On Your Behalf

Volume 68 • Number 4 • August 2014 • San Francisco Dental Society Organized 1869

Attention toPrevention - FluorideVarnish: Another Toolto Help Fight the War

on Dental CariesPage 8

39th AnnualSan Francisco

Children’s DentalPoster Contest

Page 10

On Your Behalf -Protect Access to

Quality Health Careand Patient Privacy

Page 15

San Francisco Dental Society • Page 2

2014 SAN FRANCISCO DENTAL SOCIETY OFFICERS AND

BOARD OF DIRECTORS

2014 Executive CommitteePresident

Paul Weller, DDS, MS

President-Elect Dennis Song, DDS, MD

Immediate Past-President Peter Lee, DDS, MS

SecretaryCarlos Nogueiro, DDS

TreasurerGail Duffala, DDS

CDA TrusteesIrene Hilton, DDS, MPH

Natasha Lee, DDS

Executive DirectorDeborah A. Elam, MS CAE

THE BRIDGE EditorCraig S. Yarborough, DDS

DirectorsEarl Capuli, DDS

Wayne Del Carlo, DDSDavid Ehsan, DDS, MD

Courtney Fitzpatrick, DDSJoseph Gabany, DMD, MSD

Terry Im, DDS, MSWilliam Lee, DDS

Curtis D. Raff, DDSSima Salimi, DDS

Eric M. Scharf, DDSVlad V. Shuster, DMD

SFDS StaffAlfonso Estera, Jr. – Membership Administrator

Lisa Tamburrino – Administrative & Advertising Assistant

2014 Committee Chairs & Vice Chairs

Community Dental Health - Jeff Jang, DDS & Allen Wong, DDS,

Ethics - Mark Wiesen, DDS

Executive - Paul Weller, DDS, MS

Finance - Gail Duffala, DDS

Legislative - Claudia Masouredis, DDS MPH

Membership/New Dentist - Vlad V. Shuster, DMD

Peer Review - Michael Ramsay, DDS

Poster Contest - Dennis D. Shinbori, DDS & Stafford Duhn, DDS

Professional DevelopmentDennis Song, DDS MD

Well-Being - Bruce Hiura, DDS(Confidential assistance to professionals,

spouse and staff for drug and alcohol abuse, call (415) 776-5855)

Olga Antipova, DDS; GP; USC2012; Ste 1022, 490 Post St

Sushmita Bhardwaj, DDS; GP;VCU 2010; 520 Lennon Ln, Ste A,Walnut Creek

Heather H. Dinh, DDS; GP; UCSF2014; AEGD Lutheran MedicalCenter/UCSF 2015

Christine Fu, DDS; GP; UOP 2014;AEGD Lutheran MedicalCenter/UCSF 2015

Darren Goring, DDS; GP; UOP2014; Prosthodontics VA MedicalWest Los Angeles 2017

Hana D. Litterman, DDS; GP;Minnesota 2012; Office Address Pending

Leslie McGarvey, DDS; GP;Michigan 2014; AEGD LutheranMedical Center 2015

Ashwin Nanda, DDS; GP; UOP1996; Office Address Pending

Nina M. Nattiv, DDS; GP; USC2007; Office Address Pending

Krunal Sherathiya, DDS; GP;UCSF 2013; Office Address Pending

Kristina N. Svensson, DDS; GP;UOP 2012; Children’s Hospital ofWisconsin Pediatric Dentistry 2014

Helen Thai, DMD; GP; Pittsburg2006; 950 Stockton St, Ste 400

Braulio Ulloa, DDS; GP; UCSF2000; 3448 Mission St

A STANDING OVATION… TO WELCOME OUR NEWEST

SFDS MEMBERS:

CONTINUING TOTHANK OUR MANYVOLUNTEERS…

CDA Cares Solano Volunteers:Russell Taylor, DMD

Additional Clinic By The Bay Volunteers:

Peter E. Lyu, DDS, MD J. Reed Rayher, DDS, MD

Michael E. Barkin, DDS, MDWilliam Chan, DDSMichael Chan, DDS

Monica Lara-Cordoba, DMD, DMScDean Duncan, DDS

Eric Scharf, DDSTerry Im, DDS, MS

Darren Machule, DMD, PhDDustin Wirig, DDS

Morvarid Khatibian, DDSScott Meyers, DDSSandy Shih, DDS

Kindergarten School Screenings:Irene Hilton, DDS, MPH


EDITORIALCraig Yarborough, DDS, Editor

With apologies to the bandOrleans, I am going to takeliberty with the lyrics to

their song “Still the One.” I am using“One” as a reference to our profession– dentistry, as in “We’re still the one”profession that individuals in thehealth profession, or just in general,want to join. Whether you are one ofthose, like me, where “We’ve beentogether since way back when” or juststarting your career, or if you are oneof those who feel “Sometimes I neverwant to see you again”, the media andthe public still think we have a goodthing going. And, they are right.

The US News and World Report (USN&WR) listed their 100 Best Jobs for2014 at the beginning of the year withDentistry ranked #3, behind only #1Software Developer and #2 ComputerSystems Analyst. Obviously, thismeans we were the “#1 Best HealthCare Job” but kudos to the DentalHygienists who ranked #10. The USN&WR primarily used demand astheir main discriminator reportingdentistry will see a 16 percent employ-ment growth between 2012 and 2022including more than 23,000 newopenings. Adding to the attractivenessis a “comfortable salary” (US N&WRstates $145,240 as the median,$104,230 as the 25th percentile. TheADA used $192,392 as the annualincome of a GP in 2011). Additionally,

sions and 62% of the respondents putdentists at “very high” or “high” inhonesty/integrity in the surveys.Nurses were at the top at 82% in com-parison. The reliability of this poll isvery good, in my mind, since Membersof Congress were rated at 8%.

