MARCH 2011 VOLUME 12, ISSUE 3 AVAILABLE ONLINE AT TDA.ORG

Inside

Texas LegislatureTDA Testifies TDA Presents Award

TDA Smiles FoundationSmiles on Wheels, McCameyA&M Leads Bragging Rights Campaign Perks Partner News MK’s Board Notes TEXAS Meeting Preview Ron’s Ruminations Evidence-based Practice Tip of the Month TSBDE Rule Update In the News

April Journal News

Can I Use Chlorhexidine as the Only Irrigating Solution in my Endodontic Treatments? Fritz Heitmann: Hunter, Dentist, Hardware Baron, Houston Leader

Around the State

April 1 & 2TDA Board MeetingAustin April 15 & 16Texas Mission of MercyDallas

Click & Connect

Join us on Facebookwww.groups.to/texasdental Follow us on Twittertwitter.com/theTDA Get LinkedINlinkedin.com, search “Texas Dental Association” March TDJtda.org/tdapublications

JUNE, 2008 VOLUME 9, ISSUE 6 AVAILABLE ONLINE AT TDA.ORG

Inside

Medicaid in My Office?Yes, I Think So!Richard M. Smith, DDS

TDA Smiles FoundationTMOM gains ardent advocate

Ask the President

Incoming President’s message

Hilton Israelson, DDS

Let’s TalkOutgoing President’s message

A. David May, Jr., DDS

2008-2009 TDA Board of Directors

Meet Your TDA Staff

TDA’s new Finance Director

Dee Dee Delagarza

Congratulations to TDA Component Societies

Streamline Your Insurance ClaimsSpeeding up confirmation of benefits and eligibility

TSBDE Rule UpdateRequirements for dental office radiograph machines

In the NewsTDA members in the news

July Journal NewsTooth Whitening: A Clinical Review

TDA Historical PerspectivesDentists, dental hygienists, and the dental team

The 2007 C.T. Rowland AwardOrthodontic case report

The El Paso Dental Conference

Around the StateAugust 14:TDA Board MeetingAustin, Texas

October 15-19:ADA Annual SessionSan Antonio, Texas

Click & ConnectUpdate Profile tda.org – Membership Info Ask a Colleague tda.org – Features TEXAS Meeting Photostexasmeeting.com/estore

Volunteer for ‘08 ADAtda.org/volunteerada08

Every Member MattersRise’ Lyman, DDS, TDA Future Focus Committee

Membership growth is vital to any thriving organization. The Texas Dental Association (TDA) Board is strongly committed to the Membership goal within the “TDA 2009” strategic plan, which addresses continued growth. I am proud to report that, as evidence of that commitment and for the second year in a row, the TDA received the following ADA awards in 2008:• Greatest Percentage Membership Net Gain: Texas had a net gain of 198 members in the year 2007.• Top Constituent Dental Society with Greatest Percentage of Non-Members to Membership: Represents a conversion of 4.7 percent of non-members into membership at end of year 2007.• Top Constituent Dental Society to Improve Retention Rate Percentage in 2007: Represents a 97 percent Association retention rate, which is an increase of 7 percent from the previous year.• Greatest Percentage of New Dentist Members: Represents a gain of 111 new dentist members (those dentists who are 1-9 years out of school).

Another example of the commitment to the growth of our Association is the TDA Externship Program, which builds student awareness of organized dentistry. This innovative program, created in 2007, offers students the opportunity to gain insight into the different components of organized dentistry including legislative and regulatory affairs, membership, governance, continuing education, and charitable dentistry and to gain a better understanding of their role as future leaders of the dental team. The program is open to dental students from each of the three dental schools in Texas. This year the externship program will take place June 20 – June 27 in Austin at the TDA central office. As an ongoing effort to enhance the value and benefits of the Association, the TDA Council on Membership developed a survey that was sent to all members in 2006. The results clearly showed that members have a high satisfaction rating with benefits such as the TEXAS Meeting, TDA publications, and the ability to participate philanthropically in the TDA Smiles Foundation. A great number of the discounted programs offered to members through the TDA Perks Program also received a high satisfaction rating. In accordance with the strategic plan, the Council on Membership, will survey members again in 2009. Participation from all members and a collaborative effort between the ADA, TDA, and local component societies are the keys to successful membership recruitment and retention. We encourage every member to get involved whether it is by attending local meetings, taking part in Give Kids a Smile! Day activities, volunteering at a Texas Mission of Mercy, or participating in TDA Legislative Day activities in Austin. Each member matters and is essential to the continued growth of our Association and of organized dentistry. This is the seventh and final in a series of articles focused on the TDA’s accomplishments guided by the strategic plan. To view the entire plan, log in at www.tda.org and click on “TDA 2009” under “Current Issues” on the member homepage. For more information, please contact Lyda Creus Molanphy, staff liaison to the Future Focus Committee, at the TDA central office, (512) 443-3675.

MembershipDentists will value membership and participation in the TDA.

Objectives1. Improve perceived value and benefits of membership in TDA. a. Increase members’ knowledge about the impact and benefits of TDA membership. b. Ensure that components are an integral aspect of the membership process. c. Create greater awareness of the availability of the Peer Review, Ethics & Judicial, and Risk Management benefits. d. Actively promote adherence to the Code of Ethics. e. Enhance communication with members and non-members. f. Build student awareness of and interest in organized dentistry and membership in TDA. g. Ensure ongoing contact with students throughout dental school. h. Work closely with dental school faculty. i. Evaluate number of nonmember dentists who attend and participate in TDA activities (TEXAS Meeting, TDA Smiles Foundation programs, etc.).Metrics1. Seventy percent of active licensed dentists in TX will be members of TDA by 2009 (baseline of 68.5% in January 2007); increase

membership retention rate to 97 percent by April 2007 (baseline 96% in 2006). a-d. Increase the number of dentists serving on component peer review and ethics and judicial affairs committees to attain a

participation rate of 2-5 percent relative to the total number of component society members by August 2009.2. Ninety percent of TX dental school graduates actively licensed in TX will be members of TDA five years after graduation (89%

dental student conversion from the graduating class of 2005 in Texas).3. Increase the number of member dentists actively participating in TDA by 1 percent a year (as measured by a variety of means

– participation at TX Meeting, TMOM, TXDDS, FSI programs, DENPAC participations, TDA legislative day) with annual report to TDA Board by the Council on Membership.

