Fall 2011 - Oakland County Dental Society

Transcription

Fall 2011
InsIde:
Life Changing Dentistry
by Jeffrey S. Haddad DDS
Oakland RevivesYoung Dentist
Committee
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Volume 51
No. 1
contents
Editors Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
President’s Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Members In The News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Young Dentists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Life Changing Dentistry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Meeting Photos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
MDA Trustee Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Mel Reminisces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Classifieds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
About the Cover: Oakland County glows in the fall. Photo taken by Robert J. Schoenfeld, MD in 2011
Editor . . . . . . . . . . . . . . . . . . . Craig .Duhaime
Managing .Editor . . . .Franziska .Schoenfeld
Business .Manager . . . . . . .Brigitte .Boyungs
Advertising .Manager . . . . . . . .Brigitte .Boyungs
Editorial .Staff . . . . . . . . . . . . . Nick .Fontana .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .David .Thompson
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .James .Wright
Oakland County Dental Society Officers
President . . . . . . . . . . . . . . . . . .Larry .Palmer
Past .President . . . . . . . . . . . . . . . .Paul .Lange
President-Elect . . . . . . . . . . . .Larry .Duffield .
Secretary/ .Treasurer . . . . .Steven .Gustafson
Council
Doug .Henke, .Lynne .Moseley,
Laris .Stumpos, .Karen .Frank .
MDA Trustees
Scott .Meldrum, .Bob .Tremblay
Hours:
Monday .thru .Thursday, .9 .am .to .4 .pm . .
Friday .hours .are .9 .am .until .noon .
How to ReacH Us
Executive Director
Brigitte .Boyungs
Phone: .
E-mail: .
Fax: . .
Mail: . .
.
(248) .540-9333
ocdsdental@aol .com
(248) .540-2016
16205 .W . .14 .Mile .Road, .Suite .201
Beverly .Hills, .MI . .48025
Letters to the Editor
Letters . to . the . Editor . are . welcome: . by . mail . .
or .e-mail . .They .may .be .edited .for . .brevity .and .will .
become .property .of .the .Oakland .Dental .Society .
The Oakland County Dental Review .(USPS .401-180) .
is .published .quarterly . . .Non-Profit .postage .paid .at .
Birmingham, .Michigan
POSTMASTER .send .address .changes .to: .Oakland
County Dental Society, 16205 W. 14 Mile #201,
Beverly Hills, MI 48025
Subscription .rate .for .OCDS .Dental .Review . .
is .$15 .per .year .
Copyright .© .2011 .Oakland .County .Dental .Society
Mission Statement
The .Dental .Review .strives .to .serve .the .needs . .
of . its . members . by: . publishing . news . and .
articles .of .interest; .serving .as .a .sounding .board .
for .ideas .and .opinions; .promoting .the .concept .
that . Oakland . County . members . comprise . a .
dental .family .
Editorial Policy
All .statements .or .opinions .and/or .supposed .
fact .published .herein .are .those .of .the .author .
under .whose .name .they .appear . .They .are .not .
to .be .regarded .as .the .views .of .the .OCDS .unless .
the .Society .has .adopted .such .statements .
All . text . published . in . the . Dental Review .
may . be . reproduced . or . reprinted . only . after .
written . permission . has . been . granted . by . the .
Oakland . County . Dental . Society . . The . Society .
reserves . the . right . to . edit, . revise . or . reject . .
any . manuscript . submitted . for . publication . .
Manuscripts .must .be .typewritten . .The .Society .
reserves . the . right . to . reject . any . advertiser . .
or .advertising .copy .
Member Publication
Editor’s Corner
Your Profession – Your Dental Society
Your Dental Review
by Dr. Craig Duhaime
. . . . . . . .Last .week .a .patient .
presented .to .me .who .needed .
root .canal .therapy .followed .
by .a .core .buildup ./ .crown .
restoration .on .tooth .#3 . . .
Even .though .the .patient .was .
referred .for .that .particular .
tooth, .she .asked .if .I .would .
take .a .look .at .tooth .#14 .as .
well . .When .I .looked .at .#14, .
I .noticed .a .fractured .DB .
cusp .and .amalgam .restoration . .After .completing .my .
clinical .exam .I .determined .that .the .patient .would .need .
to .have .that .tooth .restored .which .would .most .likely .
cause .an .exposure .into .the .pulp .chamber .and .a .need .
for .an .additional .root .canal .