Then there is the rumor, though, that“dentists have the highest suiciderate”. We don’t, but at #3, we don’twant to try harder in this area. Basedon information in 2011 from theNational Institute for OccupationalSafety and Health (NIOSH), marineengineers hold down the top rankingwith a suicide rate 89% above average.Our friends in the health profession,physicians, are at 87% above average.We drop down to 67% above averagebased on the 19 professions ranked.Realize this is way down the list ofcauses for death, to begin with.NIOSH recorded 148 suicides among6,274 white male deaths or 2.4%. The average for white males is 1.4%.

Hopefully, those of you reading thiseditorial enjoy your profession, yourpatients, your reputations and yourlives. Finishing with the theme, “Stillthe One”, optimistically you will agreewith me that “We’re still having fun,and (we’re) still the one”. ❖

a low unemployment rate of 1.5% andtheir work-life balance ratio factoredinto the rankings. (Editor’s note: Ichallenge US N&WR’s credibilitywhen it claims “the University ofPennsylvania, University of Michiganand University of California-SanFrancisco are widely considered tohave excellent dentistry programs.”This is tongue-in-cheek; do not takepen to paper or thumbs to iPhones toopine on this).

On the “prestige” scale, Dentistry isranked #1, also. I had to track thisdown to the National OpinionResearch Center at the University ofChicago (NORC). The NORC, estab-lished in 1941, is one of the largestindependent social research organiza-tions in the United States. These soci-ologists use prestige to refer to theadmiration and respect that a profes-sion holds in our society. They identi-fied 700 occupations, created a scalefrom 0 being the lowest to 100 thehighest, and found dentistry scored86.05 to far outdistance the lawyersranked #2 and Computer SystemsAnalysts at #3 with scores of 74.77and 73.70, respectively. To be fair, theNORC did list us in combination withMD’s and DO’s.

Dentistry was #5 in the rankings inhonesty and ethical standards for peo-ple in their fields by the Gallup Poll in2012. The public ranked 22 profes-

We’re Still the One


BASEBALL NIGHTThe SFDS Baseball night was a great hit! SFDS members and

guests watched the Giants beat the Atlanta Braves 4-2!


The purpose is to establish and imple-ment a state oral health program. Thebudget would provide $474,000 infunding for the first year. The fundswould be used to assess oral healthneeds in the state, develop and managea state oral health plan, and apply forand manage federal and private grantsto support oral health.

This is one of the most major state oral health achievements in decades.The idea is to address the oral healthcare crisis facing millions ofCalifornians through coordinated stateoral health education and preventiveprograms led by a dental director andpartnered with care provided by dentists across the state.

In addition to developing and imple-menting a state oral health plan, thedental director’s role will also includeestablishing prevention and oral healthliteracy projects, working to securefunding for prevention-focused oralhealth and essential disease preventionservices. While it remains to be seenhow this will all play out and the effectiveness of the plan, it is a positivestep forward with a licensed dentist in a leadership position involved in the process.

PRESIDENT’S MESSAGEPaul Weller, DDS, MS, President

I invite you to access the CDA websitefor the full report on Reducing Barriersto Dental Care(http://www.cda.org/Portals/0/pdfs/access_report.pdf)

Here is a snapshot of the 3-PhaseProposal: First, enhance capacity byexpanding what works and establishinga foundation for public oral health pro-grams. Second, optimize early diseaseprevention, and third, further expandthe capacity to provide care to at-riskpopulations. There are three broadphases, each comprised of multiple recommendations:

1. Establish State Oral HealthLeadership and Optimize ExistingResources (years 1-3)

2. Focus on Prevention and EarlyIntervention for Children (years 3-5)

3. Innovate the Dental Delivery Systemto Expand Capacity (years 4-7) ❖

For quite a few years, theCalifornia Dental Associationhas been working on “Phased

Strategies for Reducing Barriers toDental Care in California”. CDA has agood working relationship with theState's Legislature in the establishmentof dental and health related issues andlegislation. Having been a Delegate onthe CDA House of Delegates for a num-ber of years, I have seen and beeninvolved in the ongoing process ofaddressing barriers to care. Dental careneeds in California will only be increas-ing in the years to come.

A milestone and goal CDA has activelypursued for years has recently beenachieved. This is part of Phase I ofCDA's proposed strategy. The establish-ment of a state dental director positionis slated to become a reality after thestate Legislature approved the 2014-15state budget on June 15. CDA advocat-ed to the governor’s office that a dentaldirector must be a licensed dentist withstrong experience in state oral healthprograms to organize and executeessential dental public health functions.

The budget, signed on time this year,calls for two positions in theDepartment of Public Health 1) a statedental director, who must be a licenseddentist, and 2) an epidemiologist.

Reducing Barriers to Care In California. A Milestone Achieved!


raises the caveat that if such a suspen-sion, without pay, reduces the employ-ee’s monthly salary to an amount lessthan the statutory minimum, theexemption could be lost.

Employers also should be aware that ifthe exempt employee works part of theday, he or she must be paid for the wholeday. Employers can fill in the missed partof the partial day, however, from avail-able sick leave or vacation banks.

Criteria for Exempt Employees

California Labor Code Section 515 pro-vides that executive, administrative andprofessional employees are exempt from

LABOR LAW CORNERBy Gary Hermann, CalChamber HR Adviser

overtime if they meet the establishedduties tests, customarily and regularlyexercise discretion and independent judg-ment in performing those duties and earna monthly salary of no less than doublethe minimum wage for full-time work.

As the current California minimumwage is $8 per hour, the statutory mini-mum would be $2,773.33 per month.On July 1, 2014, the state’s minimumwage increased to $9 per hour, the mini-mum monthly salary for exemptemployees also increased—to $3,120. ❖

Reprinted with permission ofHRCalifornia.com

Can an employer suspend an exemptemployee without pay for disciplinaryreasons?

Perhaps! If an employer suspends anexempt employee for less than a fullworkweek, the employee must be paidfor the time, for the purpose of main-taining the employee’s exempt status.