4. Establish baseline of nonmember participation at TDA activities (CAS, TDA Smiles Foundation, Membership) 5. Established baseline of members’ understanding of and satisfaction with the benefits of their TDA membership through Member

Benefits and Services Survey (completed Nov 2006), re-evaluate % increase at that time for 2009.6. Sixty-five percent of all full-time faculty will be TDA members by 2009 (2006 baseline = 63%).

Mission: To be The Voice of DenTisTry in Texas

Manpower Advocacy OrganizationalExcellence

Public Image

Development Membership

The TDA will update it’s strategic plan with another statewide retreat in August of 2008.

In 2003, Texas Dental Association members from across the state develop TDA’s first strategic plan, TDA 2009.

Texas Medicaid Providers Can Now Enroll for Health IT Incentive Payments

This is the fourth in a series of articles to keep you informed of the Texas Medicaid Electronic Health Record (EHR) Incentive Program and continuing efforts to implement health information exchange

initiatives across Texas. The incentive program provides incentive payments to Medicaid providers for the adoption and meaningful use of certified EHR technology. Future articles will focus on helpful reference web sites, health information exchange, meaningful use for dentists, certified EHR technology for dental practices, and other relevant topics of interest to dentists and health information technology (IT). TheTexasHealthandHumanServicesCommission(HHSC)ishelpingdentistsandotherhealthcareproviderssignupfornewincentivepaymentsforusingelectronichealthrecords. Dentistswhoestablishelectronichealthrecordsystemsthatmeetfederalstandardscanearnupto$63,750inMedicaidincentivepaymentsover6years.Providerscanbeginparticipatingintheprogramnow,andthefirstpaymentsareexpectedinMay2011. “Theincentivepaymentsareagoodwayforsmallpracticesordoctorsinruralareastomakechangesthatwillbenefittheirpatientsandthestate,”TexasMedicaidDirectorBillyMillweesays.“Havingelectronicrecordsmakesitmucheasiertoensurethatdoctorshavealltheinformationtheyneedaboutapatientwhenmakingtreatmentdecisions.”

How to Participate: ProvidersmustfirstregisterwiththeCentersforMedicare&MedicaidServices(CMS)atthefederalleveltostarttheirregistrationprocess.Onceregisteredatthefederallevel,theproviderwillreceiveane-mailtobeginparticipationatthestatelevel.

TDA Extension Building Opens TherenovatedTDAExtensionBuildingisofficiallyopenandinuse.ThebuildingsitsadjacenttotheTDAheadquartersinAustin,andaribboncuttingonFebruary23,2011,inaugurateditsopening. Morethan100TDAmembers,dentalstudents,andcomponentsocietystaffattendedtheopenhousewhichwasheldthesamedayasTDALegislativeDayattheTexasCapitol.Thisallowedout-of-townmemberstotourthenewfacilitywhichhousesastate-of-the-art,multi-functionalconferencecenterservingtheTDABoard,councilandcommittees , andforhostingspecialTDAevents.Thebuildingwillbeavailableforrentalbyotherassociationsandorganizations. The2010HouseofDelegatesapprovedtherenovationofthebuildingwhichwaspurchasedbytheAssociationinDecember2007.

Pictured at last month’s TDA Extension Ribbon Cutting Ceremony are (L-R back) contractor Mr. Richard Galbraith, architect Ms. Wendy Rosamond, TDA Building Committee members Drs. Glenda F. Smith, Jeran J. Hooten and J. Kavin Kelp, all of Austin, (L-R front) TDA director of member services Ms. Lee Ann Johnson, TDA executive director Ms. Mary Kay Linn, TDA Building Committee chair Dr. Paul E. Stubbs of Georgetown, TDA president Dr. Ronald L. Rhea of Houston, and TDA president-elect Dr. J. Preston Coleman of San Antonio.

TDA Legislative Day 2011

Federal Registration ToregisterwiththeCMS,allprovidersmusthaveaNationalProviderIdentifier.Tobeginyourregistration,goto:https://ehrincentives.cms.gov/hitech/. CMShaspublishedaRegistrationUserGuideforMedicaidEligibleProfessionalsthathasstep-by-stepinstructionsforregistering.Aninformationcenteralsoisavailable7:30AM–6:30PMCSTMondaythroughFridayat(888)734-6433or(888)734-6563(TTYnumber).ProvidersalsomaysubmitaninquirytotheEHRInformationCenteronline.

State Level Registration DentistswhoregisterwithCMSwillreceiveane-mailinvitingthemtoinitiateparticipationintheTexasprogram. ProvidersmustbeenrolledinTexasMedicaidbeforeparticipatingintheincentiveprogram.EnrolledproviderswillusethelogininformationprovidedbyTMHPtoaccesstheincentiveprogramportal.Theportalcanbefoundthroughtheprovider’saccountintmhp.combyfollowingthesesteps:

1. Goto“MyAccount”.2. Scrollto“ManageProviderAccounts”.3. Thelastitemonthelistshouldbe“TexasMedicaidEHRIncentive Program”.Ifthelinkisnotavailable,thepersontryingtoaccessthe siteisnotdesignatedasaprovideradministratorintheTMHPportal system.Where can I go for help? CMShasdetailedinformationfortheMedicaidprogramatwww.cms.gov/EHRIncentivePrograms.ForhelpintheTexasenrollmentprocess,e-mailHealthIT@tmhp.comorcall(800)925-9126.

