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Gator Dentist times

The ASDA Mission Statement“The American Student Dental Association is a national student-run organization that protects and advances the

rights, interests and welfare of dental students. It introduces students to lifelong involvement in organized dentistry and provides services, information, education, representation and advocacy.”

Connect. Support. Advance. Find out more at www.asdanet.org.

UFCD ASDA News www.UFASDA.com Winter 2013

CalendarJanuary

21 MLK Holiday

February

2 ASDA Business Fair (Jrs & Srs, HPNP Auditorium)

15-19 Fall Break

March

4-8 Spring Break

6-9 ASDA Annual Session (Atlanta, GA)

April

3 FDA Dentists Day on the Hill

5-6 Spring Synergy

6 ASDA Banquet

15 National Dental Student Lobby Day (Washington D.C.)

Ethics CornerPage 2DR Service TripPage 3Licensure ExamsPage 4

InvisalignPage 5

YDW, LeadershipPage 6

Mighty MolarPage 7

LegislationPage 8

District 5 Meeting- Destin, FLChelsea Brinkman, President

We had an educational and eventful weekend at the ASDA District 5 Meeting in Destin, FL along with other schools and the Alabama AGD. This event was eye opening for us to realize the importance of organized dentistry during school, and once we have graduated. Especially during an election year and with large health care changes on the horizon, it is important that as a profession we present as a united group to the governing officials making important decisions for our career. Without organization, the field of dentistry could be subject to changes that affect how we can practice and provide for our patients. We encourage you to read the articles in this newsletter that board members have written summarizing different relevant speakers from this event. Please make sure to read the interesting Legislative Liaison update that addresses important hot topics in our education and field today. It is important for us all to stay involved AND educated on these pivotal issues.

A Discussion of Organized DentistryAli Best, Vice-President

During the ASDA District Meeting in Destin, FL, several great speakers, including Dr. Paul Bussman, presented some interesting and relevant information to us as students. Dr. Paul Bussman, a former dentist and representative of Alabama for District 4, spoke at the ASDA District Meeting about “Organized Dentistry in Alabama Politics.” He stressed the importance of staying involved in legislation because

as a political official, he has observed the influence that lobbyists can have in government. Up until two years ago, Alabama lobbyists could give representatives money for no specific reason without reporting their donation, and then they would return later when they wanted a particular bill to pass. Although lobbyists

continued on page 6

ADA Annual SessionPage 9

Mid-Level ProvidersPage 11

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The Ethics CornerSean Coyle, D3

I always found it odd that part of our curriculum was devoted to teaching us about

ethics in dentistry. To me, ethics is something that shouldn’t be taught but more of something ingrained in each and every one of us.

Looking back, I think it is extremely important. Albert Einstein once said, “Relativity applies to physics, not ethics.” What I think he was getting at is that physics has strict laws, it follows very precise theories and there is little to no deviation from this. Ethics on the other hand is not as cut and dry. What might be right to you, may not be right to me. Often that is fine, but when it comes to our profession we need to be more so on

the same page. The old adage that a few bad apples spoil the bunch is so true. A few poor decisions by a small minority of practicing dentists gives the profession a bad public image. So is one class taught in dental school going to rectify this? Of course not. At the minimum, it attempts to lay a framework of values that most of us will hopefully uphold in attempts to better serve ourselves, our patients, and our communities.

ASDA Board MembersPresident: Chelsea Brinkman

Vice President: Ali Best

Secretary: Jessica Biggs

Corresponding Secretary: Ashley Baptiste

Fundraising Coordinators: Tristan Hensley and Olga Lucas,

Special Events Coordinator: Cassie Lichkay

Social Chairs: Desmond Foster and Camie Miskovich

Membership Coordinator: Ann Hoang

Pre-dental Chairs: Haley Freymiller and Shawn Stott

Legislative Liaisons: Frank Berdos, Sunny Patel, and Daniel Sabra

Treasurer: Deborah Lowry

Lunch and Learn Coordinator: Jacqueline Garcia

Lunch and Learn Secretary: Sara Makary

Webmaster: Eddy Sedeno

Community Service Chair: Courtney Sargent.

Ethics Chair: Sean Coyle.

