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JAN/FEB 2013 / v80, n1 PENNSYLVANIA DENTAL JOURNAL TIKKUN OLAM | REPAIRING THE WORLD 145 TH ANNUAL SESSION

PENNSYLVANIA DENTAL JOURNAL · PENNSYLVANIA DENTAL JOURNAL (ISSN 0031-4439), owned and published by the Pennsylvania Dental Association, 3501 North Front Street, Harrisburg, 17110,

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Page 1: PENNSYLVANIA DENTAL JOURNAL · PENNSYLVANIA DENTAL JOURNAL (ISSN 0031-4439), owned and published by the Pennsylvania Dental Association, 3501 North Front Street, Harrisburg, 17110,

JAN/

FEB 20

13 /

v80,

n1

PENNSYLVANIA DENTAL JOURNAL

TIKKUN OLAM | REPAIRING THE WORLD

145TH ANNUAL SESSION

Page 2: PENNSYLVANIA DENTAL JOURNAL · PENNSYLVANIA DENTAL JOURNAL (ISSN 0031-4439), owned and published by the Pennsylvania Dental Association, 3501 North Front Street, Harrisburg, 17110,
Page 3: PENNSYLVANIA DENTAL JOURNAL · PENNSYLVANIA DENTAL JOURNAL (ISSN 0031-4439), owned and published by the Pennsylvania Dental Association, 3501 North Front Street, Harrisburg, 17110,
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Of f i c e r s

Dr. Bernard P. Dishler (President) PsXX

Yorktowne Dental Group Ltd.8118 Old York Road Ste A • Elkins Park, 19027-1499(215) 635-6900 • [email protected]

Dr. R. Donald Hoffman (President-Elect) PsX

105 Penhurst Drive, Pittsburgh, 15235(412) 648-1915 • [email protected]

Dr. Dennis J. Charlton (Imm. Past President) Pss

P.O. Box 487 • Sandy Lake, 16145-0487(724) 376-7161 • [email protected]

Dr. Jerrold H. Axler (Vice President)34 Newport Drive, Chesterbrook, 19087-5850(610) 725-1031 • [email protected]

Dr. Peter P. Korch III (Speaker) ll

4200 Crawford Ave., NorCam Bldg. 3P.O. Box 1388, Northern Cambria, 15714-1388(814) 948-9650 • [email protected]

Dr. Jeffrey B. Sameroff (Secretary) lX800 Heritage Dr., Ste 811 • Pottstown, 19464-9220(610) 326-3610 • [email protected]

Dr. Samuel E. Selcher (Treasurer) PPX

700 Spring Garden Drive, Middletown, 17057-3034(717) 944-0426 • [email protected]

Tru s t e e s By D i s t r i c t

1st | Dr. Thomas P. Nordone | 2013P207 N. Broad Street, Philadelphia, 19107-1500(215) 557-0557 • [email protected]

2nd | Dr. Ronald K. Heier | 2015PDrs. Graff & Heier, LLC100 Deerfield Lane #290 • Malvern, 19355-2159(610) 296-9411 • [email protected]

3rd | Dr. Eli Stavisky | 2016 s700 Glenburn Road, Clarks Summit, 18411-2306(570) 587-5495

4th | Dr. Michael S. Shuman | 2013 l1052 Park Road, Blandon, 19510-9563(610) 926-1233 • [email protected]

5th | Dr. David R. Larson | 2013 lX1305 Middletown Rd. Ste 2Hummelstown, 17036-8825(717) 566-9797 • [email protected]

6th | Dr. John P. Grove | 2014 lXPO Box 508, Jersey Shore, 17740-0508(570) 398-2270 • [email protected]

7th | Dr. Wade I. Newman | 2014 lBellefonte Family Dentistry115 S. School St., Bellefonte, 16823-2322(814) 355-1587 • [email protected]

8th | Dr. Thomas C. Petraitis | 2015 s101 Hospital Ave., DuBois, 15801-1439(814) 375-1023 • [email protected]

9th | Dr. Joseph E. Ross | 2016Olde Libray Office Complex106 E. North St., New Castle, 16101(724) 654-2511 • [email protected]

10th | Dr. Herbert L. Ray Jr. | 2015PUniv of Pittsburgh School of Dental Med3501 Terrace St., 3063 Salk AnnexPittsburgh, 15261-2523(412) 648-8647 • [email protected]

ADA Th i rd D i s t r i c t Tr u s t e e

Dr. Charles R. Weber606 East Marshall Street, Ste 103West Chester, PA 19380-4485(610) 436-5161 • [email protected]

PDA Comm i t t e e Cha i r s

Communications & Public Relations CommitteeDr. Tamara Brady

Dental Benefits CommitteeDr. Tad S. Glossner

Government Relations CommitteeDr. Andrew Mramor

Membership CommitteeDr. Nicole Johnson

Access to Oral Health Care CommitteeDr. Gary Davis

Annual Awards CommitteeDr. Jon J. Johnston

Concerned Colleague CommitteeDr. Bartley J. Morrow

Environmental Issues CommitteeDr. Wilbert H. Milligan III

New Dentist CommitteeDr. Sara L. Haines

PDA Cen t ra l O f f i c e

3501 North Front StreetP.O. Box 3341, Harrisburg, 17105(800) 223-0016 • (717) 234-5941FAX (717) 232-7169

Camille Kostelac-Cherry, Esq. Chief Executive [email protected]

Mary DonlinDirector of [email protected]

Marisa SwarneyDirector of Government [email protected]

Rob PuglieseDirector of [email protected]

Rebecca Von NiedaDirector of Meetings and [email protected]

Leo [email protected]

Boa rd Comm i t t e e s Le gend

X Executive Committee XX Chairman

PBudget, Finance & Property PP Chairman

l Bylaws Committee ll Chairman

s Strategic Planning Committee ss Chairman

Ed i t o r i a l B o a rd

Dr. Daniel BostonDr. Allen FieldingDr. Marjorie JeffcoatDr. Kenneth G. MillerDr. Andres PintoDr. Deborah Studen-PavlovichDr. James A. WallaceDr. Charles R. WeberDr. Gerald S. Weintraub

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL2

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The Official Publication of the Pennsylvania Dental Association

FEATURES

CONTENTS

JAN/FEB 2013 | v80, n1

PENNSYLVANIA DENTAL JOURNAL (ISSN 0031-4439), owned and published by the Pennsylvania Dental Association, 3501 North Front Street, Harrisburg, 17110, is published bi-monthly: Jan/Feb, Mar/Apr, May/June,July/Aug, Sept/Oct, Nov/Dec. Address advertising and subscription queries to 3501 North Front Street, P.O. Box 3341, Harrisburg, 17105. Domestic subscriptions are available to persons not eligible for membership at$36/year; International subscriptions available at $75/year. Single copies $10. Periodical postage paid at Harrisburg, PA. “The Pennsylvania Dental Association, although formally accepting and publishing reports of the variousstanding committees and essays read before the Association (and its components), holds itself not responsible for opinions, theories, and criticisms therein contained, except when adopted or sanctioned by specialresolutions.” The Association assumes no responsibility for any program content of lectures in continuing education programs advertised in this magazine. The Association reserves the right to refuse any advertisement forany reason. Copyright ©2013, Pennsylvania Dental Association.

The mission of the Pennsylvania Dental Journal is to serve

PDA members by providing information about topics and issues

that affect dentists practicing in Pennsylvania. The Journal also

will report membership-related activities of the leadership of the

association, proceedings of the House of Delegates at the annual

session and status of PDA programs.

Editor | Dr. Bruce R. Terry85 Old Eagle School Road, Wayne, 19087-2524(610) 995-0109 / [email protected]

Associate Editor | Dr. Brian Mark Schwab1021 Lily Lane, Reading, 19560-9535(610) 926-1233 / [email protected]

Director of Communications | Rob PuglieseP.O. Box 3341, Harrisburg, 17105(800) 223-0016 / FAX (717) 234-2186 / [email protected]

Editor Emeritus | Dr. Richard Galeone3501 North Front Street, Harrisburg, 17110(215) 855-4092 / [email protected]

Editor Emerita | Dr. Judith McFadden3386 Memphis Street, Philadelphia, 19134(215) 739-3100 / [email protected]

POSTMASTER: Send address changes to Pennsylvania Dental Association, P.O. Box 3341, Harrisburg, PA 17105. MEMBER:American Association of Dental Editors

3

IMPRESSIONS

DEPARTMENTS

5GOVERNMENTRELATIONS

INSURANCECONNECTION

CONTINUINGEDUCATION

CLASSIFIEDADVERTISEMENTS

39

13 145TH ANNUAL SESSION

20 WHAT STATE GOVERNMENTS SHOULD CONSIDERBy Sita Patel, Maurice H. Kornberg School of Dentistry, Temple University

28 MEMBERS MAKING A DIFFERENCE: CHESTER GRACEDENTAL CLINICBy Jennifer McClure, Creative Design Manager

30 BE PART OF THE SOLUTION — MOM-N-PABy Dr. Bruce R. Terry, Editor117

41

IN MEMORIAM

19

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4 JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL

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IMPRESSIONS

• Sleeping pills — Better living throughchemistry, right? Well, I know it’s greatfor many people, but I am a purist andshun pills if I can.

• Herbal Tea — Ancient Chinese cure.Problem is that I am not of ancientChinese descent and I’ll just have to peethree hours later when I wake up.

• Warm milk — similar to the tea thing,only I will likely pee in the bed instead.

• Wiggle toes before you fall asleep. Thisis suppose be like reflexology. The onlyproblem with that at 1:00, 2:00 or 3:00a.m. is that my toes crack when I wigglethem and it wakes up my wife. Next!

• Take a warm bath — Yeah, that’s whatguys do, take warm baths. Not! It evensays it’s better with scented candles.Not, Not!!

• Visualize — I need to be careful withthat one. Visualizing might get me moreexcited than relaxed. I am suppose tovisualize myself on a beach and I juststart thinking about the beautiful womanon that beach. Now I don’t know if Idreaming or thinking. My wife is sleepingnext to me. This can’t be good!

• Sex — finally, a solution I can live with.Nothing more needs to be said. Sexalways puts me to sleep.

“Honey?”

“Yes, dear”, “I can’t sleep”

“Really”

“Yeah, I’ve been up for an hour now.”

“So, what you do want me to do?”

“You know.”

“You should really try medication.”

“Don’t want any medication.”

“How about a nice bath?”

“Honey, you know what I want.”

“How about some warm milk? I’ll godownstairs and get you some warm milk.”

understood the problem I could master asolution. Funny how I don’t fit the profilefor this illness. I am not female, nor overage 60, yet. I don't take any prescriptionmedication, although maybe I should. Idon’t have sleep apnea. I don't think I amoverweight. I could be depressed, but Iwould deny it in a heartbeat. I am also notanxious — can’t you tell by my nonchalant,laissez faire attitude toward my sleepdeprivation? And I am not from Texas!I tell my family that I don't need much

sleep. That is why I can get up on a Sundaymorning at 6 a.m. and run, hike or bikefor 3 hours and come back. I can make acup of coffee and read the paper in deadsilence as the rest of my family sleeps.Years ago I remember a highly

respected faculty member sitting at mytable during a luncheon. He was braggingto others about his ability to survive ononly 2-3 hours of sleep per night. At thattime I was in my early 30s. I asked himhow that was possible since I covetedthat sacred time with my head on thepillow. He told me that he has been livingon little sleep for most of his adult life. Hesaid, “Just you wait, you’ll be like me soonenough.” During the afternoon lecturethis revered educator fell asleep and atone point began to snore. As I lie awakein my bed I wonder if he counted thoseafternoon naps toward his daily totals?I can see my future clearly at 4:00 a.m.

I am going to be that guy. I will be asleepduring dessert at my next all-day CE. Mycolleagues are going to draw a mustache onmy face and make a hat out of newspaperfor my head. Just last weekend I fell asleepon the couch during a family gathering.Granted, I don’t much enjoy my extendedfamily, but come on, I’m not that old!When I wake up occasionally I don’t

get too bothered by the whole thing, butrecently it’s been happening with moreregularity. So, I did my homework andgoogled insomnia cures. What I got backmay or may not surprise you.3

Who Needs Sleep?