DentistsfromaroundthestateandmanyoftheirspousestookpartinaverysuccessfulTDALegislativeDayinAustinonFebruary23,2011.PriortovisitinglegislatorsattheStateCapitol,approximately250attendeesmetattheStephenF.AustinIntercontinentalHotelforashortprogram. Atthehotel,TDApresidentDr.RonaldRheawelcomedparticipantstotheevent.TheTDAwashonoredtohaveTexasComptrollerSusanCombsandLieutenantGovernorDavidDewhurstaddresstheassemblyonissuesrelatedtothecurrentlegislativesession.ComptrollerCombsgaveexpertinsightintostaterevenue,therainydayfund,andthebiennialbudget.LieutenantGovernorDewhurstaddressedchallengesthatfacelawmakersincludingMedicaidfunding,theproposedshifttodentalmanagedcare,andthefutureofTexas’oralhealth.Bothspeakerstookquestionsfromtheaudience. Followingtheguestspeakers,Dr.RichardBlack,chairofTDA’sCouncilonLegislativeandRegulatoryAffairs,andTDAstaffreviewedtheAssociation’slegislativeagendaandansweredquestionsregardingspecificlegislativeissues.Dr.DavidSibley,TDAleadlegislativeconsultant,followedwithadviceoneffortstomaximizetheeffectivenessoflegislativevisits. AttheTexasCapitol,participantsvisitedwithlegislatorsandstaffregardingtheTDAlegislativeagenda.Materialdiscussedincludedoppositiontoinsurancecompaniescappingfeesfornon-coveredservices,strengtheningenforcementagainstindividualspracticingdentistrywithoutalicense,oppositiontotheproposedshifttodentalmanagedcare,oppositiontohygienistsadministeringlocalanesthetic,andfundingfortheTexasOralHealthProgram. AspecialwordofthanksgoestomembersoftheAllianceoftheTDAfortheirhardworkonassemblinganddistributingthegoodiebagsthatwenttolegislatorsandstaff.

(L-R) Pictured at the 2011 TDA Legislative Day at the Texas Capitol are Dr. Gary E. Finch of Richmond, Dr. James D. Condrey of Missouri City, Texas Rep. John Zerwas (R-Richmond), Dr. S. Jerry Long of Houston, and Dr. Trever E. Keele of Houston.

Pictured at the 2011 TDA Legislative Day at the Texas Capitol are (L-R back) Dr. Larry D. Herwig of Dallas, Dr. Arlet R. Dunsworth of Dallas, Dr. Lee P. Oneacre of Carollton, Dr. Hilton Israelson of Richardson, (L-R front) Ms. Kathryn Stuart, Texas Rep. Cindy Burkett (R-Mesquite), Dr. Michael L. Stuart of Sunnyvale, and Dr. Wayne Woods of Dallas.

(Left) Texas Comptroller of Public Accounts Susan Combs offers insight into state revenue, the rainy day fund, and the biennial budget at the 2011 TDA Legislative Day in Austin.

(Right) Texas Lieutenant Governor David Dewhurst addresses attendees at the 2011 TDA Legislative Day in Austin. He discussed the challenges facing lawmakers during this session, including Medicaid funding and the proposed shift to dental managed care.

March 2011 / TDA Today / 2

Happy, Healthy Smiles … That’s Our Mission!

February was an amazing month for the TDA Smiles Foundation (TDASF). On February12, TDASF held a Smiles on Wheels in McCamey. Not only was this the 15th Smiles onWheels, the event broke the TDASF record of most patients seen at a Smiles on Wheels eventin 1 day! TDASF volunteers worked tirelessly from 5:00 AM to 5:00 PM pulling, cleaning,and restoring teeth. At the end of the day, 192 people received $92,424 worth of much-neededdental care. Plus, 11 new volunteer dentists came out to treat these citizens.

New volunteer dentists are what keep these events going! If you have not come to anevent, please consider coming to one this year! We bring the equipment, the town providesthe patients. All we need is you and your amazing skills.

Here is a list of upcoming events; please consider coming to one or all of them:

Texas Mission of Mercy of Mercy of (TMOM), DallasApril 15-16, 2011

Smiles on Wheels, Mineral WellsJune 11, 2011

½ TMOM, TexarkanaAugust 5-6, 2011

Smiles on Wheels, Bridge CitySeptember 24, 2011

TMOM, AmarilloOctober 28-29, 2011

To register to volunteer, go to tdasf.org.

Smiles on Wheels, McCamey

Perks PartnerNewsPerks Adds Three New ProgramsThe TDA FinancialServices Board of Directors

approved two new TDA Perks programs at itsMarch 4 meeting in Austin, as well as expandedits endorsement of an existing program. Lookfor information regarding The Glove Group andSedation Resource, Inc., as well as Managed BackupSolutions and Data Security’s (MBS) IT services, inthe coming weeks at perks.com and in TDA’s printpublications; or call (512) 443-3675 and speak witha Perks staff member.

TDA Perks Program Sponsors the 2011 TEXAS PartyIf you’re going to TEXAS Meeting in May, stop bythe Perks-sponsored TEXAS Party for some goodfun, great food, dancing; and live music from Dr.Bud Luecke and his band, “Morning.” Don’t forgetto pick up your free guitar pick; and stick around tosee if you’re the lucky winner of a special door prizefrom Perks: a new Dell Inspiron laptop!