Both the U.S. Department of Labor andthe Labor Commissioner allow anexempt employee to be off a full work-week without pay.

Caution

Even if the suspension is for a fullworkweek, the Labor Commissioner

Be Careful When Suspending an Exempt Employee Without Pay

CDA LEADER RUNNING FOR ADA PRESIDENT

Carol Summerhays, DDS, a general dentist with a San Diego private practice, is a candidate for theoffice of ADA president-elect 2014.

In addition to her role as the ADA Thirteenth District trustee, Summerhays has held numerousADA leadership positions and has served on various committees, including strategic planning,compensation, governance, government affairs and new dentist. She also served as CDA presidentin 2009, and held many positions on CDA committees and councils, including the CDA PresentsBoard of Managers, and was chair of the CDA Foundation Board of Advisors and its initial com-prehensive campaign that raised $24 million in contributions and commitments. Her work alsoincludes leadership positions with the San Diego Dental Society and the Academy of GeneralDentistry.

“As a private practice owner, I’m well aware of the challenges facing our profession today. Thisopportunity will allow me to focus on the future of our profession and advocate for our members and the patients we serve,”said Summerhays. “I am very grateful for the support I have received from many of my colleagues in California and across thenation, and I would be honored to serve as ADA president-elect.”

Summerhays is a graduate of the USC Ostrow School of Dentistry. She and her husband, Soames, live in San Diego and havetwo sons, Giles and Bryce.

Matthew Campbell Jr., DDS, CDA speaker emeritus, is serving as campaign chairman. He can be reached at [email protected] 916.425.1523. ❖


Generosity

EXECUTIVE PERSPECTIVEDeborah Elam, MS, CAE, Executive Director

The generosity of dentistry, like thegenerosity of Sean’s spirit, rang loudand clear during this transformationaljourney…from the SFDS board of direc-tors, who offered their support andflexibility in permitting me to workremotely so that I could be with ourson, to a remarkable team, Al and Lisa,who not only took care of the local dayto day, but also knew when to reach out to me. This generosity was furtherevidenced by the donations made inmemory of Sean by Drs. Gail Duffala,William Lee, Jeffrey Jang, Curtis Raff,Stephanie Jee, Irene Hilton, Eric Scharf& Dean Duncan, Craig Yarborough, theADA and Dr. O’Loughlin, the CDA andPeter DuBois, the Santa Clara CountyDental Society, ACSE of the ADA; bymany of my dental society executivecolleagues; by the beautiful orchid fromDrs. Peter Lee and Dorothy Pang; thelovely orchid from Dr. Sima Salimi; bythe many cards and notes that movedme and brought tremendous comfortto both Tony and me, from Drs. CarlosNogueiro, Paul Weller, Earl Capuli,Vlad Schuster, Richard Leeds, Terry Imand Biana Roykh, Monterey Bay DentalSociety Board, Colorado Springs DentalSociety, Tri-County Dental Society, Dr.Nita Dixit, San Fernando Valley DentalSociety; by the notes, emails, texts, andcalls of my executive director colleaguesboth in and out of dentistry; and bythose of you who emailed and called tooffer a shoulder to cry on, and time toreminisce. A generous, hearfealt, thankyou to all.

When one door of happiness closes, anotheropens, but often we look so long at theclosed door that we do not see the one thathas been opened for us. - Helen Keller

I can't go back to yesterday - because Iwas a different person then.-Lewis Carroll

Editor’s Note: We knew we had the best dentalsociety executive director in the country, but itis always nice to see her recognized by herpeers. Many thanks to CalSAE for honoringDeborah as we know her. Having the pleasureof working closely with Deborah these past twoyears as editor, I see her as a follower of LaoTzu - A leader is best when people barelyknow he exists, when his work is done, his aimfulfilled, they will say: we did it ourselves.

As a Dental Society, we offer our thoughts,condolences and prayers to Deborah and Tonyin the loss of Sean, indeed a brave soul. ❖

To say that this has been a trans-formational year both personallyand professionally, a year in

which the generous nature of othershas left its mark, is putting it mildly.

Each year, the California Society ofAssociation Executives (CalSAE, a 1200member association of association pro-fessionals and industry partners) recog-nizes an association executive for excep-tional service to the Society, the associa-tion community, and the organiza-tion(s) they help lead. In April, atCalSAE’s annual conference, I felt high-ly honored to learn that I was named asthe Association Executive of the Year.The honor bestowed upon me, the gen-erosity of my colleagues’ recognition,strengthens my belief that my lifewould not be the same without mywork and the opportunity to serve thedental profession as an associationexecutive, and to help you succeed inyour day-to-day practice of dentistry.

And yet, it was a year of immense loss,too, the loss of our son Sean. I thought“brave” was not being afraid. Seantaught me that bravery is being terri-fied and moving past and through itanyway. During Sean’s last weeks, wespent each day sitting outside…some ofit in silence, other days in reflection.Sean shared his loving nature, acerbicwit, and a generosity of spirit up to hislast hours of life…and he taught usabout living and leaving bravely.


the procedures. As dental careproviders, we ought to be knowledge-able and aware of current evidence-based strategies to help prevent caries.

Fluoride is one tool in the fight againstcaries. The application of fluoride canbe both systemic and topical. Systemicoptions for fluoride delivery includeperinatal fluoride tablets and fluoridat-ed water. Despite increasing efforts toeducate the public about fluoride andoral health, dental caries continues torise steadily as the controversy over flu-oride safety rages on. The use of fluori-dated water in therapeutic amounts issafe, but, in some populations, the issueat hand is having the choice to receivefluoride at all. Topical delivery systemsof fluoride include foams, gels, and var-nish.3 This article will highlight theaspects of fluoride varnish.