It starts out pretty benign. I go to bedand fall asleep within minutes. I usuallygo out like a light, as the expression goes.When I wake up I feel refreshed despiteit being dark. I check the clock and realizethat I’ve been asleep for only a few hours.Ugh, five hours until I need to get up! Istart thinking about what I need to do thenext day. I think about what I did earlierin the day. I think about what I need to donext week. I think about what I did whenI was 10. I curse at the fact that I amawake and I really need to be asleep. Iusually fall back to sleep within 30 minutes.Sometimes I dream, sometimes nothing.Again I wake feeling ready to go. But Ididn’t hear the alarm. I realize it’s still darkand turn to the clock: 4:30 a.m.Did you know that one in three people

suffer from some form of insomnia? Morethan 50 percent of individuals lose sleepdue to stress and/or anxiety. Women aretwice as likely to suffer from insomnia.Did you know that 10 million people in theU.S. use prescription sleep aids?1 A recenttelephone survey by the CDC found that4.2 percent of those questioned havedozed off behind the wheel of a movingautomobile in the past 30 days.2 Thereport found more dozing drivers weremen and statistically more from the stateof Texas. Go figure!I know this because it’s my job to

investigate things that go on in and aroundmy life. Don’t you do the same thing? Itgives me something to think about duringthose long nights of being asleep, thenawake, then asleep. I thought that if I

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL 5

By Dr. Bruce R. TerryEditor

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JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL6

IMPRESSIONS continued

“I don’t want any damn milk, I want,you know, it.”

“What’s it?”

“You know, IT.”

Eventually I get so tired of begging I fallasleep. It works every time.

P.S. My wife disavows any part in theabove conversation. She must talk in hersleep.

P.P.S. Many people have asked me howI think of topics for editorials. My answer:“It comes to me when I’m in bed!”

—BRTREFERENCES

1. http://www.better-sleep-better-life.com/insomnia-statistics.html

2. http://www.cdc.gov/mmwr/preview/ mmwrhtml/mm6151a1.htm?s_cid=mm6151a1_w

3. http://lyleagotii.hubpages.com/hub/How-To-Cure-Insomnia

Come toDay on the hill

June 4help shape the future of the

dental profession or it will be shapedfor you! talk with Pennsylvania’slegislators about the key issues

affecting you as a small businessowner and a dental practitioner

looking out for the health and safetyof your patients. Registration will

take place online only atwww.padental.org/dayonthehillFollow us on twitter for updates@padentalassn #DayOnTheHill

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GOVERNMENT RELATIONS

incumbents and ensuring newly electedlegislators are updated on issues pertinentto the practice of dentistry.

Non-Covered Services UpdateSB 1144 unanimously passed the

House of Representatives in early October.Governor Corbett signed the legislationinto law on October 25.The bill, which wentinto effect 60 days after the Governor’ssignature, will apply to new and renewedemployer contracts. This legislation willbe in effect for any contract that renewsafter December 25, 2012. SB 1144 was asignificant win for PDA, and we are proudto have passed a bill that was so stronglyopposed by the insurance lobby.

their party leadership on an annual basis.The positions in leadership correspondwith a higher salary and better pensionbenefits. For 2012-13, almost all Democratsand Republicans kept their leadershippositions in the House and Senate. Therewere two exceptions for House Democratsdue to retirements. With the retirementof Rep. Jennifer Mann (D – Lehigh),Rep. Ron Waters (D – Phila) was electedCaucus Secretary. Rep. Neal Goodman(D – Schuylkill) replaced Rep. Ron Buxton(D – Dauphin) as Caucus Administrator. The General Assembly will continue to

determine your fate on dental-relatedissues, such as insurance practices, scopeof practice, and small business ownership.PDA looks forward to working with

Election Results Following a major election year,

legislators returned to Capitol Hill inJanuary to begin a new two-year legislativesession, which runs from now throughNovember 2014. The legislaturereconvenes after major victories for PDAin the 2011-12 session, including thepassage and Governor Corbett’s signatureon general anesthesia insurance coverage(House Bill 532) and non-covered services(Senate Bill 1144) legislation. TheNovember election served as a renewedcontract for returning incumbents, but anumber of new faces will be spotted in theCapitol’s hallways after a few incumbentssuffered general election defeats or retired.Largely due to the Pennsylvania

Supreme Court’s rejection of new statelegislative district lines in January 2012,the makeup of the General Assemblygenerally remained the same. Theunchanged districts, however, did producea few surprises for Harrisburg.In the State Senate, Democrats picked

up three seats on Election Day, the biggestpickup for the party since 1970 and thelargest swing since Republicans won fourseats in 1994. The party went three forthree in open seats, picking up districtsformerly held by Sens. Jane Earll (R – Erie),Jeff Piccola (R – Dauphin) and John Pippy(R – Allegheny). The districts will nowbe represented by Sean Wiley (D – Erie),Rob Teplitz (D – Dauphin) and State Rep.Matt Smith (D – Allegheny).The state House largely stayed the

same, with Democrats picking up one seatin Allegheny County, putting the chamberat 111 Republicans and 92 Democrats.In the Senate, Republicans also retainedtheir majority with 27 seats, while theDemocrats claimed 23 seats.A week after the election, the House

and Senate held their leadership elections.Democrats and Republicans choose

7JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL

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JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL8

GOVERNMENT RELATIONS continued

2013-14 Legislative PrioritiesPDA will focus on the following

legislative issues during the upcoming2013-14 session.

Assignment of BenefitsPDA continues to educate lawmakers

on the importance of passing HB 1536,legislation that would require insurers toassign benefits directly to the provider.Many legislators believe direct payment isbeneficial for patients participating withinsurance companies, but this process toooften leaves you and your staff wastingvaluable time to collect payments frominsurance plans to which you do not belong.Legislators need to learn how passingthis legislation will not only improve theefficiency of your office, but will helppatients choose dental providers.

Donated Dental ServicesPDA will introduce legislation

addressing Pennsylvania’s Donated Dental

Services (DDS) program. Following thestate’s fiscal crisis in 2009, funding for theprogram was cut. Dental Lifeline Network,which runs the DDS program, faces thepossibility of DPW eliminating the program.The DDS program has successfullyconnected the state’s most vulnerablecitizens with dentists who volunteer theirtime and money to provide them with oralhealth care. From its inception, DDS hassuccessfully partnered the private andpublic sectors. By completely cutting theprogram, DDS volunteers could no longertreat the disabled, elderly, and medicallycompromised who are ineligible for publicassistance.

Medical Assistance Reforms and FundingThe Adult Medical Assistance Program

remains in regulatory limbo. After thelegislature empowered DPW SecretaryGary Alexander to decide how availablefunding is allocated to adult MedicalAssistance (MA), PDA learned that a

number of changes would go into effect.Among these changes were limits onexaminations and cleaning, the eliminationof coverage for crowns, endodontics, andperiodontal services, and a limit of onedenture per lifetime, regardless ofprocedure code used.During this current legislative session,

PDA hopes to work with the GeneralAssembly to enact meaningful reforms tothe MA program, removing financial andadministrative barriers for your practice.

Additional Reform EffortsIn addition to Assignment of Benefits

legislation, Medical Assistance reforms andDonated Dental Services funding, PDAwill continue to monitor a number of issuesand developments throughout the sessionyear. Although the Affordable Care Actwas signed into law in 2010, a number ofprovisions that have not yet kicked in willgo into effect during the current legislativesession. PDA will represent dentistry’sinterests if the Commonwealth implementsa health insurance exchange andcomplies with other federal health carereform measures. PDA will also respondto any additional access to care,regulatory, dental practice ownership,safety and oral health issues or reformsthat arise during the 2013-14 session.Log on to the Advocacy section of the

website at www.padental.org, forinformation about the legislation PDAmonitors and responds to on your behalf.Want to get involved in helping us pass

legislation that impacts your professionand patients? Learn how by contactingPDA’s government relations staff at(800) 22-0016, or [email protected] check out the Get Involved sectionunder the Advocacy tab on the front pageof the website.

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National Provider IdentifiersAll individual Health Insurance Portability and Accountability Act( HIPAA)

covered health care providers (physicians, physician assistants, nurse practitioners,dentists, chiropractors, physical therapists, athletic trainers etc.) or organizations(hospitals, home health care agencies, nursing homes, residential treatmentcenters, group practices, laboratories, pharmacies, medical equipment companies)must obtain an National Provider Identifier (NPI) for use in all HIPAA standardtransactions, even if a billing agency prepares the transaction.Once assigned, a provider's NPI is permanent and remains with the provider

regardless of job or location changes.The NPI is a HIPAA Administrative Simplification Standard. The NPI is a

unique identification number for covered health care providers. Covered healthcare providers and all health plans and health care clearinghouses must use theNPIs in the administrative and financial transactions adopted under HIPAA.The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).This means that the numbers do not carry other information about healthcareproviders, such as the state in which they live or their medical specialty. TheNPI must be used in lieu of legacy provider identifiers in the HIPAA standardstransactions.As outlined in the Federal Regulation, HIPAA covered providers must also

share their NPI with other providers, health plans, clearinghouses, and any entitythat may need it for billing purposes (our emphasis added).If you have not already done so, you may apply for an NPI online. For the most

efficient application processing and the fastest receipt of NPIs, use the web-basedapplication process. Simply log onto the National Plan and Provider EnumerationSystem (NPPES) and apply on line (see related links inside CMS.gov).

INSURANCE CONNECTION

Periapical Radiographs

Periapical radiographs (D0220, D0230)taken in conjunction with a periodic oralevaluation (D0120) will be reviewed on aprepayment basis by a dentist.

• Those taken routinely in the absence of apatient complaint/specific signs andsymptoms will be denied. A participatingdentist will not be able to bill the member.

• Those taken as the result of specific signsand/or symptoms that are supported by theFDA guidelines for prescribing radiographswill be allowed.

Claims for periapical radiographs must includethe following supporting documentation:

1. A copy of the radiograph(s) taken(If submitting electronically, provide theattachment control number on theelectronic claim.)

2. An explanation of the patient’s specificsigns and symptoms (If submittingelectronically, provide the explanation inthe line level narrative/notes field. Ifsubmitting a paper claim, please providethe explanation on the claim form, ifpossible.)

Without this information, the periapicalradiographs will be denied for lack of diag-nostic materials.

The fax also describes UCD’s rationale forthe change in policy:

Why United Concordia Is Changing ItsPolicy for Periapical Radiographs

Taking routine periapicals at preset levels forall patients is not supported by the FDAGuidelines for Prescribing Radiographs, which:

1. Suggest taking the minimal number offilms necessary for both diagnostic reviewand to limit radiation exposure.

2. Provide guidance indicating dentistsshould not prescribe routine radiographsat preset intervals for all patients.Radiographs should be prescribed afterevaluation of each patient’s needs.

request a review and submit documenta-tion for consideration.PDA representatives spoke with UCD

representatives and were advised that thefax did not accurately reflect UCD’s posi-tion. On November 6, UCD issued anotherstatement via fax clarifying the previouslydistributed policy, and indicated thatPAs taken to diagnose a dental conditionwill not routinely be rejected. Please notethat this policy change does not apply toPennsylvania at this time.Following is an excerpt from the state-

ment which initially applies only to thestates of Washington, Oregon, Idaho andMontana, effective January 1, 2013.

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL 11

United Concordia DentalDr. Tad Glossner, Chairman of the

Dental Benefits Committee, and PDA staffdiscussed a report from United ConcordiaDental (UCD) concerning periapicalradiographs.On October 10, UCD sent a fax to

participating dentists stating that effectiveNovember 1, 2012, periapical radiographs(PAs) taken in conjunction with a periodicalexam would routinely be rejected. Further,once rejected, if the dentist believesthat the PAs were necessary to diagnose acondition, the dentist would need to

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JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL12

INSURANCE CONNECTION continued

3. Do not suggest dentists prescribe periapical films at routine recallevaluations. Periapical radiographs are to be used for problem-focused identification and should be driven by patient complaints/specific signs and symptoms.

4. Suggest the frequency of bitewings needed for caries detection, notperiapical radiographs. Periapicals taken at recall visits as theresult of patient complaints/specific signs and symptoms supportedby the FDA guidelines will be covered.

In addition, radiation exposure should be considered. While UCDrecognizes that radiation from dental films is minimal, we areconcerned about over exposure to radiation, particularly radiationfrom films that are prescribed on a routine basis in the absence ofspecific signs and/or symptoms.

The FDA guidelines can be found on the American Dental Association’swebsite at www.ada.org or on the FDA’s website at www.fda.gov.We encourage dentists to review these guidelines in advance of thechanges.

For more information on this United Concordia policy, pleasecontact PDA at (800) 223-0016.

Temple’sKornberg Schoolof DentistryCareer DayLooking to retire, need an associate?On April 5, Temple University KornbergSchool of Dentistry will be hosting aCareer Day for our soon to be graduatingseniors. We invite you to interviewinterested students on campus. For moreinformation or to schedule interviews,contact Ross Markman, M.Ed., StudentServices Specialist, at (215) 707-2801 oremail [email protected].