MBS to Sponsor TDA Perks Laptop Giveaway at TEXAS MeetingManaged Backup Solutions and Data Security(MBS), a TDA Perks Program partner, is generouslysponsoring three Dell laptops for Perks’ annualpromotional giveaway at TEXAS Meeting. MBSprovides secure, automated, reliable and cost-effective electronic data backup and file recovery,as well as IT services. Look for more informationregarding MBS, the Perks giveaway, and other Perksevents at TEXAS Meeting at perks.com and in theApril issues of TDA’s print publications.

Questions? CallQuestions? CallQuestions? TDA Call TDA Call Perks Program Perks Program Perks at: (512)443-3675.

Register Now for the Healthy Smiles Golf Tournament

Register to play at next month’s Healthy Smiles Golf Tournament.This is an amazing tournament held at the beautiful Pecan Valley GolfCourse in San Antonio during the TEXAS Meeting in San Antonio.The event starts at 7:30 AM and includes breakfast and lunch, andprizes. To register to play, or to learn about sponsorship opportunities,visit tdasf.org and click on the Healthy Smiles Golf Tournament logo.

Friday, May 6, 2011Pecan Valley Golf Club4700 Pecan Valley DriveSan Antonio, TX 78223

6:30 AM: Registration and access to driving range and putting green7:30 AM: Shotgun startAround 12:00 PM: Awards luncheon

TDA member Dr. member Dr. member James C. James C. James Lemon of Slaton of Slaton of and non- and non- andmember Dr.member Dr.member David DeWitt David DeWitt David of DeWitt of DeWitt Midland of Midland of volunteer Midland volunteer Midland at volunteer at volunteerSmiles onSmiles onSmiles Wheels in Wheels in Wheels McCamey last McCamey last McCamey month. last month. last

Dr. Terry L. Terry L. Terry Schul of Schul of Schul Crane of Crane of (second Crane (second Crane from (second from (second left) ispictured withpictured withpictured pre-dental with pre-dental with students pre-dental students pre-dental at students at students last at last at month’s last month’s last Smiles month’s Smiles month’son Wheels in Wheels in Wheels McCamey.

Dr. Larry W. Larry W. Larry Spradley W. Spradley W. of Spradley of Spradley Keller of Keller of provides Keller provides Keller charitable provides charitable provides care charitable care charitableat theat theat Smiles the Smiles the on Smiles on Smiles Wheels in Wheels in Wheels McCamey in McCamey in McCamey February.

Dr. James B. James B. James Lovering of Lovering of Lovering Lubbock of Lubbock of (right) Lubbock (right) Lubbock is pictured is pictured iswith anwith anwith allied team allied team allied member at member at member the at the at Smiles the Smiles the on Smiles on Smiles Wheelsin McCamey in McCamey in McCamey February.

Drs. Hedley Rakusin Hedley Rakusin Hedley of Dallas, of Dallas, of WilliamH. Gerlach of Gerlach of Gerlach Plano, of Plano, of Larry D. Larry D. Larry Herwig of Herwig of HerwigDallas, and Michael and Michael and L. Michael L. Michael Stuart of Stuart of Stuart Sunnyvale of Sunnyvale ofparticipate inparticipate inparticipate the TDASF the TDASF the Healthy TDASF Healthy TDASF Smiles Healthy Smiles HealthyGolf ClassicGolf ClassicGolf during Classic during Classic the during the during 2010 the 2010 the TEXAS 2010 TEXAS 2010Meeting inMeeting inMeeting San Antonio.

A&M Leads TDASF Bragging Rights Campaign

This is it! It is the last month you can donate to the TDASF Bragging RightsCampaign. With the Healthy Smiles Golf Tournament right around the corner,we need to know what color the golf shirts will be! So far it looks like the TDASFbooth at the annual session and the Healthy Smiles Golf Tournament will becovered in maroon. It seems that A&M University has some of the strongestsupporters in our dental community! If you want to prove otherwise, donate today!

One hundred percent of your donation goes directly to TDASF’s operatingbudget, which allows TDASF to continue to provide four amazing programsthat help both the dental community and ensure Texas citizens have accessto oral health education and services — Texas Mission of Mercy, Smiles onWheels, Donated Dental Services, and educational opportunities for the dentalcommunity like the Beverly Bane Lectureship.

Don’t forgetDon’t forgetDon’t to forget to forget show your show your show school your school your spirit and spirit and spirit donate and donate and to this worthy cause worthy cause worthytoday attoday attoday tdasf.org at tdasf.org at or tdasf.org or tdasf.org e-mail or e-mail or TD SFA missions manager Melinda manager Melinda manager Biggs Melinda Biggs Melinda atmelinda@tda.org.

TDA Testifies Before the State Senate Subcommittee on MedicaidOn February 22, 2011, Dr. Richard Black, chair of the TDA’s Council on Legislative & Regulatory Affairs, testified before the State

Senate Subcommittee on Medicaid regarding potential reductions in funding for the Medicaid dental program as part of the Health andHuman Services Commission’s cost containment proposals.

Dr. Black advised the committee about the negative consequences from reducing Medicaid dental provider rates and changing theMedicaid dental delivery model to an HMO-style managed care model. He focused upon possible decreases in accessing dental care andthe diminished ability of individual, non-corporate, dental providers to continue delivering dental care to Medicaid children.

To view the hearing, please go to http://www.senate.state.tx.us/avarchive/ and scroll down to “February 22nd “February 22nd “February Senate 22nd Senate 22nd Subcommittee Senate Subcommittee Senate on Subcommittee on SubcommitteeMedicaid: Part 1” Part 1” Part and click on “February 22nd.” Dr. Black’s testimony Black’s testimony Black’s starts testimony starts testimony at starts at starts approximately at approximately at 1.28.26. approximately 1.28.26. approximately

TDA Testifies Before the State House Public Health CommitteeOn February 23, 2011, TDA past president Dr. Matthew B. Roberts testified before the State House Committee on Public Health

regarding access to dental care in Texas, possible reductions to Medicaid dental provider rates, changing the Medicaid dental delivery modelto an HMO-style managed care model, reducing CHIP dental funding, eliminating funding for the Children’s Medicaid Loan RepaymentProgram, and eliminating funding for the Texas Department of State Health Services Oral Health Program.