Newsletter Coordinators: Roshan Patel and Juliana Chang

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From the Editors

If you have any comments, questions, or if you would like to contribute a topic or article in future editions of the newsletter, please do not hesitate to contact us.

Regards,

Juliana Chang (jchang2@dental.ufl.edu) Roshan Patel (ropatel@dental.ufl.edu)

The publication of this newsletter was made possible by UF Student Government.

Dominican Republic Service Trip

Ashley Baptiste & Olga Luaces, D2

Since 1987, dental students and faculty from UFCD have worked to organize an annual international service trip to rural and impoverished areas of the Dominican Republic. Every year, participants are welcomed by hundreds of children and adults

in dire need of emergency dental treatment. This past summer marked the 25th anniversary of the

UFCD International Service Trip to the Dominican Republic. For the first time in the organization’s history, trip directors Eddy Sedeño and Stacey Nedrud led not one, but two trips to different areas of the country.

The first trip took place during the June 2012 break at San Francisco de Marcoris, located on the northeastern part of the country. Headed by dental faculty Dr. Rosalia Rey, a group of 15 dental students worked in conjunction with the Universidad Católica Nordestana

(UCNE) School of Dentistry located within the city. The dental team was stationed each day at a local elementary school or church. Both UF and UCNE students performed diagnostic exams to assess the dental needs and medical risks of each patient. Following examination, patients received oral surgery or restorative treatment if appropriate. Post-operative instructions and oral hygiene instructions were provided to all patients in Spanish. As a result of the collaborative efforts of dental students and faculty from UF and UCNE, over 400 patients were treated at San Francisco de Marcoris.

The second trip occurred in August 2012 at Las Matas del Farfan, a more rural city located near the border of Haiti. A large group of 35 dental students was led by Dr. Timothy Garvey, who has provided dental assistance in the DR for many years. Participants were split into smaller groups and traveled by car to different areas of the city, bringing all the necessary supplies along with them. Dental students, in conjunction with faculty guidance and supervision, treat patients in need of restorations or tooth extractions. Due to the efforts of trip participants and community leaders, over 600 patients received much needed dental care throughout the

city.

Having the opportunity to interact with the people of the Dominican Republic has aided UF dental students in becoming more culturally competent individuals. Before the trip itself, student participants attend Spanish terminology sessions hosted by the University of Florida Hispanic Student Dental Association. Becoming more familiar with dental vocabulary and common phrases in the native language allows students to better communicate with their patients and provide a more satisfactory level of care. Dental students not only strive to treat their patients’ chief concerns, but also provide simple post-operative instructions and oral hygiene guidelines in the Spanish language. Students return home with an increased appreciation of the culture of the Dominican Republic and a greater awareness of the importance of patient-practitioner communication, culturally sensitive treatment, and need for oral healthcare in developing countries.

The 2013 Dominican Republic Service Trips will be led by Olga Luaces and Frank Berdos. Please be sure to keep a look out for upcoming fundraising events in the Spring semester to support UF DR!

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Dental Licensure Exams: Ethical or Profitable?

Jessica Biggs, D3

As time spent in dental school continues to fly by, another group of exceptional dentists will soon

enter the work force. Each year is marked by a new set of requirements and stresses in order to proceed to the next, especially boards and licensure exams. While many focus on trying to do well and pass these exams, some are concerned that dental ethics may be compromised in the process.

The first question that comes to mind when preparing for exams is, “Which exam do I have to take?” Multiple exams exist because certain state boards of dentistry only accept certain clinical exams. Whether you sign up for the CITA, CRDTS, NERB, SRTA, WREB, or a combination

of a few depends on which states you are hoping to practice in. The cost range starts at $1760 and can go up a few thousand for just one of the exams. These costs add up if you are job searching in different regions. So the next question to be raised is “Why can’t they just make one exam?” The American Student Dental Association and American Dental Association first explored this and originally fought to develop one licensure exam for all states. This was not accepted and it led many to believe it was because of the loss in profit from testing centers.