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145TH ANNUAL SESSIONAs General Chair of the 145th Annual Session of the Pennsylvania DentalAssociation, it is my pleasure to invite all members of the PDA to TheHotel Hershey on April 26-27, 2013. It has been an especially productiveand exciting year with major legislative achievements such as the passageof the “general anesthesia for at risk patients” and “non-covered services”acts. Planning for the spring Mom-n-PA outreach program is in full gearand an important report from the Governance Task Force will be presentedthat offers suggestions for changes in the governance of PDA. Join us aswe celebrate our past accomplishments and plan for the future.

cont inued

TIKKUN OLAMREPAIRING THE WORLD

13JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL

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For those who plan to arrive early on Thursday,April 25, the International College of Dentistry-USASection District 3 will offer a complimentary half daycontinuing education course titled “Optimal Aging—Living to 100,” presented by nationally known speaker,Dr. Barbara J. Steinberg. This program is open to allAnnual Session attendees as well as ICD membersin the Harrisburg/Hershey area and is scheduled for3:00 p.m. Thursday evening will be filled withopportunities to meet old friends and make new onesin the various district-sponsored hospitality suites.The official opening of the PDA House of Delegates

begins with the First Meeting at 8:00 a.m. on Friday,April 26. Immediately following the conclusion of theFirst Meeting reference committee hearings will takeplace. It is important to note that every PDA memberis invited to these reference committee hearings andis encouraged to take this opportunity to expresstheir concerns and opinions on the issues that arepresented during these hearings. This is an invaluableopportunity to present your thoughts to representativesfrom every region of the state. All delegates andalternates are invited to attend a complimentaryluncheon hosted by PDAIS between the morning andafternoon reference committee sessions.As is customary, Friday afternoon and evening will

be dedicated to camaraderie. All attendees are invitedto meet with old and new acquaintances at thereceptions hosted by the University of PittsburghSchool of Dental Medicine and PADPAC. In addition,Temple University Kornberg School of Dentistry willhost a dessert reception for all to enjoy. The districthospitality suites will be open following these events.Saturday morning starts bright and early with the

annual Fun Run/Walk. All walkers and runners willreceive appropriately fashionable t-shirts and awardswill be given to the winners of the various categories.District caucuses and the past president’s breakfastalso will be held Saturday morning. Again, PDAIS willtreat all the delegates and alternates to lunch.Following lunch, the House of Delegates will reconveneto discuss and vote on the important issues facingdentistry and PDA that were raised at the referencecommittee hearings. In addition, the members ofthe House will elect the new officers, ADA delegatesand alternate delegates as well as our ADA trustee. “Tikkun Olam,” the theme for this year’s meeting,

is a Hebrew phrase literally translated as repairingthe world. “Tikkun Olam,” a Judaic philosophy whichdates to the early 16th century, affirms that one gainsspiritual meaning in their life by serving the needs ofthe underserved and the vulnerable in society. Similarconcepts are prevalent in other religions and we seek

to acknowledge the volunteer acts of many of ourmembers by incorporating this theme in our annualcelebration. Dr. and Mrs. Dishler embody the spirit of“Tikkun Olam” in their many and varied contributionsto the needs of others in our society and were theinspiration for the use of this theme. In keeping withthis year’s theme, you are requested to bring anonperishable food item that will be distributed at theMOM-n-PA dental clinic on May 31 – June 1, 2013.Following the completion of the duties of the

House of Delegates we will reconvene to celebratethe many accomplishments of this year’s Board ofTrustees under the leadership of outgoing president,Dr. Bernie Dishler. Dr. Dishler and his wife, Lana,invite you and your family to attend the President’sReception and Dinner Dance on Saturday for anevening of good food and conviviality. Continuing therecent tradition of celebrating our different heritages,the evening will feature entertainment by a Klezmerband. Klezmer music is the traditional dance andinstrumental music of eastern European Jews that isplayed on celebratory occasions like weddings andbar mitzvahs. Also known as “Jewish Jazz,” thesejoyous and familiar tunes will raise the spirit and addto a fun evening. As you review the program highlights in this

section please note the various social eventssponsored by PDAIS, the Pennsylvania Society ofOral and Maxillofacial Surgeons and ThayerLaboratory. On behalf of the committee, I would liketo express our appreciation to all our sponsors fortheir generosity in hosting these events. Themembers of the Annual Session Committee hopethat you and your family come and enjoy the manyactivities during the meeting and enjoy the manyattractions in Hershey. Golf, shopping, the HersheyGardens, Zoo America, Chocolate World, restaurantsand The Spa are either on site or within closeproximity. Please feel free to contact the hotel’s guestservices staff at (717) 534-8860 for information onthings to see and do in the Sweetest Place on Earth®.All spouses are encouraged to register andparticipate in the events planned by the Alliance ofthe Pennsylvania Dental Association. Please seepage 17 for more information about those activities.The committee members look forward to

welcoming you to Hershey and we encourage you tocheck the website at www.padental.org/as forAnnual Session updates.

See you in Hershey,

Jerrold H. Axler, DDSGeneral Chair

COMMITTEE CHAIRS

Dr. Linda K. HimmelbergerRegistration

Dr. Cary J. LimberakisFinance and Fundraising

Dr. Elliott D. MaserFun Run/Walk

Dr. Lauri A. PasseriHospitality

Dr. Nancy R. RosenthalPresident’s Dinner

Dr. Robert R. SingerEntertainment

Dr. Bruce R. TerryPrinting and Publicity

Jerrold H. Axler, DDSGeneral Chair

Bernie P. Dishler, DDSPresident

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL14

Tikkun OlamREPAIRING THE WORLD145TH ANNUAL SESSION

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ICD-USA Section District 3 SponsorsComplimentary CEJoin ICD-USA, District 3 for a dynamic and motivatinglecture on “Optimal Aging—Living to 100” presented byBarbara J. Steinberg, DDS, on April 25, 2013, from 3:00 p.m.to 6:00 p.m. at The Hotel Hershey. This complimentarycourse is available to all Annual Session attendeesand ICD fellows in the Harrisburg/Hershey area. PDA isan ADA CERP Provider. PDA designates this activity for3 credit hours.

Optimal Aging—Living to 100

At least 75% of health care costs in the U.S. are spenton treating diseases such as heart disease, diabetes,breast cancer, prostate cancer and obesity. Many of thesediseases are largely preventable and even reversible bysimple choices that we make in our lifestyle—what weeat, how we respond to stress, whether or not we smokecigarettes, how much exercise we get, the quality of ourrelationships and social support. At times, these lifestylechoices can be seen as powerful as drugs and surgery!

When it comes to aging gracefully—we want it all! Wewant to feel good, look good and most of all live a longhealthy life. This course will look at some of today’s majorhealth concerns as well as the 4 “S’s” of optimal aging,“sex, sleep, stress and social networks” and their impacton aging. This is a high energy, entertaining course basedon the most current scientific information for living a longhealthy life. Recommendations will be offered to improvenot only your patient’s health, but your own and yourloved ones too!

Upon completion of this course, the participant should:• Learn the risk factors and preventive strategies forheart disease, cancer, etc.

• Understand the impact of obesity on health and learntips for good weight loss, exercise and good nutrition(even chocolate can be healthy!).

• Learn the role that sex, stress, sleep, social networks,optimism and laughter play in living a long healthy life.

• Discover the commonalities associated with successfulaging.

About the Speaker

Dr. Barbara J. Steinberg received her DDS from the Universityof Maryland School of Dentistry and completed a residency atthe Medical College of Pennsylvania. She is clinical professorof surgery at Drexel University College of Medicine, as well asadjunct associate professor of oral medicine at the Universityof Pennsylvania School of Dental Medicine. She is a Diplomateof the American Board of Oral Medicine. She specializes in thetreatment of medically compromised patients.

Dr. Steinberg is a nationally and internationally invited lecturerin the area of dental treatment of the medically compromisedpatient and women’s health, and has authored numerousarticles and contributed to major textbooks on these subjects.For the last ten years Dr. Steinberg has been named by DentistryToday “One of the Top Clinicians in Continuing Education.”

This course is financially supported by Philips, the makers ofSonicare and ZOOM.

PROGRAM HIGHLIGHTSPennsylvania Dental Association | 145th Annual SessionApril 26-27, 2013, Hotel Hershey

Thursday, April 25, 2013

Registration 2:00 PM

Complimentary CE Lecture 3:00 PM

Hospitality Suites TBA

Friday, April 26, 2013

Registration 7:00 AM

House of Delegates 8:00 AM

Reference Committee Hearings 10:30 AM

Luncheon for Delegates and Alternates 12:45 PMSponsored by PDAIS

Reference Committee Hearings Resume 1:45 PM

Pitt Alumni Reception 4:30 PMOpen to all Attendees

PADPAC Reception 6:00 PMOpen to all Attendees; Sponsored in part by Demandforce

Temple University Kornberg School of Dentistry Reception 7:30 PMOpen to all Attendees

Hospitality Suites 8:30 PM

Saturday, April 27, 2013

Fun Run/Walk 6:30 AM

PDA Former Presidents’ Breakfast 7:00 AM

District Caucuses 8:00 AM

Voting 11:00 AM

Luncheon for Delegates and Alternates 11:30 AMSponsored by PDAIS

House of Delegates 12:45 PM

President’s Reception & Dinner Dance 6:30 PMSponsored in part by the Pennsylvania Society of Oral andMaxillofacial Surgeons, the Second District Valley ForgeDental Association, Thayer Dental Laboratory and the Montgomery Bucks Dental Society.

Hotel Reservation Information / Reservation Deadline March 18, 2013*Reserve your room at the Hotel Hershey by calling (717) 533-2171 or (800) 533-3131and providing the group code 53087.

Room rate: $219 single/double plus 11% tax. All guest rooms are non-smoking.

Upgrade to a Woodside Cottage room for an additional $100 per night, per roomplus applicable taxes. Rent an entire cottage (4 or 6 bedrooms) with your family andfriends to enjoy the Great Room as a communal gathering place.

*The block of rooms at the Hotel Hershey will be held until March 18, 2013, or untilrooms are exhausted. After March 18 or once rooms are exhausted, whichever shalloccur first, rooms will be assigned on a space available basis.

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Please help us spend our resources wisely by indicating your attendance plans below.

Event Date Event # Attending Cost Total

Thursday, April 25 Optimal Aging CE Lecture _____ X Complimentary

Friday, April 26 Luncheon for Delegates and Alternates (sponsored by PDAIS) _____ X Complimentary forUse zero if you are not attending delegates & alternates

Friday, April 26 PADPAC and Alumni Receptions _____ X ComplimentaryOpen to all attendees, spouses and guests; business casual dress code

Saturday, April 27 Fun Run/Walk—Circle T-shirt size: M L XL XXL _____ X $15 = ________

Saturday, April 27 Luncheon for Delegates and Alternates (sponsored by PDAIS) _____ X Complimentary forUse zero if you are not attending delegates & alternates

Saturday, April 27 President’s Reception and Dinner Dance _____ X $85 = ________Please indicate each attendee’s meal choice: ( ___ ) Filet of Beef ( ___ ) Salmon ( ___ ) VegetarianChildren age 12 and under (chicken tenders) _____ X $30 = ________

Sponsor a Dental Student Leader _____ X $85 = ________

Total Enclosed

Method of Payment — Please make check payable to: 2013 PDA Annual Session

qCheck qMasterCard qVISA qAmerican Express qDiscover

CARD NUMBER EXP. DATE SIGNATURE

$

April 26-27, 2013Hotel HersheyPlease fill out this form and return byMarch 18, 2013, even if you will not beattending any social events. Return to:

PDA Annual SessionP.O. Box 3341Harrisburg, PA 17105Fax: (717) 232-7169 ORRegister via the PDA website atwww.padental.org/as

Mark the appropriate line with “M” for yourself and “S” for spouse.

____ PDA Member (District #______ ) ____ ASDA Member ____ APDA Member (Alliance) ____ Guest

I am a: qPDA Delegate qPDA Alternate Delegate

ATTENDEE REGISTRATION FORM

Cancellations must be received, in writing, by April 5, 2013, in order to obtain a refund. NO on-site ticket sales.

Sponsor a Dental Student LeaderASDA delegates and alternates, with financial support from PDA,attend Annual Session to participate in our governance structurewhile representing the interests of ASDA. PDA has welcomed otherdental students, beyond the ASDA delegation, to the meeting. Thesestudents have an interest in organized dentistry and PDA is askingfor your financial assistance to support their attendance at themeeting. Please consider sponsoring a dental student member.Funding will be used to offset the cost of meals for dental students.

President’s Reception and Dinner Dance on April 27Please join us to honor the outgoing president, Dr. Bernie Dishler and hiswife, Lana, and enjoy an evening of Klezmer music and the musical variety ofa DJ. Klezmer music, or “Jewish Jazz,” is the traditional dance andinstrumental music of eastern European Jews that is played on celebratoryoccasions. Sponsored in part by the Pennsylvania Society of Oral andMaxillofacial Surgeons, the Second District Valley Forge Dental Association,Thayer Dental Laboratory and the Montgomery Bucks Dental Society.