He also highlighted the TDA’s successful Head Start Dental Home Initiative and the significant amount of charitable dental caredelivered by Texas dentists.

To view the hearing, please go to http://www.capitol.state.tx.us/ and click on “Legislature Activity Video Broadcasts House.” Fromthat ebpagew click on “82 Session”“82 Session”“82 under archived broadcasts. Then click on “Public Health“Public Health“Public February Health February Health 23rd February 23rd February 12:00 23rd 12:00 23rd PM 12:00 PM 12:00 to PM to PM 4:44PM.” Dr.Robert’s testimonyRobert’s testimonyRobert’s starts testimony starts testimony at starts at starts approximately at approximately at 3.35.50. approximately 3.35.50. approximately

Additionally, Health and Human Services Executive Commissioner Mr. Tom Suehs testified regarding the Frew vFrew vFrew Suehs v Suehs v (formerlyFrew vFrew vFrew Hawkins v Hawkins v ) Hawkins) Hawkins settlement agreement and its impact on improving access to dental services. Com. Suehs told the committee that theFrew rate increases to certain dental codes caused a “major increase” in access to dental services.

To view Com. Suehs testimony, please go to http://wwwww wwww .w.w capitol.state.tx.us/ and click on “L“L“ egege igig sisi lalal tutut rerer Actitit vitytyt ViViV deded o Broror adcdcd acac sasa tstst HoHoH use.”From that webpage click on “82 Session” under archived broadcasts. Then click on “P“P“ uPuP blilil c HeHeH aeae ltltl htht FeFeF bruaryryr 23232 rdrdr 8:00 AMAMA totot 9:59595 AMAMA .”CoCoC m. SuSuS ehehe s’ tetet sese titit mimi onynyn statat rtstst at apapa pppp roror xoxo imimi atetet lylyl 1:5:5: 5555 :5:5 2:2: 3232 .

TDA Presents Award to Texas Senator Carlos Uresti At the conclusion of each legislative session, the TDA Board of Directorsapproves “Excellence in Patient Advocacy Awards”Awards”A to be given to select lawmakerswho were instrumental in assisting the TDA with its legislative agenda. On February 22, 2011, members of the TDA’s Council on Legislative andRegulatory Affairs (CLRA) presented Texas Sen. Carlos Uresti (D-San Antonio)with the award for his dedication to improving the oral health of children inTexasin81stTexasLegislature(2009). After accepting the award, Sen. Uresti spoke with CLRA about thenumerous issues facing the Texas Legislature. Sen. Uresti also expressedappreciation for the TDA’s continued support of his legislation to require dentalsupport for a child subject to a child support order – SB 120.

TDA president Dr. Ronald L. Rhea presents the TDA’s Excellence in Patient Advocacy Award to Texas Senator Carlos Uresti (D-San Antonio) last month for his dedication to improving the oral health of the state’s children.

Evidence-BasedPractice

Tip of the of the of Month

Stephen R. Matteson, DDS, TDA Editor

March 2011 / TDA Today / 3

On November 18, November 18, November 1995, at the at the at Lincoln the Lincoln the Center for Center for Centerthe Performingthe Performingthe Arts Performing Arts Performing in Arts in Arts New York, New York, New violinist Itzhak violinist Itzhak violinist Perlman, Itzhak Perlman, Itzhakstricken with polio with polio with as a as a as child, a child, a slowly and slowly and slowly painfully and painfully and walked painfully walked painfullywith hiswith hiswith two his two his crutches across crutches across crutches the across the across stage the stage the until stage until stage he until he until reached he reached he his reached his reachedchair. After undoing After undoing After the undoing the undoing clasps the clasps the on clasps on clasps his leg his leg his braces, leg braces, leg he grasped he grasped hehis violin,his violin,his tucked it tucked it tucked comfortably it comfortably it under comfortably under comfortably his under his under chin, his chin, his nodded to nodded to noddedthe conductor,the conductor,the and began and began and to play. The audience The audience The settled audience settled audience back settled back settledto enjoy Perlman’s enjoy Perlman’s enjoy remarkable Perlman’s remarkable Perlman’s genius—until remarkable genius—until remarkable they genius—until they genius—until heard they heard they one heard one heardof hisof hisof strings his strings his snap strings snap strings abruptly.

Everyone expectedEveryone expectedEveryone the expected the expected virtuoso the virtuoso the to replace the replace the replace broken the broken thestring onstring onstring his famous his famous his Stradivarius famous Stradivarius famous or, Stradivarius or, Stradivarius perhaps, continuewith anwith anwith entirely different entirely different entirely instrument. different instrument. different But instead, But instead, But Perlmanwaited awaited awaited minute, a minute, a closed his closed his closed eyes, his eyes, his and then and then and signaled the signaled the signaledconductor toconductor toconductor start again. start again. start When the orchestra the orchestra the began, orchestra began, orchestraPerlman joined them, joined them, joined simultaneously recomposing simultaneously recomposing simultaneously the recomposing the recomposing music the music thein his mind his mind his to mind to mind adjust for adjust for adjust the for the for missing the missing the string. missing string. missing That night, That night, ThatItzhak PerlmanItzhak PerlmanItzhak accomplished an accomplished an accomplished impossible feat: impossible feat: impossible he played he played he a played a playedsymphonic worksymphonic worksymphonic with work with work just with just with three just three just strings three strings three on strings on strings his violin. his violin. his