Having multiple licensure exams can be a bit of an expensive annoyance, but there are other controversies- the greatest being the ethical dilemma of live patients in the exam process. From searching for the perfect lesions and delaying treatment until exam day to not providing comprehensive care, the American Dental Association is recognizing

problems with this method. The ADA “…supports elimination of human subjects/patients in the clinical licensure examination process with the exception of the curriculum integrated format within dental schools and be it further, resolved, that the Association encourages all states to adopt methodologies for licensure that are consistent with this policy. (2005:3351)”

Currently some states are exploring the option of adopting the Canadian OSCE (testing on clinical scenarios), portfolio exam, or requiring one year of General Practice Residency to avoid human subject licensure exams. Currently California is developing the option of submitting a portfolio and the ADA is working to further develop this prototype exam. If all states accept this concept, it could mean the end to unethical use of human subjects in licensure exams and erase the need for taking multiple exams.

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Invisalign: What training is required?Ali Best, D3

Around the world, Invisalign is being prescribed to patients as a means of correcting malocclusions by more than 40,000 doctors. The advantages of the Invisalign appliance are clear- it provides improved esthetics over conventional braces, it is removable so that sticky foods are not off-limits and oral hygiene can be more easily maintained, and it is typically more comfortable than the metal brackets and sharp wires of braces. However, Invisalign is not the answer to all orthodontic problems. There are many cases in which the appliances are not capable of generating the desired tooth movements. Invisalign should not be used if the patient presents with crowding/spacing more than 5mm, severe anterior-posterior discrepancies, severely rotated or tipped teeth, open bites, teeth with short clinical crowns, or arches with several missing teeth. Also, since it is removable, patient compliance becomes an issue in its effectiveness.

Since adults comprise almost 20% of those in braces today, aesthetics is becoming increasingly important in the correction of malalignments, and consequently, more and more orthodontists as well as general dentists are completing the training necessary to become certified Invisalign providers. However, given that Invisalign is a procedure of tooth movement, a task typically carried out by the orthodontic specialty, and given that the appliance has its

limitations, a debate has arisen as to what the appropriate training for an Invisalign provider should be. Before 2009, practitioners paid $2,000 for an 8 hour training course offered by Align Technology, Inc. that would allow them to use Invisalign. In June 2009, Align instated a policy whereby doctors had to prescribe at least 10 Invisalign cases per year or lose their certification. This new rule outraged many practitioners, who felt that it was forcing them to offer treatment to patients who did not need it. The minimum cases policy has since been revoked, but doctors are still required

to fulfill 10 Invisalign CE hours per year.

As it stands now then, doctors can enroll in an 8 hour Invisalign CE course and then they can start treating patients, provided that they complete 10 pertinent CE hours annually. But is this enough training, given the impact tooth movement can have in the oral cavity? Should doctors be required to complete a minimum number of cases every year in order to maintain their certification? And should general practitioners be allowed to treat patients with Invisalign, even though they do not have as extensive of a background regarding tooth movement as an orthodontist? In

a poll carried out by The Wealthy Dentist, 74% of GPs believe that “it is definitely appropriate for general dentists to do ortho,” while only 4% of orthodontists agree with that statement. Although Invisalign may not involve the degree of occlusal adjustments that conventional braces require, it seems that a thorough understanding of tooth movement is required so that the limitations of the appliance are recognized, especially since the adjustments are designed from digital models on a computer program by non-dentist and non-orthodontist personnel in Costa Rica. That being said, as dentists, we all agree (or will agree) to follow the principle of Nonmaleficence, or “do no harm,” as stated in the ADA Code. Consequently, just as a general dentist would refer an extraction or a root canal that he recognizes as too complicated for his skill level, so too should he recognize an orthodontic case that is not suited to the simple movements of Invisalign and refer to an orthodontist.

In conclusion, it appears that Invisalign will continue to increase in popularity as more adults become concerned with aesthetics and more dentists promote the correction of malocclusions as a way to improve oral hygiene and periodontal health. However, we must be sure that as we receive pressure from our patients for this treatment, we do not forget the limitations, both of the appliance, and of our own training. In this way, we will ensure that our patients receive the best care we can provide.

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Young Dentists WorldwideMagda AbdelFattah, D3

I am pleased to have the opportunity to write about the College of Dentistry’s newest student organization, Young Dentists Worldwide (YDW).