NAME NICKNAME FOR BADGE

SPOUSE/GUEST (IF ATTENDING) NICKNAME FOR BADGE

ADDRESS

CITY STATE ZIP

PHONE (WORK) FAX

SPECIAL DIETARY/ACCESSIBILITY NEEDS

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APDA REGISTRATION FORM

Alliance of the Pennsylvania Dental AssociationPartnering to promote oral health in the community

The Alliance of the Pennsylvania Dental Association (APDA) welcomes all dental spousesinto membership to support oral health education and legislative involvement.

Event Cost # Attending Total

APDA Member Luncheon $45 X _____ = __________

APDA Friday Social Event $45 X _____ = __________

APDA Registration Form

63R D ANNUAL MEETINGFriday, April 26APDA Registration 10:30 AMAPDA Member Luncheon 11:30 AMHonoring APDA Past PresidentsAPDA Social Event 1:30 PMWine and Chocolate Pairings

Saturday, April 27ADPA Registration 9:00 AMAPDA Board Meeting 9:15 AM

2013 APDA Membership Project –MOM-n-PA on May 31-June 1, 2013

APDA members will be volunteers at two-day freedental clinic in Philadelphia for underservedPennsylvanians. We are requesting a small monetarydonation from all attendees to help with the expenses ofthis dental clinic. Make your check payable to MOM-n-PA and drop it off at the APDA registration table or seeany Alliance member. Thank you for your support.

2013 APDA Convention

REGISTRATION FORM

Registration Deadline March 18, 2013Make Checks Payable to APDA and mail with completedregistration to Stephanie Test at 888 Kingswood Lane,Danielsville, PA 18038

Questions? Contact Stephanie at (610) 462-1109

NAME

COMPONENT

ADDRESS

CITY STATE ZIP

PHONE CELL

SPOUSE’S NAME

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL 17

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Placement ServiceOur Placement Service is a members-only job search assistanceprogram. It connects dentists who have available job opportunities orpractices for sale with dentists seeking employment or to purchasea practice.

In just the past year alone, the Placement Service was responsible forsuccessfully filling more than 10 available opportunities.

Enrolling in the Placement Service is easy! Simply visitwww.padental.org/placementservice and fill out either the positionseeker or position provider form. Electronic enrollment is complimentarywith PDA membership.

If you have any questions about the Placement Service, pleasecontact our membership department at (717) 234-5941.

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL 19

IN MEMORIAM

Dr. Angelo A. CipulloWest HomesteadUniversity of Pittsburgh (1951)Born: 1925Died: 9/13/2012

Dr. Thomas S. JubachNew WilmingtonUniversity of Pittsburgh (1979)Born: 1952Died: 10/6/2012

Dr. George A. LaymanChambersburgUniversity of Pennsylvania (1964)Born: 1938Died: 10/8/2012

Dr. Marshall L. LittleClaysvilleWest Virginia University (1979)Born: 1954Died: 11/10/2012

Dr. Thomas G. LopatofskyWellsboroTemple University (1990)Born: 1962Died: 9/9/2012

Dr. W. Carey MarcucciChurchvilleTemple University (1965)Born: 1939Died: 9/4/2012

Dr. Kara L. NiskiBethlehemUniversity of Medicine and Dentistryof New Jersey (2004)Born: 1978Died: 10/6/2012

Dr. William H. O’ShurakBedfordUniversity of Pittsburgh (1950)Born: 1923Died: 9/12/2012

Dr. Nalin PatelNewtownUniversity of Pennsylvania (1990)Born: 1950Died: 10/9/2012

Dr. Homayoun SafaviPhiladelphiaUniv. of Pennsylvania (1971)Born: 1944Died: 10/2/2012

Dr. Albert F. Sylanski, Jr.McMurrayUniv. of Pittsburgh (1977)Born: 1951Died: 10/15/2012

NOTE: In the In Memoriam sectionof our September/October 2012 issue,we included Dr. George E. Monasky,who passed away June 5, and listedhim as a graduate Pitt dental school.Dr. Monasky was a graduate of Penn.

At Your Fingertips www.padental.org

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By Sita PatelMaurice H. Kornberg School of DentistryTemple University

MANDATED DENTAL SCREENINGS :

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21JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL

As dental caries have become moreprevalent in children, the need for improved dental

care is quite evident.1 To alleviate this problem,

some states have adopted dental screening

requirements for school-aged children. Upon first

glance, this type of mandate may seem like an

impactful step in the attempt to decrease the

prevalence of dental caries. However, when these

laws are analyzed, origins explored and effects

considered, the benefits are not always clear.

Although it is a public health measure that

brings the issue of oral health into the spotlight, its

further advantages are limited.

(Part 1 of 2)

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The State Laws Of the 12 states that have passed dental screening laws for school

children, there is variety. Both Kansas and Pennsylvania passed theirscreening laws in the first half of the 20th century, but many of theother states have passed their laws within the last 10 years, creatinga relatively new phenomenon of dental screening requirements. Oneof the most important distinctions in these laws pertains to who canconduct the screenings. In Illinois, Kansas, New York and Pennsylvania,only a licensed dentist may conduct the screening, whereas inNebraska and Oregon, no persons are specified. Other states havelists that include a dental hygienist and can also include physiciansand nurses. Another major difference is in the frequency of the dentalscreenings. Some states, such as California, require a screening onlyupon entering the first year of school. Others, such as the District ofColumbia, require screenings in pre-kindergarten, kindergarten, firstgrade, third grade, fifth grade, seventh grade, ninth grade and eleventhgrade.2 This shows that there is considerable variation between eachstate. These extensive differences show that there is a large variety from

state to state. Some states, such as Iowa, have included a clearlystated purpose in their code regarding the school dental screenings.3

On the other hand, in Rhode Island’s Rules and Regulations for SchoolHealth Programs, under Section 14.0 (Dental Health Screenings),parameters of the screenings are described in detail, while thepurpose of the screenings is not.4 Without a stated purpose, itbecomes difficult for dental professionals and other providers to givethe type of care that will result in the desired outcomes. One providermay believe that a screening for entry into the school system is just avisual inspection to identify children with early dental caries, whileanother may believe the screenings are used to identify thosechildren who are not regularly being seen by a dentist. Clarity and anevaluation of the community’s needs would greatly benefit the goalsof these dental screening laws, perhaps making them more effectivethan they currently are.

Misplaced Political AltruismThe ineffectiveness of these screenings, which will be discussed in

detail later in this paper, may stem from the origins of these mandates.It has been suggested that some of these laws have passed as a resultof political feelings of altruism instead of scientific basis.The Association for State and Territorial Dental Directors has

published an issue brief on the topic of dental screenings in which itstates that each state law was passed after the work of a “politicalchampion,” referring to a specific person or group who pushed to getthe bill signed.2 This scenario can be further exemplified by Kentucky’slaw requiring students to have their oral health checked. The law was

The purpose of this paper is to discuss

the various shortcomings of the state

mandated dental screenings for school

children. In this first of two parts on the

discussion of mandated dental screenings,

the topic will be considered in broader

terms discussing the content, the politically

driven sources, the effectiveness and

the public health malpractice concerns of

the laws. In the second part, the laws will

be considered from the point of view of

the state, provider and patient, giving

a more individualized approach. The goal

of both parts of this paper is not to

discourage such programs, but encourage

beneficial alternatives.

WITHOUT A STATED PURPOSE, IT BECOMES

DIFFICULT FOR DENTAL PROFESSIONALS

AND OTHER PROVIDERS TO GIVE THE

TYPE OF CARE THAT WILL RESULT IN THE

DESIRED OUTCOMES.

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passed in 2008, is to be implemented during the 2010-2011school year and is regulated by Kentucky’s Board of Education.The law requires screening only once, upon entry into theschool system. These screenings can be conducted by manypeople ranging from a dentist to a nurse practitioner.2 Thebill was initially introduced by Rep. Thomas Burch andsupported by two interest groups, Blueprint for Kentucky’sChildren and Kentucky Youth Advocates. It was unanimouslypassed in both houses and signed by Governor Steve Beshear.5

There seems to have been very little controversy over theissue, so one would suspect that the law would have clearbenefits for the oral health of the citizens of Kentucky. One ofthe main arguments that the Kentucky Youth Advocatesused to help get the law passed was access to care. Parentswere concerned for their children’s health because theycould not find a dentist, and when they did, it was ofteninconvenient timing.6 Although this law would still functionas a medium through which dental education is increased,it would not address the problems related to access to care.If children and their parents are having a hard time makingan appointment for regular treatment, it would make it allthe more difficult for them to schedule an appointment for ascreening. If the screenings were provided by the schools, itcould slightly alleviate the access to care problem in regardsto the screenings, but this is not the case for most of thestates passing such laws, including Kentucky. Because thelaw was passed unanimously in both houses,5 it leads one tobelieve that the governing officials did not take time toconsider all of the implications of a program like this andunknowingly put an unproductive program into place thataffects the majority of the children and their parents.

Evidence, Efficacy and EvaluationUnfortunately, as much as these laws are trying to better

the oral health of their respective communities, there is noevidence to prove their efficacy. A study was done analyzingthe British screening system, which has been in place foralmost 100 years. The study followed over 8,000 subjectsaged six to nine years old. The screenings are similar tothose conducted in the United States and whose purpose isto identify those children in need of more involved dentalcare. The results showed that less than half of those whowere screened positive (i.e., in need of follow-up care) wentfor a follow-up visit, and a quarter of those receivedtreatment for their problems. The data showed that this wasnot significantly different from those who were screened

negative. What’s more is that income also played asignificant role in deciding if treatment was received or not.Those children who came from more affluent families weremore likely to receive treatment than their underprivilegedcounterparts. The authors of the paper suggest that due tothis disparity, the inequality in dental care between childrenfrom different income levels will increase, which opposesone of the original intentions of the screenings.7

In an article written in the British Dental Journal to questionthe current relevance and motives of the British dentalscreening system, KM Milsom has stated that many of thepoliticians involved in the passage and continuance of thismandate have been doing so under “blind faith.”8 The authorsuggests that the function of the screenings has changedover the last 100 years and needs to be re-evaluated to proveits current effectiveness. He points to the data that provesno benefit of these screenings, which have become such anintegral part of the school systems in England and Wales.8

Similarly, the Association of State and Territorial DentalDirectors states that there is no scientific evidence provingthe benefit of these screening programs in the United Statesand that the lack of evidence suggests that the purpose andprocess of the programs needs to be both identified andevaluated.2With these kinds of studies proving that theseprograms do not better the oral health of a community, onemust question why these school dental screenings arebecoming mandated.

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Public Health MalpracticeLastly, something the states might want to consider before implementing such a

law is that the screenings can potentially be considered public health malpractice.Some may not think so, but subjecting children to ineffective and potentially harmfulscreenings could lead to such allegations.There has been controversy over the obesity epidemic and whether state

governments should be required to implement programs that have proveneffectiveness.9 Some suggest that it is public health malpractice that the governmenthas not taken action, especially if they can decrease the threat of obesity.9 In asimilar sense, would it be considered public health malpractice if the government issubjecting children to programs that have no proven effectiveness, and further, areproven ineffective? In his argument regarding childhood obesity and governmentintervention in Public Health Reports, Kevin W. Ryan points out what previousSurgeon General C. Everett Koop said in 1998. He accused the United States Senateof committing public health malpractice because they went directly against theadvice of health professionals and failed to pass a tobacco control bill.9 Althoughthe case being considered here may not be as severe or controversial, it is another

THOSE CHILDREN WHO

CAME FROM MORE

AFFLUENT FAMILIES WERE

MORE LIKELY TO RECEIVE

TREATMENT THAN

THEIR UNDERPRIVILEGED

COUNTERPARTS.

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL24

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case where government officials do not heed the advice ofscientific evidence, which could eventually raise issuesregarding public health malpractice.Although it is difficult to imagine the government’s attempt

at trying to decrease the prevalence of dental caries beingseriously accused of malpractice, the previous argumentserves to underscore the importance of reviewing theevidence and re-evaluating the purpose of programs whichare introduced into the lives of all the children in the state. Itwould be prudent for government officials to remember theimplications each law has for their constituents beforeconsidering such programs.

DiscussionThese arguments serve to show the way the laws were

derived and formulated predisposes them to be ineffective inachieving their goal. For these laws to have a significantimpact on children’s dental health, they need to be reevaluatedand restructured to address the dental issues and problemsspecific to each community.In the United Kingdom, a National Screening Committee

has been established to review all screening programs andadvise government officials on such matters. It is importantto note its recognition of a screening process as one in aseries of steps required to identify those at risk.8

The following list describes a process of measuring theeffectiveness of any screening program:

• Identification of the target population.• Identification of the ‘at risk’ population via screening test.• Measurement of attendance of screened-positive individualsfor a diagnostic test.