When it was it was it over, was over, was the astonished the astonished the audience astonished audience astonished jumped audience jumped audience to jumped to jumpedits feetits feetits and feet and feet cheered and cheered and wildly. cheered wildly. cheered Perlman smiled and smiled and smiled raised and raised and his raised his raisedbow tobow tobow quiet the quiet the quiet crowd. the crowd. the

“You know,” he know,” he know,” said he said he thoughtfully, said thoughtfully, said “sometimes it “sometimes it “sometimes is it is it the is the isartist’s taskartist’s taskartist’s to task to task find out find out find how out how out much how much how music much music much you music you music can still make still make stillwith whatwith whatwith you what you what have left.” have left.” have

This story is often told as an inspiration to those of uswho are less than perfect and live in this less than perfectworld. Some have discounted the tale as a mere urbanlegend. Nevertheless, Perlman displays the attitude we allshould have when faced with less than ideal circumstances.

As dentists working today in less than perfecteconomic conditions, we should all remember what awonderful profession we have. Regardless of the economypeople always need the care we have to offer. While theymay not accept the huge restorative treatment plan weknow would be ideal for them, they will forever appreciateus if we can care for their immediate needs until timesimprove.

As the TDA works to bring to you improvedinformed consent forms, I was reminded by TDApresident-elect Dr. J. Preston Coleman of a lesson learnedyears ago at the L.D. Pankey Institute in Miami, Florida.“Never treat a stranger.” With more open time on Texasdentists’ appointment books, it is a wonderful time toenjoy getting to know your patients better. It is also awonderful time to advance your skills with continuingeducation.

Those spare moments, spent in positive pursuits,instead of bemoaning your down time, will pay off manytimes over in increased case acceptance and productivityin the coming upturn. It is also a great time to becomeinvolved more in organized dentistry and in the politicalprocess of Texas state government. These are the thingsthat have made Texas truly the best place in our nationin which to practice dentistry. Let us build upon ourstrengths in our offices and in our state.

Ron’s Ruminations

Ronald L. Rhea, DDS, TDA President 2010-11

141st Annual Session of the of the of Texas Dental Association

May 5 – 8, 2011 • San Antonio, Texas

May is Almost Here … Make Plans Now for the 2011 TEXAS MeetingThe TDA Council on Annual Session encourages TDA members to make arrangements now to attend the 2011 TEXAS Meeting, the 141st Annual Session of the Texas Dental Association, scheduled

May 5-8, 2011, at the Henry B. Gonzalez Convention Center in San Antonio.

• REGISTER TODAY.REGISTER TODAY.REGISTER Avoid additional onsite fees and receive your materials in advance by registering before April 5, 2011. Register online at texasmeeting.com.

• HOTEL RESERVATIONS.HOTEL RESERVATIONS.HOTEL Don’t delay booking your hotel room, the April 5, 2011, deadline is quickly approaching. Take advantage of these special hotel rates. Make hotel reservations online at texasmeeting.com.

• CE VERIFICATION. The TEXAS Meeting will meet all of your continuing education needs. Attendees can earn up to 18 hours of continuing education within 3 days. Verification certificates areavailable onsite or electronically following the meeting.

• ONE-STOP SHOPPING. The 2011 exhibit hall promises to be the biggest and best ever. Take advantage of special pricing on the latest supplies and services to enhance your practice.

We look forward to seeing you in San Antonio! For additional information, please visit texasmeeting.com or call the TDA Annual Session staff at (512) 443-3675.

Help for Smokers for Smokers for

Here is a Cochrane Review: “Can smokers be helpedto reduce harm by smoking fewer cigarettes or usingdifferent tobacco products.” Nicotine replacement roughlydoubled the odds of reducing the number of cigarettesper day by 50 percent or more, but levels of CO2 andcotinine did not reduce by the same proportion. Checkout the details. Google: CD005231.

Below is a summary of the actions of the TDA Board ofDirectors during an Executive Committee meeting on September24, 2010, a regular Board meeting November 12-13, 2010, and aconference call on December 28, 2010. TDA president Dr. RonaldL. Rhea presided.

Non-Policy and Board Policy Resolutions (17)

APPOINTMENTS (1)82-2011-B (NP): Created a task force to explore training of TDAofficers and volunteers.

BUDGET (5)93-2011-B: Approved additional costs related to the purchase offurniture for the TDA Extension building.68-2011-B (NP): Approved funding to purchase furniture,upgrade existing phones and data cabling as well as mediaequipment for the TDA extension.69-2011-B (NP): Approved items over budget, totaling $241,701.85-2011-B: Approved for the year 2011 the Texas DentalAssociation will cover the premium costs of the individualpolicies recommended by the Frost Insurance group provided thecomponent societies elect to have Directors and Officers insurance.91-2011-B (__): Approved the purchase of a laptop MACcomputer for the Texas Dental Association to be used by the editor.

CORRESPONDENCE (3)60-2011-EC-B (NP): Approved TDA president Dr. Ronald L.Rhea and TDA legal counsel Mr. William H. Bingham preparea letter to the members of the Capital Area Dental Societyin response to their letter dated August 18, 2010, requestingadditional information of the settlement of the National LaborRelations Board case.64-2011-B (NP): Approved the TDA write a letter supporting Dr.Jacqueline M. Plemons for appointment by Governor Rick Perry tothe Texas State Board of Dental Examiners.92-2011-B (__): Approved the TDA president send a letter to eachcomponent society president and president-elect in response to pasttransmitted letters concerning the TDA and the National LaborRelations Board matter involving former TDA employees.