Fluoride varnish was originally used tocombat root sensitivity, but due to thehigh concentration of fluoride, it hasbecome a moderately effective tool foranti-cariogenic therapy. According to anarticle published by the UCSF group ofWeintraub et al, the efficacy of fluoridevarnish as an anti-cariogenic therapy wasdeemed favorable and recommended.4

Fluoride varnish allows the easy andquick delivery of a high concentrationof fluoride in a temporary dose. Thevarnish allows for the fluoride toremain in close contact with the toothsurface for a longer period of time thanfoams and gels, while minimizing the

ATTENTION TO PREVENTION – FLUORIDE VARNISH: ANOTHER TOOL TO HELP FIGHT THE WARON DENTAL CARIES

By Allen Wong, DDS, EdD and Joy Magtanong-Madrid, DDS

amount that can be swallowed by thepatient.5 Fluoride varnish has come asfar as to be recommended to primarycare physicians during routine childwellness visits. A recent article (May2014) in Pediatric News, reports thatthe United States Preventive ServicesTask Force (USPSTF) recognizes themoderate benefits of fluoride varnishfor the prevention of dental caries andrecommends to their physicians toapply varnish to their patients ages 5and under living in low fluoridatedwater areas, less than 0.6ppm:

Approximately 42% of children aged 2-11 years old have dental caries in theirprimary teeth, according to the 1999-2004 National Health and NutritionExamination Survey, making dentalcaries the most common chronic dis-ease among U.S. children. Risk factorsfor increased dental caries include fre-quent snacking or sugar consumption,inappropriate bottle feeding, lowsocioeconomic status, being an ethnicminority, poor dental care access, fail-ure to use fluoride toothpaste, a historyof previous caries in the child or family,dry mouth, and developmental defectsof the tooth enamel. The task force didnot recommend limiting fluoride var-nish application only to children athigher risk for dental caries because novalidated tools exist for assessing whichchildren are at highest risk, and "a risk-based approach to fluoride varnishapplication will miss opportunities to

According to the Centers forDisease Control and Prevention(CDC), dental caries is one of the

most common “preventable diseases”affecting “children aged 6 to 11 yearsand adolescents aged 12 to 19 years.Tooth decay is four times more com-mon than asthma among adolescentsaged 14 to 17 years. Dental caries alsoaffects adults, with 9 out of 10 over theage of 20 having some degree of tooth-root decay.”1 In the ongoing fightagainst tooth decay, the CDC recognizeswater fluoridation as one of the greatestachievements in health prevention andis credited for reducing the amount ofcaries in children by 18-40%.2

The current recommendations of theADA for oral hygiene are as follows:1

1) Brush twice a day with fluoridetoothpaste

2) Clean between your teeth daily withfloss or interdental cleaner

3) Eat nutritious and balanced mealsand limit snacking

4) Visit your dental team for a profes-sional cleaning and oral examination

5) Check with your dentist about sup-plemental fluoride and sealants

Alongside these recommendations, itwould be wonderful if every personwith a high caries risk could magicallyget all their teeth sealed to preventcaries, but there are issues with cost,access to care and the ability to tolerate

continued on page 9


was moderate statistical heterogeneity(I2=68%) and some inconsistencyamong the results of the studies.

The panel concluded with low certain-ty that there is a benefit of 2.26% fluo-ride varnish application at least twiceper year for root caries prevention inadults with root caries. This statementis based on meta- analysis of two stud-ies with low to moderate risk of biasthat included only 132 participants, butthere was low statistical heterogeneity(I2=28%), showing a consistent effectbetween the two studies.

The panel identified no studies of theeffect on coronal caries of 2.26% fluo-ride varnish on the permanent teeth ofadults over the age of 18.

FLUORIDE VARNISH 0.1%Evidence statement

The panel concluded with moderatecertainty that there is no benefit of0.1% fluoride varnish application twiceper year for caries prevention of primaryteeth among children less than 6 years

old. This statement is based on meta-analysis of two studies at high risk ofbias with almost 5,000 participants;however, the results were inconsistentwith high statistical heterogeneity(I2=79% without cluster adjustment).Furthermore, when adjusted for cluster-ing, the statistical heterogeneity waseliminated (I2=0%).

The panel concluded with low certain-ty that there is no benefit of 0.1% fluoride varnish application three times per year for caries prevention ofpermanent teeth among children aged6-14 years old. This statement is basedon one study at high risk of bias with318 participants.

The panel identified no studies on theeffect of 0.1% fluoride varnish on coro-nal or root caries on the permanentteeth of adults over the age of 18.

APF 1.23% GEL FLUORIDEEvidence statements

The panel concluded with low certain-ty that there is a benefit of APF gel(1.23% fluoride) application up to everythree months for 4G minutes for cariesprevention in the primary dentition.This statement is based on one studywith a high bias score that included 255participants.

The panel concluded with moderatecertainty that there is a benefit of APFgel (1.23% fluoride) application up toevery three months for 4G minutes forcaries prevention in the permanentteeth of 6- 14 year olds. This statementis based on meta-analysis of 12 studieswith moderate to high bias scores andincluding over 4,000 participants;

provide an effective dental caries pre-ventive intervention to children whocould benefit from it," Dr. Moyer, USP-STF chairwoman, wrote.6

The ADA Council on Evidenced BasedDentistry (EBD) has an excellent reporton fluoride varnish and compares it tofoam and gels. The EBD strives to eval-uate articles for scientific scrutiny andmethods. The goal is to find enougharticles that meet a systematic reviewand meet criteria for developing ratingsof certainty. The full report by the ADAEBD can be accessed at:http://ebd.ada.org/~/media/EBD/Files/Topical_fluoride_for_caries_preven-tion_2013_update.ashx. An overview oftheir report is as follows:

FLUORIDE VARNISH 2.26%:Evidence statements

The panel concluded with moderatecertainty that there is a benefit of2.26% fluoride varnish application atleast twice per year for caries preventionin the primary teeth among childrenaged 6 months to 8 years. This state-ment is based on meta-analysis of sevenstudies that ranged from low to highrisk of bias and included over 3,000participants; however, it is noted thatthere was moderate statistical hetero-geneity (I2=58%) and inconsistencyamong the results of the studies.