In early 2012, a few dental students sought the need for expanded opportunities in the areas of treating diverse communities; it was in this notion that YDW was started. Our organization emphasizes the principles of education, knowledge, and community service. Our focus is to increase our abilities as future dental practitioners, to be able to better treat the special needs and pediatric patient.

YDW is most definitely not an exclusive club for those interested

in pediatrics or special needs dentistry. It is for any future dentist, even those students focused on other specialties. Like all patients, special needs patients and children deserve the best care available, and YDW aims to prepare the student dentist to become more capable to treat these patient populations who so often find themselves shuffled around between dentists who chose not to treat and refer or are incapable of treating them. These patients – particularly those with special needs – find themselves with limited access to care; whether it is due to difficulty finding a willing dentist to treat them, lack of continuity of care, or inadequate treatment period. Unfortunately, these are not rare occurrences, and it is YDW’s goal to change this impression in future generations of dental practitioners.

To date, we have been fortunate to have several opportunities to help others and expand our knowledge bases. Some of these activities include a Halloween party (co-joined with AAPHD and SNDA) at the Boys & Girls Club of Alachua, and preparing breakfast for families at the Ronald McDonald House of Gainesville. We were most fortunate

to bring a group of over 20 students to ESPN’s Wide World of Sports for the Special Olympics State Fall Games in November. We are also proud to say that we collected over 400 pounds of food during our Thanksgiving Feed-a-Family food drive!

We have no plans to stop this momentum either. Several events are planned for the Spring Semester, including educational lunch-and-learns, opportunities to teach oral health throughout Alachua county, and attendance at both the Special Olympics State Summer Games and the American Academy of Pediatric Dentistry Annual Session.

Again, anyone can benefit from participating in our events, and we hope to see you in the Spring! Please be on the look out for emails regarding opportunities to learn and serve with YDW!

A Brief Synopsis of Leadership Habits Discussed at ASDA

District MeetingDesmond Foster, D2

At this year’s district meeting I was assigned to report on a specific discussion about office leadership as a practitioner. There were several attributes covered during this presentation but throughout the presentation, three main objectives were addressed: 1) Always abide by the fundamentals, 2) Know how to relate to your staff and patients, and 3) Always be ready to think on your feet.

In order to set and maintain a standard of execution within a practice, it is suggested that we abide by the basic

fundamentals learned in school. As the business owner/leader we should ourselves and our staff accountable to the standards which we set. Develop a mission statement and stick to it. To maintain the standards of the profession, we must continue your education and learning to be sure that our treatments are evidence based.

As employers and practitioners we should explore ways to best relate to our staff and patients. First, we have to understand our own personality. Studies have shown that many individuals display an altered personality at work or under stressful conditions. It was suggested that new practitioners take the Myers Briggs test to learn more about their own

personality and recognize potential employee personality types that may be more compatible for successful working relationships.

Finally, the ability to think on your feet was discussed. As a business owner, it is important to deal with issues directly and quickly. Learning to exercise emotional intelligence is a necessity for the proper conflict resolution and problem solving demands of business leadership.

Along with addressing the mistakes of others, it is also important to outwardly admit to our own mistakes. The ability to efficiently delegate responsibilities and accept the ideas of staff members were also labeled as important characteristics.

Volunteers at the Special Olympics Healthy Smiles event.

YDW volunteers cooked breakfast at the Ronald McDonald House.

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Mighty MolarCourtney Sargent, D2

On Sunday, September 23, 2012 the dental students, faculty, and pre-dentals of the University of Florida College

of Dentistry showed Lake Wauburg what good times and ridiculously good oral hygiene looks like. Over 200 people arrived for the annual Mighty Molar picnic, organized by your very own UF Chapter

of the American Student Dental Association. Here’s a quick recap of the annual event, for those of you who missed it!

The weather was beautiful and the event was just as delicious as usual, with barbecue and gelato on the menu. Door prizes were handed out and the raffle was a huge success – prizes included dental decks, loupes, massages, televisions, and tons of gift cards to local Gainesville restaurants and businesses. If food and prizes weren’t enough for the attendees, we were able to get out all our frustration on our favorite classmates and faculty members thanks to a recent Mighty Molar favorite - the Dunk Tank.