• Identification of the numbers of screened-positive individualsin need of treatment following diagnostic test.

• Measurement of the number of diagnosed-positive individualsreceiving appropriate treatment.8

Identifying these factors can lead officials to establish ifthe programs are targeting and benefiting the appropriatepeople. To supplement this, the committee has also come upwith a list of standards to compare any existing or newprograms by. The checklist includes consideration of thepurpose, evidence, strategy, risks and benefits, local needsand cost among other points.8

These checklists can be used to guide states to formdental screening programs that have the intended benefits,and perhaps further benefits (i.e., economic advantages).Government officials need to work with dental and publichealth professionals to put their efforts into implementingthe proper programs to improve children’s oral health status.

Sita Patel is a sophomore at Temple University’s Kornberg Schoolof Dentistry.

Author’s Note: I would like to thank Dr. Lisa Deem for her guidance,advice and careful review of this article.

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1. Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, et al. “Trends in oral health status: United States, 1988-1994 and 1999-2004.” National Center for Health Statistics.Vital Health Stat 2007;11: 248

2. Association of State and Territorial Dental Directors (ASTDD) and the Children's Dental Health Project. “Emerging Issues in Oral Health.” October 2008.www.astdd.org/docs/FinalSchoolScreeningpaper10-14-08.pdf.

3. Iowa administrative Code. §641—51.1(135)

4. Rules and Regulations of School Health Programs R16-21-SCHO § Part III, 14.1-5

5. Conis, Elena. “Steps to Improve Oral Health in Kentucky”. Health Policy Monitor, April 2009. Available at http://www.hpm.org/survey/us/a13/5. Accessed on: December 20,2011

6. Kentucky Youth Advocates. “Kentucky’s Cavity.” 2005. Available at: www.kyyouth.org/Publications/ 05_pub_DentalCareReport.pdf. Accessed on: December 20, 2011

7. KM Milsom, et al. “The effectiveness of school dental screening: dental attendance and treatment of those screened positive.” British Dental Journal 2006; 200: 687–690

8. KM Milsom, et al. “Is School Dental Screening a Political or Scientific Intervention?” Journal of Dental Research. 2008; 87: 897

9. Kevin W Ryan, et al. “Law and the Public’s Health: Public Health Malpractice and the Obesity Epidemic.” Public Health Reports. 2007; 122: 414

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VENDOR SPOTLIGHT

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Beginning in 2011, PDA and PDAIS teamed up to offer our members secure, high-quality products and services atcompetitive prices through the PDA Endorsed Program. PDA and PDAIS are committed to increasing the value of yourmembership and to reduce reliance on dues income. Endorsements generate royalties for PDA, based on memberparticipation. Non-dues income is used to fund vital membership programs and benefits. The cost of endorsed productsis never inflated to generate royalties for PDA.

(877) 770-3323 | Mention offer code PDA-6131.*Office Staff and Family of PDA Members are eligible to participate

Want to get more from your electricity provider?Switch to Energy Plus® and earn Cash Back just for using electricity!Energy Plus is an electricity supply company that supplies millions ofkilowatt hours of electricity to more than 200,000 customers acrossnine states. The best part is nothing about the way your service isdelivered will change. Your local utility will continue to delivery yourelectricity, read your meter, handle service emergencies, and sendyour monthly statement.

As the preferred electricity supplier of PDA, Energy Plus® can helpmembers earn cash back on their home or business electric bills.PDA members can receive 3%-5% cash back on electric supplycharges each year and a $25-$50 sign-up bonus after twomonths ofactive service for each home or business accounts enrolled. For moreinformation or to sign up, visit www.pdais.com/EnergySupplier.aspxor call (877) 770-3323 and mention offer code PDA-6131.

For more information on our endorsed vendors, visit www.pdais.com/vendors or contact Brenda L. Kratzer,Director of PDA Endorsed Programs, [email protected] or (877) 732-4748.

Connect with Your ColleaguesPDA’s Social Network (SoNet)

If you haven’t yet logged on to the PDA Social Network, we encourage you to doso. This network gives you the ability to have increased communication withPDA leaders and staff, as well as endless opportunities to connect with yourcolleagues. Some highlights of the network include:

• Open forums for discussing dental office equipment and products,legislative topics and practice management issues.

• A library for you to search and share documents, as well as provideproduct reviews and share testimonials.

• Public and private groups that serve as an electronic mailing list.• A personal profile for sharing and connecting with colleagues.

There is all of this and much more. The new communication possibilitiesprovided by the social network are endless. To get started, visitwww.community.padental.org and download the first time user instructionsby clicking on the link on the homepage.

If you have any questions about the Social Network, please contact PDA at(717) 234-5941.

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL 27

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MEMBERSMAKING

A DIFFERENCE:Chester Grace Dental Clinic

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“I have been practicing for 36 years and have alwaysbeen open to the idea and interested in mission workfor quite some time now. I have attended a men’s Biblestudy and it has inspired me to become involved in themission field,” Dr. Fetter said. It was four years in the making before the Chester

Grace Dental Clinic opened its doors on May 4. Thestate-of-the-art, two-operatory facility is located onthe first floor of the Frederick Douglass ChristianSchool. The K-5 school is run by World Impact, anurban ministry that provides children with a quality,Christian-based education. Friess, a former resident ofChadds Ford, had been a longtime supporter of WorldImpact and the school. He knew Chester was in greatneed for a facility like this and donated $100,000 tostart the clinic. Friess learned there was an emptyroom in the school and construction began on thebleak concrete room. Other businesses signed on and wanted to be

involved to help support and facilitate the opening ofthe clinic. Equipment and services were donated fromBenco Dental in Horsham, Carestream Dental ofAtlanta, Cunningham Construction in Havertown andMcGillian Architecture of Bala Cynwyd. The clinic hasbrand-new dental chairs and X-ray and sterilizationequipment. “We’re offering a clinic in an environment that really

needs it.” Dr. Fetter said. “We’ve seen about 100patients since we’ve opened and it is obvious that theyhaven’t seen a dentist for an extended period of time.” Currently, the clinic offers basic care, dental hygiene

exams, restorative care and X-rays. Patients also

receive information about preventive care betweentheir routine checkups. Chester Grace is a low-feeclinic, with patients paying only $10 for the care theyreceive. Dr. Fetter is excited and optimistic about the future

of the Chester Grace Dental Clinic. He anticipates thatthe clinic will be open more than one day a week.“As many days as the patients need us to be open,”

he said. He also hopes they can bring in specialists andoffer more advanced treatment options. “TheChesPenn Hospital is located in the neighborhood andthey have two dentists on staff. They are able to seethe patients with prosthetic needs. Unfortunately, wedon’t have the finances to accept those patients yet.”The ChesPenn Hospital also offers a sliding fee

schedule and Dr. Fetter hopes to create a workingrelationship to better serve the community together. Dr. Fetter is seeking community and financial

support. “People are enthusiastic and express interestas word spreads throughout the community,” he said.By hosting open houses, Dr. Fetter hopes guests willgift a monetary donation or supplies. Ongoing effortsto host additional fundraisers will help offset the coststo operate the clinic. The Chester Grace Dental Clinic is open every Friday

from 9 a.m. to 5 p.m. Drs. Fetter and Pulliam take turnsvolunteering at the clinic on Fridays, allowing one ofthem to still see patents at their Wayne FamilyDentistry office. If anyone is interested in contactingDr. Fetter about the Clinic, he can be reached [email protected].

IT WAS BY CHANCE that Dr. Kenneth Fetter met Foster Friess

during a golf outing at the Stonewall course in Elverson. Friess asked Dr. Fetter and his

partner, Dr. Dallas Pulliam (both PDA members who practice in Wayne), if they would

like to be involved in a dental clinic project in Chester. Dr. Fetter instantly said yes. He

was ready to get involved with this local opportunity and serve his community.

By Jennifer McClureCreative Design Manager

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Be Part of the Solution — MOM-n-PA | May 31 and June 1, Philadelphia | By Dr. Bruce R. Terry, Editor

Pennsylvania and several other states have seen a decrease in Medicaid funding for dental care. In October, 2011, Pennsylvania stoppedfunding non-basic services for adults under Medicaid. Root canal treatment, crowns and bridges are no longer covered. This ensuresextractions as the only viable alternative for Medicaid eligible adults in our state. But Pennsylvanians are not alone. Recently states like NewJersey, Illinois, Texas and Michigan have all reduced benefits for adult dental services. In each case, the cost of the program was cited asthe reason for reducing funding. Nearly every state in the United States is faced with a lower tax base and increased expenses. As a result,lawmakers are making tough choices and cutting programs they feel are optional.

It’s obvious that I would pick this issue because it’s dental-related. We can all identify with the lack of importance that dentistry has in thepecking order of state-funded necessities. If it’s this easy to drop coverage for adult dental care, then how important is dental care to ourlawmakers? Can they see the forest for the trees? Don’t they get the message that a lack of proper dental care for adults and children willcause a cascade of health and other associated problems, from systemic infections and ER visits to loss of work and productivity? Do theyunderstand that lack of access to dental care can also be psychologically painful? Maybe if lawmakers were refused dental treatment for afew years they would know what it feels like to be an adult without access to dental care.

But I know that the lawmakers would answer my comments by saying that we have to make cuts somewhere. Someone has to lose.Something has to go. They would suggest that dentists should be more charitable and help make up this difference. But we know that charityalone is not going to solve this problem.

On May 31 and June 1, a non-profit foundation in Pennsylvania will sponsor our state’s first large scale dental mission. This is not a PDAevent. The MOM-N-PA dental mission intends to deliver care to more than 2,000 dental patients during this Friday/Saturday event.If you or someone you know would like to help, please visit www.mom-n-pa.com. You can read about what we are going to do during thisevent and you can register to help. We need volunteers to help with both patient care and non-patient care. Consider bringing your staffor adult family members. There is so much to do that we need every volunteer we can get. Pennsylvania has never had an event like thisbefore, and certainly never in an inner city environment like North Philadelphia.

Restoring benefits for Medicaid adults is not going to happen anytime soon. But you can be part of the solution by either donating to theevent or volunteering your time. Let’s show lawmakers that we (dentists) care. This type of event will help show our community that we careand that we are helpful and compassionate. You can help create goodwill for our profession and feel good doing it!

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but...

ElderlyThe Proportion

of

In Pennsylvania Is Slipping,

but...

ElderlyThe Proportion

of

In Pennsylvania Is Slipping,

STATE RANKINGS:

By H. Barry Waldman DDS, MPH, PhDDolores Cannella PhDSteven P. Perlman DDS, MScD, DHL (Hon)

AbstractMedia reports describing the anticipated increase of tens of millions of elderly residents and their attendant billions of dollarcosts for health services during the next decades are difficult for any person to place in proper perspective. As a result, theseestimates become “just numbers” not actual people. Census Bureau reports are used at the national, state and county levelsto provide an increased meaningful picture when the 65 and older population of Pennsylvania will increase to 22.6 percentof the state population.

In 2000, 12.4 percent of the U.S. population was 65 years and older (15.6 percent in Pennsylvania, 1.9 million elderly). Onlyin the state of Florida was the proportion greater. In 2010, the proportion of elderly in the population of Pennsylvania ranked4th (behind Florida, West Virginia and Maine). It was tied for 3rd (behind Florida and North Dakota) with 2.5 percent of thepopulation 85 years and over. By 2030, the projected number of elderly in Pennsylvania (22.6 percent of the state population)will rank 11th.1,2 But …

“Starting on Jan. 1, (2011) our 79-million-strong baby boomer generation will be turning 65at the rate of one elderly every eight seconds.” 3

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Unfortunately, the use of all-inclusive “mega numbersand proportions” in the listing of the prospects for 20percent of the population are difficult for any person to placein proper perspective. As a result, these estimates become“just numbers” — not actual people. The need is tosomehow personalize these numbers if we are to bringincreased attention to the health and social needs of theseindividuals. The use of available Census Bureau data at thestate and county levels provide an increased meaningfulpicture at a more local level during the period when the65 and older population of Pennsylvania will increase to 2.9million residents in 2030. 7

Note: Specific information from the 2010 census on seniorresidents at the state and county levels may not be availablefor a period of time.

Numbers and percentagesIn 2007, there were 1.9 million residents 65 years and over

in Pennsylvania.