The panel concluded with moderatecertainty that there is a benefit of2.26% fluoride varnish application atleast twice per year for caries preventionin the permanent teeth among childrenaged 5 to 15 years. This statement isbased on meta-analysis of nine studiesthat ranged from low to high risk ofbias and included over 4,500 partici-pants; however, it is noted that there

ATTENTION TO PREVENTION – FLUORIDE VARNISH: ANOTHER TOOL TO HELP FIGHT THE WAR ON DENTAL CARIES continued from page 8

continued on page 13

“Despite increasingefforts to educate thepublic about fluorideand oral health, den-

tal caries continues torise steadily as the

controversy over fluo-ride safety rages on. ”


39TH ANNUAL SAN FRANCISCO CHILDREN’S DENTAL POSTER CONTESTBy Katherine Vo, D.D.S.

senting the San Francisco Board ofEducation. “Everyone is a winner and Iam very proud of your accomplish-ment.” Ms. Murase went on to sharewith us the results of a recent study list-ing San Francisco Unified SchoolDistrict as the top performing largeurban school district in the state ofCalifornia and one of the top perform-ing urban districts in the country.

Ms. Murase presented this year’s grandprize winner, Jeremy Lum, a 5th graderfrom Zion Lutheran School, with one

night accommodations atthe Marriott Hotel SantaClara, passes for 2 toGreat America ThemePark, $50 cash award, anda Sunstar/Butler PowerBrush. Jeremy’s teacher,Ms. Lao, and principal,Ms. Laughlin, eachreceived recognition andprizes as well.

Jeremy’s fellow winnerswere presented withaward prizes by Dr. PeterLee, SFDS ImmediatePast President, Dr. JeffJang, Chair of

Community Dental Health Committee,Ms. Cathi Fuller, RN, SFUSD Nurse, Dr.Weller and me, as a member of SFDSCommunity Dental Health Committee(CDHC). One of the winners, 4th graderMckenzie Kirk from Alice Fong YuSchool, is the daughter of our very ownSFDS member Dr. Frank Grimaldi. Youcan see these winning posters on displayat the Main Public Library during the

summer and the San FranciscoInternational Airport Children’sMuseum next year.

The Dental Poster Contest, held everyFebruary during National Children’sDental Health Month, raises awarenessabout the importance of oral healththrough artistic means of inspiration.The San Francisco Dental Society pro-motes dental health and educationthrough numerous programs and volun-teer efforts, including those of the SFDSDental Health Committee. If you areinterested in serving your communityand working on one of the DentalHealth Committee’s many programs,please give us a call.

I would like to extend our thanks to myfellow judges - Dr. Paul Weller, Dr.Jeffrey Jang, Dr. Sandy Shih and Dr.Russell Taylor – member of SFDSCDHC, Drs. Stafford Duhn and DennisShinbori, co-chairs of the PosterContest, as well as Ms. Lisa Tamburino –SFDS Poster Contest Coordinator.

Last, but not least, we would like toacknowledge the following donors, fortheir generous donations that providecrucial funding ensuring the continua-tion of this time-honored contest:

Pacific Dugoni School of DentistryGreat America Theme ParkSunstar Americas, Inc,

Manufacturer of ButlerNorthern California Practice SalesMarriott Hotel Santa ClaraTDIC/TDIC Insurance SolutionsSan Francisco Public LibraryMitchell and Mitchell Insurance Agency

“Join the Super Smile Team” –the theme of this year’s poster contestwhich is open to all San Francisco publicand private Kindergarten through 5thgrade students. Among an estimated1500 entries, 60 winners were chosenand presented with awards at a ceremo-ny held on Friday, May 2nd at Universityof the Pacific, Arthur A. Dugoni Schoolof Dentistry.

After spending an evening looking withawe at these amazingly colorful andintelligently drawn posters, I was excitedto personally meet these pint-sizedartists myself. Super styled in their mostsparkly shoes, bright ruffled dresses andminiature clip-on ties, one couldn’tignore the loud giggles and feel the con-scious anticipation of hundreds of chil-dren, teachers, and camera ready parentspacked in the large auditorium.

The program started with openingremarks from Dr. Stafford Duhn, co-chair of the poster contest, followedwith welcome greetings from Dr. PaulWeller, President of our San FranciscoDental Society (SFDS). “It was tough topick out winners and great to see yourenthusiasm about oral health,” Dr.Weller commented. We were also privi-leged to have Ms. Emily Murase repre-



DELEGATES Head to the House!2014 House of Delegates: The SFDS delegation heads to the CDA House of Delegates in San Diego, November 14-16 to represent all 1,100 + members of the San Francisco Dental Society. During the year, we hope you will contact your delegates ifyou have issues concerning your profession…they are here to represent your interests in California.

1.) Paul Weller, DDS, MS (President)

2.) Peter Lee, DDS, MS (Immediate Past President)

3.) Dennis Song, DDS, MD (ExCom/President-elect)

4.) Gail Duffala, DDS (ExCom/Treasurer)

5.) Wayne Del Carlo, DDS

6.) Courtney Fitzpatrick, DDS

7.) William Lee, DDS

8.) Curtis Raff, DDS

9.) Sima Salimi, DDS

10.) Carlos Nogueiro, DDS (ExCom/Secretary - First Alternate)

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To receive credit for a referral, an appli-cant must add the name of the memberwho referred them to membership on aCDA membership application. Thereferring member may also enter thename of the dentist they referred on therecruiter’s form at ada.org/MGAM.Once the referred member pays theirdues, the referral incentives are mailedto the referring dentist.