MISCELLANEOUS (7)59-2011-EC-B (NP): Approved the TDA to enter a contract withDr. David Sibley to provide lobby services as the lead lobbyistfor the Association beginning September 24, 2010 and endingDecember 31, 2011.80-2011-B (NP): Amended the annual strategic planning processof the Association and rescinded Resolution 74-2006-H.81-2011-B (NP): Retained the services of the public relations firm,Hahn, Texas, for a day-long message development workshop toidentify target audiences and messages for social media campaigns.The firm presented a report on the workshop at the February 2011Board meeting.

MK’s Board Notes

Mary Kay Linn, TDA Executive Director

Proposed Changes to Texas Medicaid Dental ProgramSince the February update, the Health and Human Services Commission (HHSC) released the formal Request for Proposals

(RFP) on February 22, 2011, to obtain services of at least two dental managed health organizations (DMHO) to administer the State’snewly proposed Medicaid capitated dental managed care program in March 2012.

The TDA met privately with HHSC officials on February 25, 2011, to discuss the RFP and address items of continued concernfor the Association. Additionally, the TDA submitted a follow-up memo to HHSC by the March 11th deadline detailing thoseconcerns that must be addressed if the State intends to change the delivery model for dental services. As part of the RFP process, HHSC hosted a vendor conference on March 1, 2011. The conference included a review of the RFPand an explanation of HHSC’s procurement process. Amerigroup, Delta Dental, DentaQuest, Liberty Dental, MCNA, Metlife, andUnited Concordia were among the participants attending the conference. On the legislative front, Dr. Richard Black, chair of the TDA’sTDA’sTDA Council on Legislative & Regulatory Affairs, and Dr. Matthew B.Roberts,Roberts,R TDA past president, testified before the legislature regarding Senate Bill 1 and House Bill 1 (General Appropriations Act),Article II agencies (Health and Human Services), and the proposed dental managed care delivery model. Look for your next update in the April 2011 TDA Today. For questions or comments, contact TDA’sTDA’sTDA policy manager Ms. Diane Rhodes at (512) 443-3675 or diane@tda.org.

83-2011-B (NP): With approval of TDA legal counseland outside accounting, all accounts in the OperationsDivisions of the TDA be consolidated into the leastnumber of accounts possible, maintaining separaterestricted accounts for the employee’s dental prepaymentaccount, dues prepayment account, legislative account,and the building account such that all accounts includingfuture accounts (i. e. IRS, ERISA or other accountsthat are regulated by governmental requirement) will bemaintained by the TreasurerTreasurerT to maximize returns with theleast amount of risks.

OUT-OF-STATE TRAVEL (1)70-2011-B (NP): Approved out-of-state travel formembers and staff to attend the 25th Annual AmericanDental Association Lobbyist Conference on December 2-4,2010 in Tucson,Tucson,T Arizona.

Board Policy Resolutions (11)MISCELLANEOUS (11)58-2011-EC-B (P): Waived quarter year dues from$113.75 to $0 for former and non-members who join fromOctober 1 December- 31, 2010.65-2011-B (P): Approved TDA to be a sponsoringorganization of the TexasTexasT Public Health Coalition.71-2011-B (P): Approved the TDA to compensate acomponent society when a TDA annual meeting is held inits area.72-2011-B (P): Authorized the Council on Annual Sessionto establish fees, with approval of the Board of Directors,for all TEXAS Meeting sessions including those to supportaccurate assignment of meeting rooms/classroom spaceand the quality of the program. Rescinded Resolutions 94-2010-BS-H and 48-2002-H.75-2011-B (P): Approved annual presentation of a servicerecognition award at the TDA annual session to thepresident of the Alliance of the TexasTexasT Dental Association.77-2011-B (P): Approved the TDA support thecontinuation of the American Dental Association DirectReimbursementReimbursementR publicity campaign. Rescinded Resolution191-1999-H.78-2011-BS (P): Rescinded Resolutions 11-1994-H, 81-2001-H, 83-2000-H, 86-1999-H, and 124-1991-H.79-2011-B (P) (2/3 Vote Required): Amended theTDA Peer Review Manual, Section III B. Matters thatare Outside of the Scope of Peer Review by adding anew subsection 1 and renumbering existing subsections.RescindedRescindedR Resolution 125-2010-H.86-2011-BS1 (P) (2/3 Vote Required): AmendedCHAPTER XVI. AMENDMENTS of the Bylaws anddesignated the amended paragraph as a new SECTION10. AMENDMENT and deleted the EXPLANATORYNOTE.86-2011-BS2 (P) (2/3 Vote Required): Defeated theaddition of a new SECTION 20. AMENDMENTAFFECTING A DUES CHANGE OF ACTIVEMEMBERS. to be added to CHAPTER XVI.90-2011-B (P): Approved that all TDA Councils andCommittees submit a yearly written report to the TDABoard and House of Delegates, and if a council orcommittee has not met or conducted business, the annualreport should so state.

2-4,-2-4,

MARCH 2011 VOLUME 12, ISSUE 3 AVAILABLE ONLINE AT TDA.ORG

EDITORIAL STAFFDr. Stephen R. Matteson, D.D.S., Editor

Nicole Scott, Managing EditorBarbara S. Donovan, Art DirectorPaul H. Schlesinger, Consultant

BOARD OF DIRECTORS

Ronald L. Rhea, D.D.S., PresidentJ. Preston Coleman, D.D.S., President-elect

Matthew B. Roberts, Immediate Past PresidentVice Presidents

R. Lee Clitheroe, D.D.S., SoutheastJohn W. Baucum III, D.D.S., Southwest

Kathleen M. Nichols, D.D.S., NorthwestDonna G. Miller, D.D.S., Northeast

Senior DirectorsKaren E. Frazer, D.D.S., SoutheastLisa B. Masters, D.D.S., Southwest