Note: detailed demographic data regarding the seniorpopulation are not available from the Census Bureau at thecounty level. While there were lesser numbers of elderly incounties with smaller total population, there were:

• Between 10 and 42 thousand elderly in 29 counties.• Between 51 and 84 thousand elderly in 9 counties.• 114 thousand elderly in Montgomery County• 187 thousand elderly in Philadelphia County.• 206 thousand elderly in Allegany County. (Table 1)

Between the Census in 2000 and 2008 estimates, thenumber of individuals 65 years and older in Pennsylvaniadecreased by 2.7 percent, compared to 10.8 percentincrease nationally. However; the 85 and over population inPennsylvania increased by 30.6 percent, compared to a33.5 percent increase at the national level. The numeric and

By the end of the next decade, in 2030, one-in-five residents of this country will be 65 years of ageor more, and in six states, one-in-four residents will reach this milestone (Florida [highest at 27 percent], Maine, Montana,

New Mexico, North Dakota, Wyoming).4 These predictions regarding the aging “baby boomer” population have appeared

repeatedly in the public and professional media as government agencies have sought to prepare for the eventual massive

consequences for the health and services industries, national and individual family economics and the need for a seemingly

endless array of private and public programs.

“Elderly to double to 14 percent of globalpopulation by 2040.” 5

“Census Bureau reports world’s older populationprojected to triple by 2050.” 6

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proportional changes are for the period just prior to theprojected increases in the aging “baby boomer” population.(Table 2) Note:The increasing number of “very” elderly in thestate and nationally portends the potential for even greaterincreased supportive services and financial expenditures.

Elderly with disabilitiesNationally, 18.1 million senior residents (52 percent) have

a disability. Of this number, 12.9 million (37 percent) have asevere disability, and 5.5 million (15.6 percent) needassistance with daily living. Senior females were more likelyto be disabled (56.5 percent) than senior men (45.4 percent),to a degree, related to the longer life span of females.Among the non-institutionalized population, 14.2 millionseniors (38 percent) have a disability.9

In Pennsylvania, more than one-third of the elderly (37.7percent) have a disability (713 thousand individuals). Thenumber of elderly with a disability range as high as 21 to 33thousand in Berks, Bucks, Delaware, Lancaster, Luzerne,Montgomery and Westmoreland counties, and greater than84 thousand in Allegany County and 97 thousand inPhiladelphia. (Table 1)

PovertyIn 2009, 14 percent of the U.S. elderly population and

12 percent of the Pennsylvania elderly population lived inpoverty.11 Note: The Census Bureau reports county levelpoverty data for senior residents for the ten year decennialcensus. In 2000, in the Pennsylvania counties, theproportion of elderly ranged as high as between 10.0 percentand 13.5 percent in 16 counties and almost 17 percent inPhiladelphia County. (Table 1)

Minority populationsThe Census Bureau only reports the minority population

proportions at county and age levels for the ten year decennialcensus. Estimates for the proportion of elderly minority in2009 for each county were developed by assuming that theproportion of minority elderly in each county was comparableto the reported proportion of minorities in the total countypopulation. Based upon this assumption, in 2009, theproportion of the elderly minority population ranged as highas approximately 10 percent to 25 percent in 9 counties and51.5 percent in Philadelphia County. (Table 1)In 2009, 84 percent of the Pennsylvania population was

reported as white, 10.8 percent black, 2.5 percent Asianand 5.1 percent Hispanic (may be of any race). These data arefor individuals who reported a single race.12

Health concerns

The average life expectancy of a U.S. new born male is75 years and 80 years for a female. As a consequence of thegeneral health of individuals who have reached the olderages, however, the average life expectance of a sixty-five yearold male and female is 82 years and 85 years, respectively.13,14

The fact is that any planning for the services of the elderlymust take into consideration the reality of the potential longterm needs for this population. For example, the CensusBureau projects that by 2030 there will be more than threemillion 90+ year olds in the U.S. 15

• One-quarter of non-institutionalized elderly are infair or poor health.

• Two-thirds of elderly men and more than seventypercent of elderly women have hypertension.

• One-third or more of elderly men and womenare obese.

• Almost one-quarter of non-institutionalized elderlyhave been diagnosed with diabetes.

• Almost ten percent currently smoke cigarettes.

Use of health services:

• More than a quarter of a billion ambulatory carevisits are made by the elderly to physician offices,hospitals and outpatient departments.

• There are more than 1.3 million elderly nursinghome residents.

• About 58 percent of the elderly reported a dentalvisit in the past year.

Mortality:• The leading causes of death of the elderly are heartdisease, cancer and stroke.14

“…more than 10,000 people per day, or morethan four million per year, for the next 19 yearsfac(e) an increased risk of Alzheimer’s.”1

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Table 1.Pennsylvania counties 65+ years old population (numbers in 000s) by selected characteristics 2000, 2007, 2009 8,10,12

Pennsylvania 1,890 713 9.1% 16.1%

Adams 14 4 6.2 4.0Allegany 206 84 9.0 17.0Armstrong 13 5 7.9 2.0Beaver 32 12 7.3 7.7Bedford 9 3 10.2 1.7Berks 57 21 7.6 8.4

Blair 22 8 8.8 3.2Bradford 10 4 8.8 2.3Bucks 84 24 5.5 8.7Butler 26 9 9.7 2.8Cambria 27 12 9.3 4.9Cameron 1 < 1 7.6 2.0

Carbon 11 5 9.0 3.2Centre 16 5 5.9 9.0Chester 59 16 5.5 11.3Clarion 7 2 8.9 2.3Clearfield 15 6 9.6 4.2Clinton 6 3 8.5 2.2

Columbia 10 4 10.0 3.0Crawford 14 5 8.4 3.6Cumberland 35 10 6.1 7.4Dauphin 35 13 7.1 22.5Delaware 78 29 7.1 24.8Elk 6 2 5.6 1.6

Erie 40 14 7.7 9.3Fayette 25 12 13.5 5.7Forest 1 < 1 9.8 19.5Franklin 23 7 8.6 4.9Fulton 2 1 11.2 2.6Greene 6 3 11.0 5.2

Huntingdon 7 3 9.9 6.7Indiana 14 5 9.4 3.5Jefferson 8 3 9.2 1.6Juniata 4 1 8.0 2.2Lackawanna 38 17 10.8 4.4Lancaster 72 22 6.6 6.8Lawrence 17 6 8.7 5.6Lebanon 21 7 7.2 3.9Lehigh 51 17 7.5 5.5Luzerne 57 26 11.0 4.9Lycoming 20 7 7.8 6.1McKean 7 3 8.3 4.7

Mercer 21 8 7.2 7.8Mifflin 8 3 12.0 1.8Monroe 19 6 8.3 16.3Montgomery 114 33 5.1 15.5Montour 3 1 10.2 4.6Northampton 42 15 7.3 8.4

Northumberland 17 7 11.8 3.3Perry 6 2 8.4 2.0Philadelphia 187 97 16.9 51.5Pike 9 3 5.4 8.4Potter 3 1 9.9 2.7Schuylkill 27 12 10.7 4.2

Snyder 5 2 9.2 2.4Somerset 14 6 10.1 2.7Sullivan 1 < 1 12.0 5.0Susquehanna 7 3 11.0 1.8Tioga 7 4 10.2 2.3Union 6 2 7.0 10.6

Venango 9 4 9.1 2.8Warren 7 3 5.9 1.6Washington 35 14 8.8 5.4Wayne 9 3 10.2 4.0Westmoreland 66 25 8.0 4.2Wyoming 4 1 10.1 2.4York 57 18 6.8 8.2

Note: Numbers and percents have been rounded

NUMBER NUMBER PERCENT PERCENT(IN 000S) DISABLED IN POVERTY MINORITY (2007) (2000) (2000) (2009)

NUMBER NUMBER PERCENT PERCENT(IN 000S) DISABLED IN POVERTY MINORITY (2007) (2000) (2000) (2009)

Table 2.The change in number and proportion of the elderlypopulation in the United States and Pennsylvania between2000 and 2008 6,7

NUMBER CHANGE

Age 2000 2008 Number Percent(Numbers in 000s)

United States

65+ yrs 35,077 38,870 3,793 10.8%

85+ yrs 4,286 5,722 1,436 33.5

Pennsylvania

65+ yrs 1,919 1,857 - 52 - 2.7

85+ yrs 238 310 72 30.6

Note: Numbers and percents have been rounded

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Who will pay the costs for heath care for the elderly?Dependency ratios are an indicator of the potential burden on those in the

working-age population.

Population aged 65years and over Old age dependency = ———————————————— X 100

Population aged 20-64 years

Between 2010 and 2030, the old-age dependency ratio will increase rapidlyas the population of baby boomers moves into the 65 years and over category.The realities are:

• Greater numbers of older individuals will be dependent upon smallernumbers of working age persons to provide the financial support for healthcare services.

• The smaller working age population will need to continue its support foryoungsters under twenty years of age.16

As to actual costs for health care, in 2006 the average annual expenditure forthe major components of health care among Medicare enrollees increased withage, from $11,300 for the 65-74 age group to $23,700 for the 85 years and olderpopulation.17 Elderly persons in better health have a longer life expectancy thanthose in poorer health but have similar cumulative health care expenditures untildeath. A person with no functional limitation at 70 years of age has a lifeexpectancy of 14.3 years and expected cumulative health care expenditures ofabout $136,000 (in 1998 dollars). A person with a limitation in at least oneactivity of daily living has a life expectancy of 11.6 years and expected cumulativeexpenditures of about $145,000. Persons who are institutionalized at the age of70 have cumulative expenditures that were much higher than those for personswho were not institutionalized.18

CommentsThe use of mega numbers and proportions is important to provide a general

perspective, but more local and individual impact considerations afford a personalunderstanding for health providers and the general public to derive an appreciationof the developing realities when one-in-five residents of this country will reach themilestones of older age.As to the particular perspective of the dental practitioner, given the continuing

decrease in edentualism rates,19 the average elderly patient (with the anticipationof a potential increase in life expectancy) is expanding the use of dental services.Note: in 2008, Pennsylvania ranked 25th with 18.3 percent of the elderly reportedto be edentulous. Hawaii was ranked 1st with a 9.8 percent rate of edentulism forthe elderly; West Virginia was ranked 50th with a 37.8 percent rate of edentulism.Nationally, the rate of edentulism for the elderly was 18.5 percent.20

The need exists to comprehend the physical, psychological, economic, familyconditions and a seeming endless array of related factors which affect olderpatients. But the reality is that despite the many changes as individuals age, thelimited availability of dental insurance, and economic difficulties, they increasinglyare reporting the use of dental services. The question remains, is your practiceprepared for the increasing numbers of elderly coming to your neighborhood?

35JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL

About the Authors

Dr. Waldman is a Distinguished Teaching

Professor in the Department of General

Dentistry at Stony Brook University, NY.

Dr. Cannella is Director of Behavioral

Sciences in the Department of General

Dentistry at Stony Brook University, NY.

Dr. Perlman is Global Clinical Director,

Special Olympics, Special Smiles and

Clinical Professor of Pediatric Dentistry at

the Boston University Goldman School of

Dental Medicine.

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JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL36

1. Centers for Medicare and Medicaid Services. Program information on Medicare,Medicaid, SCHIP and other programs. Web site: http://www.cms.hhs.gov/charts/series/sec3-b5.pdf. Accessed November 28, 2010.

2. Census Bureau. Population projections by age, sex and state. Web site:http://www.census.gov/population/www/projections/projectionsagesexhtml AccessedDecember 2, 1010.

3. O’Connor SD, Prusiner S, Dychtwaid K. The age of Alzheimer’s. NY Times October 28,2010. pA33.

4. Proximity. State population rankings 2000-2030. Web site: http://prximityone.com/st003065.html Accessed October 27, 2010.

5. Waters R. Elderly to double to 14% of global population by 2040 (Update2). Web site:http://www.bloomberg.com/apps/news?pid=newsarchive&sid=axV6K65QoAg8Accessed July 22, 2010.

6. Census Bureau News. Census Bureau reports world’s older population projected totriple by 2050. Web site: http://www.census.gov/newsroom/releases/archives/international_population/cb09-97.html Accessed October 28, 2010.

7. Census Bureau. Projections 65 years http://www.census.gov/population/www/projections/files/PressTab3.xls Accessed October 28, 2010.

8. Pennsylvania State Data Center. Pennsylvania counties population, under 18, 65 and overand median age: 2007 estimates. Web site: http://pasdc.hbg.psu.edu/pasdc/PA_Stats/estimates_and_projections/2007/County_Popular_Tables/CountyCharacteristics_Age_2007.xls Accessed December 3, 2010.

9. Senior Journal.com. More than half of U.S. citizen have a disability. Over 70 percent ofthose of 80. Web site: http://seniorjournal.com/NEWS/SeniorStats/2008/20081218-MoreThanHalf.htm Accessed October 29, 2010.