There are many advantages to being apart of organized dentistry, but here area few key benefits:

• Legislative advocacy;

• CDA Presents continuing education— free admission for the SanFrancisco and Anaheim meetings;

• TDIC insurance — member-onlyaccess and risk management hotline;

• Practice support services —cda.org/compass; and

• CDA publications.

Here are some tips on recruiting a newmember:

• Seek any colleague who is not cur-rently a tripartite member.

• Share the benefits and services of theADA, CDA and local dental societies.

• Ask a colleague to include your nameon the membership application or,better yet, give them an applicationwith your name on it. Applicationsare available online at cda.org/mgm.

To find out if a dentist is a current tripartite member, visit cda.org under“Find a CDA Dentist.” In addition,updated nonmember lists are availablethrough local component offices.

For more information on Member Get a Member, visit www.cda.org/mgm. ❖

Dentists who refer a new member toCDA now can receive a $100 checkfrom CDA and a $100 AmericanExpress gift card from the ADA.

The $200 total reward is part of theMember Get a Member campaign, whichprovides incentives for every CDA den-tist who refers a new member to the tri-partite membership (for a total of$1,000 maximum per referring member).

The combined campaign lasts throughSept. 30, after which time members willstill receive $100 from CDA.

A growing ADA and CDA meansgreater recognition for the dental pro-fession, more resources and support formembers and a stronger voice in thepolicy arena in Washington D.C. andSacramento. The incentive program is aresult of CDA leadership reaching outto members for input on the program.

MEMBER GET A MEMBER = $200


ATTENTION TO PREVENTION – FLUORIDE VARNISH: ANOTHER TOOL TO HELP FIGHT THE WAR ON DENTAL CARIES continued from page 9

although there was some inconsistency,there was low statistical heterogeneity(I2=43) between the studies.

The panel concluded with low certain-ty that there is a benefit of APF gel(1.23% fluoride) application 2 times peryear for 4G minutes to prevent rootcaries. This statement is based on onestudy with a high bias score including318 participants.

APF 1.23% FOAM FLUORIDEEvidence statements

The panel concluded with low certainty that there is a benefit of APFfoam (1.23% fluoride) application 2times per year for 4H minutes for cariesprevention in the primary dentition.This statement is based on one studywith a low bias score including 318 participants.

The panel concluded with low certain-ty that there is no benefit of APF foam(1.23% fluoride) application 2 times peryear for 4H minutes for caries preven-tion in the permanent dentition of chil-dren. This statement is based on onestudy with a moderate bias scoreincluding 412 participants.

PROPHYLAXIS PASTE WITH FLUORIDE Evidence statements

The panel concluded with low certain-ty that there is no benefit from pro-phylaxis paste containing fluorideapplication for 4 minutes twice per yearfor caries prevention in the primaryteeth of 3-5-year- olds. This statement isbased on one small study of 40 partici-pants with a high bias score.

The panel concluded with moderatecertainty that there is no benefit fromprophylaxis paste containing fluorideapplication for 4 minutes twice per

year for caries prevention in the perma-nent teeth of 8-16- year-olds. This state-ment is based on meta-analysis of sixstudies with moderate-to-high biasscores including almost 2,300 partici-pants that showed low statistical het-erogeneity (I2=35%) but inconsistentbeneficial effects.

No studies were identified that testedfluoride prophylaxis pastes on adultpopulations for caries preventive effect.7

The report concludes that higher con-centrations of fluoride varnish and gelsshow efficacy in the prevention and pro-gression of caries lesions. Whether or notinsurance covers a procedure should notprevent the dentist from considering theuse of varnish applications for patientswith high caries risk. As a reminder, allpatients should have a reviewed and doc-umented caries risk assessment withtheir dental providers prior to treatment.The strategic use of fluoride varnishwould be an adjunctive therapy andshould not be considered a substitute forgood judgment in the overall compre-hensive care of all patients. There cer-tainly needs to be more studies on theefficacy of fluoride varnish in the adultpopulation, but until then, our best evi-dence suggests that the benefits of fluo-ride varnish another useful tool to thedental professional in the fight againstdental caries. ❖

Works Cited

1. “Water-related Hygiene.” Centers for DiseaseControl and Prevention. Centers for DiseaseControl and Prevention, 22 Sept. 2009. Web.08 June 2014. <http://www.cdc.gov/healthy-water/hygiene/disease/dental_caries.html>.

2. “Oral Health in America: A Report of theSurgeon General (Executive Summary).” OralHealth in America: A Report of the SurgeonGeneral (Executive Summary). Web. 09 June

2014. <http://www.nidcr.nih.gov/datastatis-tics/surgeongeneral/report/executivesum-mary.htm>.

3. Adair, Steven M. et al. “Recommendationsfor Using Fluoride to Prevent and ControlDental Caries in the United States.” Centersfor Disease Control and Prevention. Centers forDisease Control and Prevention, 17 Aug.2001. Web. 09 June 2014.<http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm>.

4. Weintraub, J.A. et al. “Fluoride VarnishEfficacy in Preventing Early ChildhoodCaries.” Journal of dental research 85.2 (2006):172–176. Print.<http://www.ncbi.nlm.nih.gov/pmc/arti-cles/PMC2257982/>.

5. Association of State and Territorial DentalDirectors Fluorides Committee. “FluorideVarnish: An Evidence-Based ApproachResearch Brief.” (2007). Association of State &Territorial Dental Directors. Sept. 2007. Web.09 June 2014.<http://www.astdd.org/docs/Sept2007FINALFlvarnishpaper.pdf>.

6. Haelle, Tara. “USPSTF RecommendsFluoride Tooth Varnish for YoungChildren.” Pediatric News. 5 May 2014. Web.09 June 2014.<http://www.pediatricnews.com/home/arti-cle/uspstf-recommends-fluoride-tooth-var-nish-for-young-children/10f3d95c5f9c6915ca163cbebd02c578.html>.