Robert E. Wiggins, Jr., D.D.S., NorthwestLarry D. Herwig, D.D.S., Northeast

DirectorsRita M. Cammarata, D.D.S., Southeast

T. Beth Vance, D.D.S., SouthwestMichael J. Goulding, D.D.S., Northwest

Arthur C. Morchat, D.D.S., Northeast

Ron Collins, D.D.S., Secretary-TreasurerGlen D. Hall, D.D.S., Speaker of the HouseMichael L. Stuart, D.D.S., Parliamentarian

Stephen R. Matteson, D.D.S., EditorMary Kay Linn, Executive DirectorWilliam H. Bingham, Legal Counsel

TDA Today (USPS 022-007) is published monthly except for December by the Texas Dental As-sociation, 1946 S. IH-35, Ste 400, Austin, Texas 78704-3698, (512) 443-3675. Periodicals Postage Paid at Austin, Texas and at additional mailing offices. POSTMASTER: Send address changes to TDA TODAY, 1946 S. IH-35, Ste 400, Austin, TX 78704-3698.Annual subscriptions: Texas Dental Association (TDA) members, $5. In-state American Dental As-sociation (ADA) affiliated, $15 + tax. Out-of-state ADA affiliated, $15. In-state non-ADA affiliated, $30 + tax. Out-of-state non-ADA affiliated, $30.Single issue price: TDA members $1. In-state ADA affiliated, $3 + tax. Out-of-state ADA affiliated, $3. In-state non-ADA affiliated, $6 + tax. Out-of-state non-ADA affiliated, $6.Contributions: Manuscripts and news items of interest to the membership of the Association are solicited. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. Please refer to Instructions for Contributors in the annual September Directory of the Texas Dental Journal for more information. The Information for Contributors is available at tda.org. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are ac-cepted with the understanding that they have not been published previously. Authors must disclose any financial or other interests they may have in products or services described in their articles. Advertisements: Publication of advertisements in this publication does not constitute a guarantee or endorsement by the Association of the quality of value of such product or of the claims made of it by its manufacturer.

TSBDE Rule UpdateThis recurringThis recurringThis section recurring section recurring is designed is designed is to designed to designed help TDA members keep members keep members up with important with important with Texas important Texas important State Texas State Texas Board State Board State of Board of Board Dental of Dental of Examiners Dental Examiners Dental (TSBDE) Examiners (TSBDE) Examinersrules, other regulations, other regulations, other and state and state and law state law state affecting law affecting law their affecting their affecting practices. their practices. their

Question: Canadentistdismissapatientfromhis/herdentalpracticewithoutabandoningthepatient? Answer: Yes. A dentist may dismiss a patient (e.g. terminate the dentist-patient relationship) for a reasonable cause if the requirementsof Texas State Board of Dental Examiners (TSBDE) Rule 108.5 regarding “Patient Abandonment” are followed. The dentist must takesteps to protect the dental health of the patient by completing any dental procedures that may be in progress prior to terminating thedentist-patient relationship. The dentist must also remain available for emergency services for at least thirty (30) days after notice oftermination is served upon the patient. Please review the TSBDE rule thoroughly prior to attempting to dismiss a patient.

For your convenience, the text of Rule 108.5 is provided below.TSBDE Rule 108.5 Patient Abandonment Patient Abandonment Patient(a) A dentist, without reasonable cause, shall not abandon a dental patient. Once a dentist has undertaken a course of treatment,

the dentist, absent reasonable cause, shall not discontinue that treatment without giving the patient adequate notice and theopportunity to obtain the services of another dentist. A dentist shall exercise the level of care necessary to prevent jeopardizing thepatient’s oral health during this process.

(b) Under this section, a dentist shall give a minimum of 30 days written notice of his/her intent to discontinue undertakentreatment. Notice shall be either hand-delivered to the patient or sent via certified mail, return receipt requested to the patient’slast known address, with the dentist retaining a copy of the notice letter in the patient’s file along with proof of service. Adequatenotice shall include the following:

(1) a short description of the patient’s current status, including the patient’s current diagnosis and a summary of thepatient’s current treatment plan;

(2) a short description of the patient’s present and future needs;(3) an explanation regarding the consequences of non-treatment;(4) a recommendation that the patient continue care with another dentist; and(5) a clear statement emphasizing that the dentist is available to provide any emergency treatment necessary to prevent

patient harm during the 30-day period.(c) A dentist shall remain reasonably available to render any emergency treatment necessary under (b)(5) of this section for up to

30 days from the date of such notice.Source Note: The provisions of this §108.5 adopted to be effective February 20, 2001, 26 TexReg 1494; amended to be effective

April 14, 2002, 27 TexReg 2826.Please contact TDA policy manager Ms. Diane Rhodes for more information, (512) 443-3675, diane@tda.org.

In the NewsHigginbottom named BCD Distinguished Alumnus

Dr. Frank L. Frank L. Frank Higginbottom of Dallas was bestowed Baylor College of Dentistry’s (BCD) DistinguishedAlumnus Award on January 14January 14January ,2011 during the BCD Alumni Association’s homecoming reception in Dallas.

A 1971 BCD graduate, Higginbottom maintains a private practice in esthetic, restorative, andimplant dentistry in Dallas. At BCD, he is an associate clinical professor in restorative sciences, graduateprosthodontics and oral and maxillofacial surgery. He also is a clinical associate professor of periodontics atthe University of Texas Health Science Center at San Antonio Dental School.

Higginbottom lectures nationally and internationally on the subjects of dental implants, restorativedentistry, provisional restorations, and treatment planning. He also has authored numerous articles and

contributed to textbooks on these subjects and is active in basic research in the field of dental implant systems.A member of numerous professional dental organizations, Higginbottom is a past director and vice president of the TDA

and a fellow of the Academy of Osseointegration, the American College of Dentists, and the International College of Dentists.He has been awarded honorary membership in the American College of Prosthodontics.

Member Publication

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