted time-series analysis. Lancet 2015;385(9974):1219-28.

See page 28 for education cards from the American Dental Association and American Heart Association for patients and practitioners to use to determine when antibiotic prophylaxis is required.


All dental procedures that involve manipulation of gingival tissue or the periapical region of teeth, or perforation of the oral mucosa*

*Antibiotic prophylaxis is NOT recommended for the following dental procedures or events: routine anesthetic injections through noninfected tissue; taking dental radiographs; placement of removable prosthodontic or orthodontic appliances; adjustment of orthodontic appliances; placement of orthodontic brackets; and shedding of deciduous teeth and bleeding from trauma to the lips or oral mucosa.

Antibiotic Prophylactic Regimens for Dental Procedures

2008, American Heart Association. All Rights Reserved. Lithographed in Canada. 50-1605 0805

The Council on Scientific Affairs of the American Dental Association has approved this statement as it relates to dentistry.

National Center

7272 Greenville Avenue

Dallas, Texas 75231-4596

americanheart.org

Situation Agent

RegimenSingle Dose 30-60 minutes

before procedureAdults Children

Oral Amoxicillin 2 g 50 mg/kg

Unable to take oral

medication

Ampicillin OR 2 g IM or IV* 50 mg/kg IM or IV

Cefazolin or ceftriaxone 1 g IM or IV

50 mg/kg IM or IV

Allergic to penicillins or ampicillinOral regimen

Cephalexin** 2 g 50 mg/kg

OR

Clindamycin 600 mg 20 mg/kg

OR

Azithromycin or clarithromycin 500 mg 15 mg/kg

Allergic to penicillins or

ampicillin and unable to take oral medication

Cefazolin or ceftriaxone 1 g IM or IV

50 mg/kg IM or IV

OR Clindamycin

600 mg IM or IV

20 mg/kg IM or IV

*IMintramuscular; IVintravenous** Or other first or second generation oral cephalosporin in equivalent

adult or pediatric dosage. Cephalosporins should not be used in an individual with a history of anaphylaxis, angioedema or urticaria with penicillins or ampicillin.

Gastrointestinal/Genitourinary Procedures: Antibiotic prophylaxis solely to prevent IE is no longer recommended for patients who undergo a GI or GU tract procedure, including patients with the highest risk of adverse outcomes due to IE.

Other Procedures: Procedures involving the respiratory tract or infected skin, tissues just under the skin, or musculoskeletal tissue for which prophylaxis is reasonable are discussed in the updated document (reference below).

Adapted from Prevention of Infective Endocarditis: Guidelines From the American Heart Association, by the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease. Circulation, 2007; 116: 1736-1754. Accessible at http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.106.183095.

Healthcare ProfessionalsPlease refer to these recommendations for more complete information as to which patients and which procedures need prophylaxis.

PREVENTION OF INFECTIVE (BACTERIAL) ENDOCARDITISWallet Card

This wallet card is to be given to patients (or parents) by their physi-cian. Healthcare professionals: Please see back of card for reference to the complete statement.

Name: _________________________________________needs protection from

INFECTIVE (BACTERIAL) ENDOCARDITIS because of an existing heart condition.

Diagnosis: ______________________________________Prescribed by: __________________________________Date: __________________________________________

You received this wallet card because you are at increased risk for developing adverse outcomes from infective endocarditis (IE), also known as bacterial endocarditis (BE). The guidelines for prevention of IE shown in this card are substantially different from previously pub-lished guidelines. This card replaces the previous card that was based on guidelines published in 1997.

The American Heart Associations Endocarditis Committee together with national and international experts on IE extensively reviewed published studies in order to determine whether dental, gastrointestinal (GI), or genitourinary (GU) tract procedures are possible causes of IE. These experts determined that there is no conclusive evidence that links dental, GI, or GU tract procedures with the development of IE.

The current practice of giving patients antibiotics prior to a dental procedure is no longer recommended EXCEPT for patients with the highest risk of adverse outcomes resulting from IE (see below on this card). The Committee cannot exclude the possibility that an exceedingly small number of cases, if any, of IE may be prevented by antibiotic prophylaxis prior to a dental procedure. If such benefit from prophylaxis exists, it should be reserved ONLY for those patients listed below. The Committee recognizes the importance of good oral and dental health and regular visits to the dentist for patients at risk of IE.

The Committee no longer recommends administering antibiotics solely to prevent IE in patients who undergo a GI or GU tract procedure.

Changes in these guidelines do not change the fact that your cardiac condition puts you at increased risk for developing endocarditis. If you develop signs or symptoms of endocarditissuch as unexplained fever see your doctor right away. If blood cultures are necessary (to deter-mine if endocarditis is present), it is important for your doctor to obtain these cultures and other relevant tests BEFORE antibiotics are started.

GDA Action February/March 2016

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Transcript of GDA Action February/March 2016