7. Weyant, Robert J. et al. “Topical Fluoridefor Caries Prevention: Executive Summary ofthe Updated Clinical Recommendations andSupporting Systematic Review.” The Journalof the American Dental Association 144.11(2013): 1279–1291. Print.<http://ebd.ada.org/~/media/EBD/Files/Topical_fluoride_for_caries_preven-tion_2013_update.ashx>.


If you are showing “The LegoMovie,” “Frozen,” “The Sound ofMusic” or any other movie in your

practice, copyright is a consideration.

The Dentists Insurance Companyreminds dentists that motion picturesand other programs available for rentalor purchase are protected by the U.S.Copyright Act and are intended for per-sonal, private or home use only. Moviepresentations outside of the home, suchas within a dental office, require a pub-lic performance license. TDIC reportsincreased calls and questions from den-tists in several states about this licenseor about a letter the practice receivedregarding this topic.

The Motion Picture LicensingCorporation (MPLC) handles publicperformance licensing of more than250,000 facilities across the nation,including thousands of dental offices.Sal Laudicina, president of the licensingdivision at MPLC, said some dentistsstill do not realize they need a license toshow movies in their offices. However,this perception is changing throughagreements with dental organizationsand increased education.

MPLC offers a “blanket” or “umbrella”license that makes it simple to complywith federal copyright law regarding thepublic performance of audiovisual

works, Laudicina said. “We representDisney, Warner Brothers and more than400 other motion picture producers,and the license applies to DVD or anyother legal digital format whetherstreamed or downloaded.” The annuallicense fee is $330 per location, andMPLC offers a discount for offices withmultiple locations.

The California Dental Association’sLegal Reference Guide states that dentistsneed to obtain a public performancelicense to show movies anywhere in thedental practice, including waiting andexam rooms. The legal guide alsoincludes information about copyrightviolation penalties: “It is important tocomply with the copyright law becauseinfringement carries significant penal-ties. For example, if an infringement isconsidered ‘willful,’ you could be subjectto statutory damages as high as$150,000 for each infringed work.Moreover, even if the infringement isconsidered inadvertent, you could besubject to statutory damages rangingfrom $750 to $30,000 for each infringedwork. You may also be subject to othercosts, including reasonable attorneys’fees to the prevailing party.”

Compared to potential noncompliancefees, the public performance license isnotably less expensive.

MPLC has about 10,000 independentfield representatives nationwide whosend information to the corporationabout businesses showing movies with-out a license, according to Laudicina.

If a violation is discovered, MPLC con-tacts the business via phone or letterand explains what needs to be done tostop copyright infringement. “We justsay, ‘Here’s what you need to do,’ andwe send an application for the license,”Laudicina said. “People want to do theright thing, and we make it easy forthem to comply.”

Laudicina added that some dentistsmistakenly think a letter about a publicperformance license is a scam. “Don’tignore a letter about a public perform-ance license,” he said. “If a letter isignored, the violation becomes moreegregious and that’s not a good thing.Take the time to check it out.” ❖

TDIC’s Risk Management Advice Lineanswers questions about copyright complianceand other dental practice issues at800.733.0634 Monday through Friday 7:30a.m. to 5 p.m. PT.

RM MATTERSBy TDIC Risk Management Staff

License needed to play movies in your practice


The San Francisco Dental Societysupports a broad and bipartisancoalition of doctors, community

health centers, hospitals, local govern-ments, public safety, business and laborgroups opposing a November 2014 bal-lot proposition that will make it easierand more profitable for lawyers to suehealth care providers. Under this meas-ure, lawyers will make more money, butconsumers and taxpayers will see higherhealth care costs.

The measure’s main provision willquadruple the non-economic damagescap on California’s successful MedicalInjury Compensation Reform Act(MICRA), the law that governs legalproceedings if someone is injured as aresult of medical treatment. This singlechange will triple lawyers’ legal fees inhealth care lawsuits.

The measure contains two other provi-sions dealing with drug testing andprescription drug databases which havebeen included to act as a voter sweeten-er, an attempt to disguise the MICRAchange and the financial benefit tolawyers. One of supporters of theproposition even admitted it.According to the Los Angeles Times:

"The drug rules are in the initiativebecause they poll well, and the backersfigure that’s the way to get the public tosupport the measure. ‘It’s the ultimatesweetener,’ says Jamie Court, the headof Consumer Watchdog."

Here’s why the Lawyers’ Health CareLawsuit Ballot Measure should berejected:

Costly for consumers and taxpayers

If medical lawsuit awards are increased,somebody has to pay, and that will beconsumers through higher insurancepremiums. According to a study byCalifornia’s former Legislative Analyst,this proposition will increase healthcare costs across all sectors by $9.9 bil-lion annually. Furthermore, California’scurrent independent LegislativeAnalyst’s Office (LAO) warns the propo-sition could increase state and localgovernment medical/dental liability andhealth care costs by "hundreds of mil-lions of dollars annually," placing theburden of this additional cost on alltaxpayers.

Jeopardizes patient access to qualityhealth care

This measure will cause doctors anddentists to leave the state and practicein places where malpractice insurancerates are lower. Many people could losetheir personal physician or dentist ifthis measure were to become law.

Jeopardizes the privacy of our per-sonal health information and patientaccess to prescription medications

This measure mandates use of a gov-ernment database with personal infor-mation on patients’ prescription drughistory. California has a poor trackrecord with government databases,which jeopardizes the privacy of ourpersonal health information.Furthermore, when this database crash-es, and it will, people could have trou-ble getting their necessary prescriptionsfrom their doctor or pharmacy.

Get the facts on this measure by visit-ing www.noon46.com. ❖

ON YOUR BEHALF

Protect Access to Quality Health Care and Patient Privacy


University of the Pacific Dugoni School of DentistryUOP Dugoni Student/Alumni Recognition Banquet

SFDS award recipients at the Pacific’s Dugoni School of Dentistry GraduateAlumni Banquet, held June 13, at the Ritz-Carlton, are Drs. David Wirth (L)and Murtaja Kamal Aldeen (R) with Dean Patrick J. Ferrillo.