. This .may .not .sound .like .much .to .any .of .us .who .
treatment .plan .dentistry .on .a .daily .basis . .However, .
when .I .told .her .the .news, .the .relief .and .excitement .
over .her .newly .acquired .discount .insurance .plan .
faded .like .an .airplane .entering .a .cumulous .cloud . .Not .
only .would .she .lack .a .sufficient .amount .of .benefit .to .
cover .both .teeth, .she .would .barely .have .enough .to .pay .
for .the .tooth .that .was .referred . .Many .of .us .practicing .
dentistry .have .witnessed .this .day-in .and .day-out . .
Discount .insurance .plans .that .don’t .offer .anything .
beyond .one .dental .procedure .per .year .and .premium .
plans .that .offer .the .same .monetary .benefit .that .was .
offered .over .20 .years .ago . .While .much .has .changed .
with .the .technology .we .use .in .our .profession, .not .
much .has .changed .(when .it .comes .to .yearly .insurance .
maximums) . . .
. I’m .not .prophesying .anything .new .by .stating .that .
insurance .companies .will .continue .turning .the .screw .
on .our .profession .by .stagnating .maximum .benefits .
and .controlling .our .fee .schedules .– .both .covered .and .
non-covered . .Enter .in .the .access .to .care .problem, .
2
throw .potential .dental .health .aide .therapists .(DHATS) .
into .the .“cocktail,” .stir .it .all .up, .and .you’ve .got .a .
watered .down .version .of .what .medicine .is .today . . .
Many .exemplary .states .around .us .have .combated . .
this .by .adopting .legislation .that .limits .the .powers . .
these .juggernaut .corporations .have .over .our . .
small .businesses . . .
. On .the .local .level, .despite .having .one .of .the .lowest .
percentage .of .member .dentists .statewide, .our .dental .
society .remains .strong . .Last .year .a .lot .of .work .was .
done .by .past .OCDS .president, .Paul .Lange, .and .Board .
members .to .shore .up .committees .and .rededicate .some .
of .them . .One .example .is .the .young .dentist .committee .
which .is .co-chaired .by .Drs . .Marvin .Jabero .of .Oral .and .
Facial .Surgeons, .and .Michael .Yuen .of .Endodontic .
Associates, .P .C . .There .is .an .untapped .group .of .young .
practitioners .out .there .in .Oakland .to .help .bolster .
continued .membership .and .involvement .in .the .dental .
society . .Drs . .Jabero .and .Yuen .are .dedicated .to .the .
success .of .this .once .dormant .division .of .OCDS .and .
they .have .a .lot .of .exciting .plans .ahead .
. Oakland .also .scored .a .significant .victory .at .the .
MDA .annual .session .last .spring . . .Board .members .
fought .hard .to .have .the .Delta .Dental .Affiliated .
Healthy .Kids .Program .extended .to .all .counties .of .
Michigan .(currently .the .entire .tri-county .region .is .
excluded) . .This .was .not .only .an .important .step .for .
improving .access .to .care .in .Oakland; .it .was .good .for .
dentists .whose .practices .would .benefit .by .being .able .
to .treat .more .pediatric .patients . .Healthy .Kids .is .a .
way .to .treat .kids .at .a .lower .fee .that .reimburses .more .
competitively .than .Medicaid . .It .was .the .consensus .of .
your .Oakland .caucus .that .the .current .Healthy .Kids .
coverage .discriminates .against .the .counties .with .
higher .population .densities—arguably .excluding .
counties .that .need .it .the .most . . .I .agree .with .my .fellow .
delegates .that .a .child .should .not .have .to .live .in .rural .
continued on page 4
September-October 2011 • Oakland County Dental Society • Dental Review
President’s Page
Let’s Plan for the Future
by Dr. Larry Palmer
. The .Oakland .County .Dental .Society .is .the .
second .largest .district .in .Michigan .as .I’m .sure .the .
membership .is .well .aware . .Yet, .as .the .MDA .market .
share .is .now .74 .4 .percent, .we .in .Oakland .County .
have .not .budged .from .62 .percent . . .This .presents .a .
challenge .to .us .all .on .how .to .increase .membership . .
In .the .past .we .have .added .new .members .on .an .
individual .basis .as .they .chose .to .join . .However, .
this .will .not .be .enough .to .replenish .or .increase .our .
numbers .in .the .future .
. Over .the .years .in .a .number .of .conversations .
with .dentists .I .have .heard .one .constant .criticism . . .