The contests kicked off with the egg toss. Though everyone involved put in a tremendous amount of effort, some eggs just proved to be a little tougher than others, and the D4s used their honed hand skills to win it.

Next up was the always intense, always sanitary event “trayless impressions”. Once again, the Class of 2013 was able to use skills and strategy to grab another W.

Now comes the kicker: tug of war. We definitely have some fighters in all of the classes, and the faculty put up a great effort, but once again the D4s won it.

Finally, there came the relay--the usual shenanigans involving capsized canoes ensued, and the Class of 2013 triumphed once again.

And that’s how the Class of 2013 became victorious for the 3rd year in a row. The final scoreboard was as follows: the Class of 2014 and faculty tied for second place, third went to the Class of 2015, 4th to Class of 2016, and 5th to the pre-dentals.

But in all seriousness, the real winners from Mighty Molar are cleft lip and palate kids and their families. Thanks to your attendance and p a r t i c i p at i o n , ASDA was able to raise over $2,200 for the

charity Smile Train, an international nonprofit program that provides cleft palate surgery for children from underprivileged families.

I would also like to extend a big thank you to our president, Chelsea Brinkman, and the entire ASDA executive board for organizing such a great event, and to our sponsors, especially Crest Oral-B, for making it possible. If you have never attended, we welcome you to join us next year for more fun and games for a good cause!

The D4s after securing yet another win.

Raffle tickets were exchanged for chances to drop faculty members into the dunk tank.

In this case, Dr. Dolce was the victim.

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Legislation in DentistryDanny Sabra, with contributions from

Sunny Patel,D3

At the ASDA District 5 meeting last month in Destin, FL, we did plenty more than live it up on hundred foot yachts. We discussed multiple issues facing us as dental students and emerging dentists. Here is your legislative update:

Loans – There are no more subsidized loans, and the cost of tuition continues its upward trend. This affects us in our decision on where to practice dentistry once we graduate. Rural area loan forgiveness programs through the government are a good option for some; the military works well for others. Many more graduates are going in to practice with “corporate dentistry”

to try to pay off some loans before moving in to private practice. There are several options and many of us may have to take on slightly “less comfortable” career paths.

Licensure/Boards – This is discussion about the ethics of using live patients for our board exams. An alternative option may be for dental students to accumulate a “portfolio” during their clinic years, which would consist of a collection of patient cases students could present to board examiners. These cases would be ones in which the students were fully responsible for providing care with no continuing oversight from faculty. The options are currently being discussed. ASDA currently supports a single nationwide exam for board licensure. Additionally, boards are now pass/fail. There is

discussion to combine boards part 1 and part 2 together. It is unclear as to how this will affect applying to specialty programs and the timing of making the decision to do so.

Mid-level providers – Some states have passed legislation allowing mid-level providers (AKA dental therapists, advanced dental technicians, advance dental hygiene therapists, etc) to perform irreversible dental procedures on patients. Initially the plan was to contain MLP programs to rural areas with access-to-care problem but ASDA believes that once the ball gets rolling, MLPs will be ubiquitous. This is an issue because MLPs will take patients away from dentists, making it difficult to fill chairs and maintain a practice, and the MLPs will practice on patients without

Continued on page 10

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ADA Annual Session in Oc-tober – San Francisco

Roshan Patel, D3

The 153rd American Dental A s s o c i a t i o n (ADA) Annual Session took

place in San Francisco this past October 2012. This massive four day event took place at the Moscone Center from October 17th to the 21st. The event attracted thousands of dentists, dental hygienists, dental auxiliary, and dental students from around the country. A number of renowned speakers, some from our own UF: College of Dentistry, presented new and exciting information on current issues and topics including public health dentistry.

The ADA Annual Session 2012 held exhibitions for several days, with representatives marketing a wide range of dental products. Such products included the newest composite bonding systems, ultrasonic periodontal instruments, implant systems, and the latest in iTero and CAD/CAM technology. Over 600 companies were invited to present at what was called the ADA World Marketplace Exhibition at the Mascone North and Mascone South

buildings. The exhibition provided a great learning opportunity for dentists and auxiliary who wish to learn more about new technologies and products in dentistry.