University of California San Francisco UCSF Recognition Banquet

Michael Morris is the recipient of this year’s SFDS Professionalism and EthicsAward, presented on Wednesday, May 28 at the Annual UCSF Alumni’s StudentRecognition Banquet held at Marines’ Memorial Club. Michael is pictured receiv-ing the award with SFDS president Dr. Paul Weller and UCSF Dental SchoolDean, Dr. John Featherstone.

CAMPUS NOTES

President, Dr. Paul Weller and SFDSEditor Dr. Craig Yarborough enjoyed the

evening’s festivities.

Photos by Richard Mayer


You are not a market segment.

You are a dentist deserving of an insurance company relentless in its pursuit to keep you protected. At least that’s how we see it at The Dentists Insurance Company, TDIC. Take our Risk Management program. Be it seminars, self-study options or our Advice Line, we’re in your corner every day. With TDIC, you are not a sales goal or a statistic. You are a dentist.

Endorsed by the San Francisco Dental Society

Protecting dentists. It’s all we do.® 800.733.0633 | tdicsolutions.com | CA Insurance Lic. #0652783

COMMUNITY CORNER – GET INVOLVED IN YOUR COMMUNITY

Program/Agency

What is it? Date/Time/Loc. Contact

K School Screening Partnership with SFDPH & school district screens Kindergarteners Schools

Morning/Afternoon 2-3 hoursSF Public Elementary Schools

Lisa Tamburrino [email protected]

Project Homeless Connect

Partnership with SFDPHprovides dental care tohomeless individualsand families

Half or full dayBill Graham Civic Center/Southeast Health Center

Lisa Tamburrino [email protected]

Salvation Army Harbor House

Arranges for program clients to receive care in dentists’ offices. Dentist determines number of clients and services

Ongoing. Dentist’s office Jaime Smith Volunteer Coordinator 415-503-2720

SF City Impact (SFCI) arrange Health & Wellness Center

General Dentist Needed Thursdays 9 AM -2 PM, to Screen/Treat. Also seeking donations of small dental equipment, dental instruments & oral surgery instruments

Ongoing. 140 Turk Street

Contact Staff 415-441-1628 for volunteering and to pick up or drop off equipment at SFCI Health and Wellness Center

Everyday Connect

Seeking dental services for those who are at risk of becoming homeless, currently homeless or recently transitioned into permanent housing

Ongoing.Project Homeless Connect25 Van Ness AveSte 340SF, CA 94102

Helpline 855-588-7968; Everyday Connect staff will respond to voicemail messages or email staff at [email protected]



CLASSIFIEDS

DENTAL CONDO FOR SALEOR LEASE IN CENTRAL SF,1300 SQ FT. FULLY PLUMBEDFOR DENTAL OFFICE USE.EXCELLENT VIEW ON SECONDFLOOR ON A BUSY BLVD.

ANY QUESTIONS PLEASE REPLYTO 415-759-9613.

SAN FRANCISCO RICHMONDDISTRICT spacious 4 ops. withfixtures for lease. Please contactSteve, 650-296-6812 or [email protected]

MARK YOUR CALENDARS -

UPCOMING MEETINGS AND EVENTSMonth Date Meeting/Event Location Time CE

Aug 2 Job Fair SFDS, 2143 Lombard St 10 AM – 3:00 PM NA

2014 7 General Membership CE Marines’ Memorial, 609 Sutter St, SF 6:00 PM 2

20 Project Homeless Connect Bill Graham Auditorium 7:30 AM-3 PM N/A

21 Executive Committee SFDS, 2143 Lombard St 6:30 PM N/A

22 Infection Control/BBP SFDS, 2143 Lombard St 8 AM-12 PM 4 CE

22 California Dental Practice Act SFDS, 2143 Lombard St 1-3 PM 2 CE

27 CPR Renewal SFDS, 2143 Lombard St 6-9:30 PM 4 CE

Sept 1 Labor Day SFDS Closed N/A N/A

2014 4-6 CDA Presents Moscone Center Multi-day/Time

15 SFDS Finance Committee SFDS, 2143 Lombard St 6:30 PM N/A

16 New Dentist Seminar SFDS, 2143 Lombard St 6 PM Social/6:30 PM Seminar N/A

18 SFDS Board of Directors SFDS, 2143 Lombard St 6:30 PM N/A

24 CPR Renewal SFDS, 2143 Lombard St 6:00 – 9:30 PM N/A

Published by theSan Francisco Dental Society

2143 Lombard Street, San Francisco, CA 94123415.928.7337 • Fax 415.928.5297

Email: [email protected]/Design - SowleWork • Printing - Sundance Press

Advertising rates and information sent upon request. Acceptance of advertising in The Bridgein no way constitutes approval or endorsement by the San Francisco Dental Society of products

or services advertised. The SFDS reserves the right to reject any advertisement. Opinionsexpressed by authors are their own, and not necessarily those of the SFDS or The Bridge

editorial board. The SFDS reserves the right to edit all contributions for clarity and length, as well as reject any material submitted.

The Bridge is published bi-monthly by the SFDS, 2143 Lombard Street, San Francisco, CA 94123, 415.928.7337.

Subscriptions are $40 per year for SFDS/$45 per issue for non-members.� 2014, San Francisco Dental Society. All rights reserved.

Deadline for October 2014 publication is: September 1, 2014

2143 Lombard St., San Francisco, CA 94123

Annual Meeting & InstallationDecember 11, 2014

Join the San Francisco Dental Societyin celebrating our leaders and

volunteers, as well as installing our2015 officers!

2 CE for “The Sugar Pandemic:Policy vs. Politics”

Marines’ Memorial Club & Hotel609 Sutter St., SF

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On Your Behalf