10. Census Bureau. Summary of social economic and housing characteristics. Web site:http://www.census.gov/prod/cen2000/phc-2-40-pt1.pdf Accessed December 3, 2010.

11. Health Facts.org. Poverty rate by age. Web site: http://www.statehealthfacts.org/comparebar.jsp?ind=10&cat=1 Accessed October 29, 2010.

12. Pennsylvania State Data Center. Pennsylvania counties race alone and Hispanic origin:2009 estimates. Web site: http://pasdc.hbg.psu.edu/pasdc/PA_Stats/estimates_and_projections/2009/County_Popular_Tables/RaceHispanicData_2009.xls AccessedDecember 3, 2010.

13. Central Intelligence Agency. World Fact Book. Web site: https://www.cia.gov/library/publications/the-world-factbook/fields/2102.html Accessed October 30, 2010.

14. Center for Disease Control and Prevention. Older person’s health. Web site:http://www/cdc.gov/nchs/fastats/older_americans.htm Accessed October 30, 2010.

15. Vincent GK, Velkoff VA. Census Bureau. The Older Population in the United States: 2010to 2050. Current Population Reports. P25-1138. Web site: http://www.census.gov/prod/2010pubs/p25-1138.pdf Accessed October 30, 2010.

16. Census Bureau. The next four decades: the older population in the United States:2010-2050. Current Population Reports. Web site: http://www.census.gov/prod/2010pubs/p25-1138.pdf Accessed November 1, 2010.

17. Federal Interagency Forum on Aging-Related Statistics. Older Americans 2010: KeyIndicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics.Washington, DC: U.S. Government Printing Office. July 2010 Web site:http://www.agingstats.gov. Accessed November 1, 2010.

18. Lubitz J, Cai, L, Kramarow E, Lentzner H. Health, life expectancy, and health care.New Eng J Med 2003; 349:1048-1055.

19. Waldman HB, Perlman, SP, Xu L. Should the teaching of full denture prosthesis bemaintained in schools of dentistry? J Dent Educ 2007;71(4):663-667.

20. Centers for Disease Control and prevention. The state of aging and health in America2007. Web site: http://statehealthfact.org Accessed November 14, 2010.

References

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CONTINUING EDUCATION

JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL 39

Contact: Lori BurketteAdministrative Secretary(412) 648-8370

March 1Oral OncologyMs. Sandra Boody, CDA, RDH

March 2Update in Medical Emergenciesand Advanced Airway Techniquesfor Permit RenewalHands-On/Limited to 20 participantsMichael A. Cuddy, DMDPaul A. Moore, DMD, PHD, MPHJoseph A. Giovannitti Jr., DMDMatthew Cooke, DMD, MD, MPH

March 8Local Anesthesia Review for DentalHygienistsMarie George, RDH, MSPaul Moore, DMD, PhD, MPH

March 22Biofunctional Esthetic Dentistryand More: Take Your Practice to theNext Level in Esthetic DentistryMarshall Fagin, DDS

April 6-7 – Part 1and April 20-21 – Part 2Local Anesthetics for the DentalHygienist Matthew Cook, DDS, MD, MPHPaul Moore, DMD, PhD, MPHAngelina Riccelli, RDH, MS

April 27Dental Radiography: DANB ExamPrep courseGayle Ball, RDH, MAVictoria Green, RDH, BS

May 4What’s Hot and What’s Getting Hotter(T. F. Bowser Memorial Lecture)Howard S. Glazer, DDS, FAGD, FACD,FICD, FASD

Off Campus Courses

Altoona

March 21The Scope of Forensic DentistryJohn Hosage, DDS

University of Pittsburgh

Greensburg

March 8Advanced Topics in Esthetics andImplant DentistryEdward M. Narcisi, DMD

April 19Treating Patients with CardiovascularDisease: What To Know and WhatTo Do - Plus Treating Yourself to aHealthier LifeJames Lichon, RPh, DDS, NCCM

Johnstown

March 21Embracing New Technologies forComprehensive CareJill Taylor, RDH, BS

April 24The Latest Spin on RotaryInstrumentationGeorge Just, DDS, JD

October 16Drugs in Dentistry - IncludingHerbals and Natural Products:Most Current Information AffectingYour PracticeRichard L. Wynn, PhD

November 14 Can I Do That, and Get Paid,and Enjoy It?Robert N. Obradovich, DMD

Pittsburgh (VAMC)

February 27Medical History Mythbusters: You“CAN” Treat the Medically ComplexPatient!Colonel Timothy J. Halligan, DDSKelly Halligan, DDS

March 20 Diagnosis and Treatmentof Oral TraumaJane A. Soxman, DDS

April 24Understanding All-Ceramics:Techno-Clinical Perspectives andTips for SuccessDamon C. Adams, DDS

May 17Treatment Planning OcclusalWear CasesJoseph C. Passaro, DDSJames B. Wooddell, DDS

Pottsville

March 13 Smart Bonding: ExtraordinarySolutions for Ordinary ProblemsHoward E. Strassler, DMD, FADM, FAGD

April 11Drugs in Dentistry - IncludingHerbals and Natural Products:Most Current Information AffectingYour PracticeRichard L. Wynn, PhD

Reading

April 12Drugs in Dentistry - IncludingHerbals and Natural Products:Most Current Information AffectingYour PracticeRichard L. Wynn, PhD

May 10What's Hot and What's GettingHotter!Howard S. Glazer, DDS, FAGD, FACD

September 13Options for the Restoration of theDental ImplantSteven J. Kukunas, DMD

October 11Porcelain Laminate Veneers -The Whole Story!Steven P. Weinberg, DMD

April 25Update on Caries, Vital Pulp Therapy,Ceramics and CementsJan K. Mitchell, DDS, MEd, MAGD

Bradford

March 7Computer Guided Implant PlacementRobert Walinchus, DMD

April 25Restoration of the Complex Denture,Fixed, and Implant Patient: Pitfalls toAvoidCarl F. Driscoll, DMD

September 26Modern Endodontics - From Theoryto PracticeMartin Trope, BDS, DMD

October 24New Modalities in the Treatmentof TMDJohn E. Pawlowicz, DMD

Butler

March 14Endodontic Treatment for theGeneral Dentist: Why You Are DoingWhat You Do and Can You Do ItBetter?Herbert Ray, DDS

April 18Treating Patients with CardiovascularDisease: What To Know and WhatTo Do - Plus Treating Yourself to aHealthier LifeJames Lichon, RPh, DDS, NCCM

Erie

March 7Restoration of the Complex Denture,Fixed, and Implant Patient: Pitfalls toAvoidCarl F. Driscoll, DMD

April 18Dental Caries Update: It’s AboutMore Than Just Filling Holes!John Maggio, DDS

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CONTINUING EDUCATION continued

Scranton

February 27 Can I Do That, and Get Paid,and Enjoy it?Robert N. Obradovich, DMD

March 27 Restoration of the ComplexDenture, Fixed, and Implant Patient:Pitfalls to AvoidCarl F. Driscoll, DMD

April 17 What's Hot and What's GettingHotter!Howard S. Glazer, DDS, FAGD, FACD

Steubenville, OH

March 28 The Medically Complex Patient -Preoperative Assessment andManagementDaniel E. Becker, DDS

April 18 Update on Caries, Vital Pulp Therapy,Ceramic, and CementsJan K. Mitchell, DDS, MEd, MAGD

Titusville

March 27 Drugs in Dentistry - IncludingHerbals and Natural Products:Most Current Information AffectingYour PracticeRichard L. Wynn, PhD

April 24 Nonsurgical Periodontal TherapyJennifer Zavoral, DMD

Williamsport

March 13 Current Concepts in Oral MedicineScott S. DeRossi, DMD, DABOM

April 3Restoration of the Complex Denture,Fixed, and Implant Patient: Pitfalls toAvoidCarl F. Driscoll, DMD

University of Pittsburgh Temple University

Contact: Nicole Carreno (215) 707-7541(215) 707-7107 (Fax)[email protected] atwww.temple.edu/dentistry/ce

February 27Nitrous Oxide Sedation (Hands On)Drs. Haber-Cohen, Braid and Fielding

March 6Dental Management of Emergenciesand Medically Compromised PatientsDr. Gary Jones and Dr. Allen Fielding

March 14A Dr. Leonard AbramsDistinguished Speaker Series Lectureby Dr. Paul RosenSFC Temple Dental Faculty, Alumni,Residents and Students: FREEAll others: $75

March 27Adoption of 3D Cone-Beam CTIn Your PracticeDr. Jie Yang

March 29Engine Driven Instrumentation inEndodontics – Panel (Hands On)Drs. Yesilsoy, Glass, Herbranson, Kuttler,Maggio and Trope

April 19Porcelain Laminate VeneersDr. Steven Weinberg

June 17 – 21Surgical and Prosthetic OralImplantology — A 5 DayIntroductory Course (Part 2 in September, see site for info)

Greensburg

Giannilli’s II Restaurant& Banquet FacilityContact: Rebecca Von Nieda, PDA(800) 223-0016, ext. 117

March 15Conscious Sedation, Deep Sedationand General Anesthesia Update forDentistsDale A. Baur, DDS

April 12Salvaging Hopeless TeethEdward M. Feinberg, DMD

May 10Dose Response Relations & AvoidingAdverse Drug InteractionsElliot V. Hersh, DMD, MS, PhD

St. Marys

Gunners Inn and RestaurantContact: Rebecca Von Nieda, PDA(800) 223-0016, ext. 117

March 15Treatment of Periodontal Diseasesand ConditionsNabil F. Bissada, DDS, MSD

Brookville

Gold Eagle InnContact: Rebecca Von Nieda, PDA(800) 223-0016, ext. 117

April 19Oral Cancer and Medically ComplexDental PatientsAndres Pinto, DMD, MPH

May 10Medical Emergencies in the DentalOffice: The Six Links of SurvivalLarry J. Sangrik, DDS

Lancaster CountyDental Society

Lancaster Country Club Contact: Alycai Billy, [email protected] (717) 606-6534 for registrationand fee info

March 14Your Dentist Did What?? —Tales from the ED Dr. Maxwell Adams & Dr. ScottMcCurley

May 3The Joy of Oral Pathology:You are the Object of My Infection Dr. John Svirsky

Dental Society of ChesterCounty and Delaware County

DKU Continuing Dental EducationSpringfield Country ClubDelaware CountyContact: Dr. Barry Cohen (610) [email protected]

April 5The Latest Advances and Techniquesto Maximize Anterior ImplantEstheticsStephen Chu, DMD, MSD, CDT

May 22Achieving Financial IndependenceJohn McGill, CPA, MBA, JD

PDA & PDAIS Sponsored Courses

Contact: Rebecca Von Nieda, PDA(800) 223-0016, ext. 117

ErieMay 8Medical Emergencies in the DentalOffice: The Six Links of SurvivalLarry J. Sangrik, DDS

BedfordNovember 22Medical Emergencies in the DentalOffice: The Six Links of SurvivalLarry J. Sangrik, DDS

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JAN/FEB 2013 | P ENNSYLVAN IA DENTAL JOURNAL 41

CLASSIFIED ADVERTISEMENTS

Outstanding Career OpportunitiesIn Pennsylvania, providing ongoing professional development, financialadvancement and more. Positions also available in FL, GA, IN, MI, VA and MD.For more information contact Jeff Dreels at (941) 955-3150, fax CV to(941) 330-1731 or email [email protected]. Visit our website:www.Dentalcarealliance.com.

Lancaster Group PracticeAssociateship or Associate to Partnership in Lancaster. Large group dentalpractice. Income potential of $150,000 to $300,000 plus. Must be a multi-skilled,excellent dentist. This may be one of the best dental practices in the state! Call(717) 394-9231 or email [email protected].

Associate NeededSeeking general dentist for associateship leading to partnership. Our group islocated in the Central Susquehanna Valley near Bucknell and SusquehannaUniversities. We are seeking a general dentist capable of a wide range ofprocedures for our continually growing practice. To learn more about this rareopportunity call (570) 742-9607, email [email protected], or fax your CVto (570) 742-6397.

OPPORTUNITIES AVAILABLE

Rates: $45 for 45 words or less, $1 for each additional word. $1 foreach word set in boldface (other than first four words). $10 to box anad. $5 for PDA Box number reply. One free ad to deceased member’sspouse.

Website: All Journal classified ads will be posted on the publicsection of the PDA website, unless otherwise requested. Ads will beposted within 48 hours of receipt, but no earlier than one monthprior to the date of the Journal issue. Ads will be removed at the endof the two months of the Journal issue.

Deadlines: Jan/Feb Issue — Deadline: Nov 1 • Mar/Apr Issue —Deadline: Jan 1 • May/Jun Issue — Deadline: Mar 1 • Jul/Aug Issue— Deadline: May 1 • Sept/Oct Issue — Deadline: Jul 1 • Nov/DecIssue — Deadline: Sept 1

Payment: Upon submitting ad.