Hundreds of continuing education (CE) courses were also offered, ranging in topics that included business management, research, technology, new techniques in operative dentistry, endodontics,

and prosthodontics. Other courses were available for dental hygienists and dental assistants to participate in. Over the years, the ADA has put more emphasis on a “hands-on” approach to continuing education at Annual Session. This last year, a number of new “hands on courses” were offered to dentists to allow them to begin learning new skills, while also reviewing information attained in dental school. This year, two new workshops included a hands on cadaver session and a course on lasers in dentistry.

In addition to CE courses, open clinical and science forums were available and allowed for participants to engage in open conversation and debate about current topics affecting dentistry and research. These open forums emphasize the ADA’s understanding and support of ongoing research to further advance our field and to provide future treatment to our patients that is

based on scientific evidence.

Attending the ADA Annual Session for the first time was a unique learning opportunity for me that broadened my understanding of how diverse dentistry is. It gives students an opportunity to connect with other students, dentists, and companies that we may work with in the

future. It also gives students a chance to attend CE courses while still in dental school. The session is free to all ASDA members and I would encourage you to take some time and attend next year’s session. The next ADA Annual Session will be held in New Orleans, on October 31-November 3, 2013. Overall, the ADA Annual Session is a great opportunity to connect with other dental health professionals, and to continue to learn and grow as we enter into the profession.

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A view of the ADA World Marketplace Exhibition

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undergoing the same training as dentists, which could very well be a patient safety issue. In addition, several studies have shown that these MLP programs are not economically viable and cannot be sustained. ADA and ASDA opposes MLP programs and instead supports incorporating someone into the dental team called a community dental health coordinator who care make referrals to dentists and clinics, thus ensuring that patients have access to dental care from board-certified, fully trained dentists. ASDA was recently able to speak at the California state

congress and successfully helped stop legislation to install a pilot MLP program in the state.

Dental schools – There are currently 62 dental schools in the United States. Most schools that are opening right now are for-profit schools which have not yet attained accreditation. Approximately 6000 dental students graduate and enter the workforce every year, and this number is continuing to increase. ASDA believes that we do not need more dentists in order to meet the need for care, but rather we need to improve reimbursement rates, allow for more

procedures to be covered, and make it more economically and logistically feasible for dentists to provide care for more patients including more indigent populations. All ASDA can do on this issue is declare its opposition to more schools opening to state legislatures.

These were a few of the more relevant issues discussed at the ASDA District 5 meeting. Feel free to contact your ASDA legislative liaisons if you are interested in discussing any of these topics or any other issue affecting the continually changing landscape of our profession.

Legislation continued from page 8

must now report their donations, some are known to say whatever they need to ensure they will receive the support they desire. Dr. Bussman believes that this corruption is the reason why the federal government is

currently at a standstill. He said that “once ethics is violated, the public is out of the picture,” and he proclaimed that the only way to halt the decline of governmental standards and policies is for us to become more involved.

We need to speak to our legislators and educate our colleagues about the issues in organized dentistry in order to protect the future of our profession.

Organized Dentistry, continued from page 1

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Midlevel ProvidersDebbie Lowry, D3

As we attended the District 5 Meeting in Destin, it became apparent that the issue of midlevel providers is becoming a reality. What is a midlevel provider? ASDA defines it as “…an individual, who is not a dentist…, who may perform irreversible procedures on the public”. Why would anyone want someone not adequately educated to perform irreversible procedure? As an answer to the barriers to care issue. Perhaps it may be more advisable to address the root of the problem rather than focusing on new workforce models. The barriers

to care that are faced by many patients need to be knocked down using the care available now. Dr. Carter Brown, AGD Vice President, stated that “Barriers such as social, cultural, economic, personal responsibility, and transportation issues have the significant impact on improving oral health, not workforce.” Although midlevel providers may seem like a “quick” fix to this dilemma, in reality more aspects need to be addressed to find a resolution.

UF ASDA board members who attended the District meeting got to hear lectures, meet distinguished speakers (middle, with Dr. Sam Low), and also relax �

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