Mailing Address: Send ad copy and box responses to:PDA Dental Journal • PO Box 3341 • Harrisburg, PA 17105

Classified Advertising Policy: The Pennsylvania Dental Associationis unable to investigate the offers made in Classifieds and,therefore, does not assume any responsibility concerning them.The Association reserves the right to decline to accept or withdrawadvertisements in the Classifieds. The Journal reserves the right toedit classified ad copy.

How to reply to a PDA Box Number:

Your Name& Address Here

Pennsylvania Dental JournalPO Box 3341Harrisburg, PA 17105

Attn: Box J/F____

General Dentists NeededDental Dreams desires motivated, quality oriented general dentists to work inour busy Pennsylvania practices. At Dental Dreams, we focus on providingthe entire family superior quality general dentistry in a modern technologicallyadvanced setting with experienced support staff. Because we understand thetremendous value of our associate dentists, we make sure that theircompensation package is amongst the best. Our competitive compensationpackage includes: minimum guaranteed salary of $150,000 with potential toearn up to $300,000, visa sponsorship, and health and malpractice insurancereimbursement. Make Dental Dreams a reality for you! To apply, please emailCV to [email protected] or call (312) 274-4520.

Associate—General Dental PracticeBeaver County Pennsylvania (Pittsburgh area) extremely busy general practiceseeking quality long term associate or buy in candidate. Contemporary practice iscomputerized and has all digital X-rays. Experience in all phases of generalpractice including endo, implants and crown and bridge preferred but will considera recent, qualified graduate. Established practice includes experienced staff,modern equipment, great location, and doctors willing to make this a win-winsituation. Contact office at (724) 775-4115 or email [email protected].

DENTISTRY IN AN OUTDOOR PARADISEFull-time associate needed near Williamsport. Well established, thrivinggeneral practice seeks full-time associate. Beautiful high-tech office providingcomprehensive and quality dental care. Exceptional, committed staff, 10treatment rooms; efficient business systems in place generating strong financialreturns and generating many new patients for associate. Excess potential.The right candidate will offer excellent personal and clinical skills. Pleasant areato raise a family, excellent school districts. Send resume to: Apple Dental, PC,Attention: Dr. Lawrence Leggieri, 929 Lycoming Mall Drive, Pennsdale, PA 17756or email [email protected].

Associate NeededA P/T or F/T general dentist needed for a well-established family practice inHanover. We have a steady patient base, a friendly staff and excellent workatmosphere. Competitive base salary with bonus and other benefits. Please sendresume to [email protected] or call (215) 820-7113.

General Dentist WantedChestnut Hills Dental, formed in 1997, is an 8 office, multi-specialty groupdental practice and a leader among the Pittsburgh dental community committedto providing quality dental care to their patients. We are seeking an exceptionalgeneral dentist for our new practice in Johnstown. Enjoy the traditional doctorpatient relationship in a team environment with professional and clinical supportto best service your patients. Join our team and enjoy flexible work hours, a generous compensation andbenefits package including malpractice, life, medical, disability insurance and a401(K) plan with employer match. Future ownership possible. Please contactDr. Robert Hudock at [email protected] or (412) 372-5100.

Associateship Leading into OwnershipCentral PA: Master cosmetic/reconstructive dentist seeks qualifiedassociate to learn to “work smart, not hard.” Offer includes 4-operatoryhigh-tech "cash practice” and well-maintained 3-story building includinga 2 bedroom apartment. “Formal education will earn you an income, butself education will earn you a fortune.” Serious inquiries only. Please respondto PDA Box J/F 1.

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CLASSIFIED ADVERTISEMENTS continued

Western Pennsylvania / Greater Pittsburgh Area / Eastern PANumerous practices with collections ranging from $155,000 to $2,500,000PA - (#'s are collections) Erie $1,800,000, Erie $1,000,000, Multiple Offices-Pittsburgh Area $2,500,000, Tri State Periodontist $600,000, Robinson Twp.$670,000, Grove City $430,000, Mercer County $155,000, Airport Area$300,000, Franklin $360,000, Washington County $500,000, Oakland$300,000, Beaver County $760,000, Beaver County Pediatric $600,000,East Pittsburgh Suburb Pediatric $300,000, Plum $400,000, Mercersburg$530,000, Altoona $275,000, East Pgh. Prosthodontist $400,000.

We offer formal Valuation Services in case of divorce, business planning, estateplanning, retirement planning, help in determining exit strategy, partner “buy out”, etc.

Please contact Bob Septak at (724) 869-0533 ext. 102 or email [email protected]

As always, we treat these matters with the highest amount of confidentialityand any contact with United Dental Brokers of America will be kept completelyconfidential.

Practices for SalePA-1097: Erie County. Average Collections $832,800. Strong hygiene program.Seller motivated. PA-1104: Westmoreland County. Average Collections $268,620.3 operatories. Great starter/satellite office. PA-1099: Allegheny County. Pediatric.Average Collections $500,000. Net Profits $250,000. Contact Jason Gamble,National Practice Transitions, (877) 365-6786 ext. 229. [email protected].

FOR SALEPittsburgh east suburbs – pediatric dental practice…active long-time established.Everything in place to continue a successful career. Professional Practice Planners,332 Fifth Avenue, McKeesport, PA 15132. (412) 673-3144 or (412) 621-2881(after normal hours) or [email protected].

Associate for General/Cosmetic PracticeWe are seeking an experienced candidate to join our office as either an independentcontractor or an associate. Our office is located in Bethlehem and is an establishedpractice for 25 plus years. We take pride in our delivery of care to our patients andworking together as a team. The office has all digital X-rays and is computerizedusing dentrix and is paperless. The practice accepts most PPO insurance plans.Candidates should have completed Gpr or minimum 2 years experience. All salaryand benefit information will be discussed at the time of interview. Please sendcurrent CV to [email protected].

Dentist WantedSeeking Dentist for partnership in our Wilmington office. Five plus yearsexperience. Will assist in passing Delaware Board. Income potential well above250K. Email [email protected].

For SaleGeneral practice, Huntingdon, near Lake Raystown, college town, 500K rev. on 34hr/wk. 1,200 s/f, 4 ops, turnkey. Building with 3 BR apartment included at practiceappraisal. Doctor’s row with off street parking. Doctor will stay to introduce. Reply:[email protected].

Hanover Dental Office SuiteTake advantage of your opportunity for a quality dental office in the Heart ofHanover. One block north of Center Square, 104 Carlisle Street. Fully plumbed,1,460 s/f. “Hanover Dental Medical Office” http://www.youtube.com/watch?v=DRqS04-8hf0&feature=channel&list=UL. Available now. Call Don Stabler at(717) 637-5877 or email [email protected] to find out more.

FOR SALE

ComprehensiveCompassionate CareExclusively Dedicated to

Patients with Special Needs

At Special Smiles, we focus solelyon serving the needs of patients with intellectual

and physical disabilities who requiregeneral anesthesia for dental care.

Call 215-707-0575For an appointment or consultation

www.specialsmilesltd.com

Special Smiles, Ltd

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CLASSIFIED ADVERTISEMENTS continued

Practice SaleCentral PA – 5ops – high end dentistry, strong hyg. FFS, Rev. $865K, 2,800 s/f,condo avail for sale. Donna (800) 988-5674. www.snydergroup.net

Practice for SaleCentral Penn. – Well estab. 5 ops. Rev. $755K. R/E avail. Call Donna(800) 988-5674. www.snydergroup.net

Practice for SaleLackawanna County -General - 19 y/o practice on busy street. Very strong hygieneprogram. 50% FFS, 50% PPO patients. 5 ops, Dentrix, cameras, digital X-ray,patient ed + a pan. 1,600 active patients. The practice shows very well. Contact:Sharon Mascetti (484) 788-4071.

Office Space for RentCarlisle - 1000 s/f already fully equipped for a Dentist. 3 treating rooms,2 bathrooms, lab, off street parking in professional building on South HanoverStreet. Includes heat, electric, water/sewer and trash. $1,250/mo for space,equipment can be purchased separately. Call Scott @ (717) 249-0095.

FOR SALEPittsburgh east suburbs – general practice…well established. Excellent opportunityfor solo practice or satellite. Professional Practice Planners, 332 Fifth Avenue,McKeesport, PA 15132. (412) 673-3144 or (412) 621-2881 (after normal hours) [email protected].

PRACTICES FOR SALEMARYLAND, DC. VIRGINIA: No buyers fees. Including EASTERN SHORE -3 ops grossing $600K, ROCKVILLE - 3 ops Town center. Charles County - grossing$1 Million, Lanham - 4 ops gross $$500K. D. C. K st 3 ops. FREDERICK COUNTYfree standing. EASTERN SHORE - Retiring. PG County - grossing $475K.Call for more information. POLCARI ASSOCIATES, LTD (800) 544-1297.www.polcariassociates.com

Practice SaleHarrisburg Area - 4 ops plumbed - refers endo, perio, surgery, and ortho.Great starter or satellite practice with growth potential. Call Tom (410) 218-4061or [email protected].

Practice SaleAtlantic County, NJ - Great Area!! Fee for Service, 3 ops, 28 hrs/wk. Leased space.Rev $600K. Call Donna (800) 988-5674.

Practice SalePhiladelphia – Northeast – 3 new ops. Digital – leased space. Rev. $500K. CallDonna, (800) 988-5674.

Practice for SaleLehigh County - Home/office - Historic brick home in good, corner location in niceneighborhood. 3 ops, hyg, 16 hrs/wk. Bldg. $250K. Practice Rev. $375K. Donna(800) 988-5674. www.snydergroup.net

RENT DENTAL OFFICE SPACE (MAIN LINE)Share state of the art dental office on prestigious main line with unlimited useof three fully equipped operatories. Digital x-ray (dexis), network computersystem, chair/unit (pleton/crane), computer with 2 monitors and three 32inchflat screen TV’s. The office is equipped with lasers, bleaching light, digitalpanoramic machine and a 3m digital scanner. Dental staffing is available.Contact F. Alan Dickerman, 139 Montgomery Ave, Bala Cynwyd, PA 19004,(610) 667-0588, www.baladental.com, [email protected].

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CLASSIFIED ADVERTISEMENTS continued

Consulting ServicesCPA having 25+ years’ experience (including with AFTCO Associates) offersindependent dental advisory services involving Buying, Selling, Mediation,Valuation, Expert Witness or Tax Planning. Joseph C. Bowers, MBA, CPA/PFS,(610) 544-4100 or email [email protected].

PRACTICE TRANSITIONSSELLING – BUYING – MERGING – ARRANGING AN ASSOCIATESHIP – EXITINGpractice. Contact the Transition Specialists: Professional practice Planners,332 Fifth Avenue, McKeesport, PA 15132. (412) 673-3144 or (412) 621-2881 afternormal hours) or [email protected]. Brokerage sale commission reduced to7.5%! CERTIFIED APPRAISALS FOR ALL PURPOSES BY Master Certified Appraiser.

Practice TransitionsWe specialize in Practice Sales, Appraisals and Partnership Arrangements inEastern Pennsylvania. Free Seller and Buyer Guides available. For more details onour services, contact Philip Cooper, DMD, MBA America Practice Consultants,(800) 400-8550 or [email protected].

Financial ServicesFischer Financial Services, Inc. is an independent money management firmlocated in Harrisburg. As a “Registered Investment Adviser” with the U.S.Securities and Exchange Commission, the firm specializes in money managementfor institutions and individuals. To learn more, call (888) 886-1902 or visitwww.fischerfinancialservices.com.

Commercial Space for Lease, 2,000 S/FCommercial Space for Lease, 2,000 Square Feet, First Floor. Space suitable fordental, medical, professional services, can layout to tenants needs. Main Linelocation, Wayne, easy access to Lancaster Avenue. Ample Private Parking.2 Entrances. 3 Bathrooms. Radnor Trail view! More information/photos/pricing,contact: (610) 964-9040 or [email protected].

For SalePhilips Dental Systems Oralix Pan DC: Panoramic X-ray and Cepalometric unit.Best offer OR will consider donation to non-profit organization. Velopex X-raydeveloper for films including Pan and Ceph, daylight loader included. Please contactDr. George (Rusty) Bullock (215) 348-9521.

EQUIPMENT FOR SALE

PROFESSIONAL SERVICES

DR. FILL-IN “Dentists helping Dentists”Dr. Fill-in was established 5 years ago to match qualified dentists with dentistswho are looking for temporary or permanent dental coverage. We serve thePennsylvania and New Jersey area to keep your office open while you areaway. For more information, please visit our website at www.doctorfillin.comor if you prefer contact us by phone at (610) 216-2899.

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