“Where .is .the .value .for .the .money?” .When .I .explain .
my .reasons .for .belonging .and .actively .participating, .
their .eyes .glaze .over . .I .don’t .know .if .it’s .my .
delivery, .my .grey .hair, .or .that .they .think .I .can’t .
relate .to .them .in .this .economy . .
. I .have .been .fortunate .in .my .career .in .having .
practiced .anesthesiology .for .17 .years .at .a .medical .
school .as .well .as .practicing .private .practice .
dentistry . .I .have .seen .first-hand .how .profoundly .
medicine .has .changed .and .continues .to .change . . . .
I .also .see .profound .changes .in .the .future .of .
dentistry . .Will .these .changes .affect .my .career? .
Probably .not . .But .it .will .definitely .affect .those .who .
follow .me . .We .still .have .the .opportunity .to .affect .
change .in .our .profession . . . .But .we .can .only .do .this .
with .one .voice .
. The .next .point .I .want .to .make .is .that .we .need .
to .make .new .members .and .potential .members .feel .
welcome . .A .few .suggestions .would .be .to .encourage .
associates .to .join .the .ADA, .include .new .members .
in .conversations .at .our .meetings, .and .create .a .
mentoring .program . .We .have .a .large, .diverse, .
talented .membership .with .a .wide, .diverse .breath .
of .experience .in .Oakland .County . .This .invaluable .
asset .is .under-utilized .in .the .community .
. What .if .we .do .nothing .
and .proceed .as .usual? .We .are .
doing .O .K . .Presently .we .have .
a .steady .dues .income .which .is .
our .primary .source .of .revenue . . . .
The .Dental .Review .is .
essentially .revenue .neutral . .
and .the .golf .outing, .when . .
we .have .it, .is .our .other .source .
of .income . .What .we .face .in .
the .future .is .evident .at .our .
meetings; .our .contingent .is .getting .older . .What .
will .occur .in .the .future .is .more .of .our .membership .
becoming .lifetime .members; .therefore, .we .will .see . .
a .drop .in .income . .
. Due .to .the .size .of .our .contingent .in .the .
past, .there .was .no .major .issue .with .income .vs . .
expenditures . .But, .we .cannot .expect .this .in .the .
future . .Two .years .ago .the .board .instituted .a .budget .
to .keep .better .track .of .our .finances . .I .would .like .
to .report .we .are .on .budget .and .have .a .good .cash .
reserve . .We .are .also .making .contingency .plans .
in .case .of .a .decrease .in .MDA .outlay .to .Oakland .
County .for .its .dues .income .
. The .bottom .line .is .we .must .increase .
membership . .I .propose .a .4-year .plan .in .Oakland .
County .to .increase .our .market .share . .The .first .major .
effort .that .Oakland .County .initiated .has .ocurred .on .
October .23, .2011 . .It .was .a .membership .event .held .
at .the .Henry .Ford .Museum, .sponsored .by .the .MDA .
for .all .southeast .districts . .This .membership .gala .was .
of .no .cost .to .the .guest .and .a .great .event .for .all . .Also .
I .encourage .participation .in .the .“young .dentists” .
group, .recently .reactivated .under .new .leadership .
. I .propose .two .membership .drives .each .year .
targeting .general .and .specific .groups . .We .can .grow .
and .thrive .or .do .nothing .and .accept .the .inevitable .
3
Your Profession ... continued
Michigan .to .be .afforded .quality .dental .care . .Our .
Dental .Society .is .one .to .definitely .be .proud .of!
To .save .the .dental .society .money .during .these .
tough .economic .times, .Dr . .Franziska .Schoenfeld .and .
I .proposed .last .year .that .we .transition .your .Dental .
Review .into .a .quarterly .publication .as .opposed .to . .
bi-monthly . .Each .issue .should .be .more .action .
packed; .and .another .new .feature .involves .the .last .
issue .(summer) .which .will .feature .abstracts .of .thesis .
work .submitted .by .the .residents .at .St . .Joseph .MercyOakland . . .
It .is .also .our .goal .to .make .the .Dental .Review .
accessible .online, .and .supplement .the .paper .format .
with .automatic .e-mail .delivery . .If .members .prefer .
the .electronic .method, .this .may .also .amount .to .an .
additional .cost .savings .for .the .dental .society .and .
ultimately .member .dentists . .Lastly, .I .encourage .ALL .
of .our .members .to .get .involved .in .the .submission .
of .articles, .especially .if .it .involves .a .hobby, .dental .
meeting, .or .interesting .clinical .information .that .you’d .
like .to .share .with .your .fellow .colleagues . . .
In .an .evolving .digital .world .where .choosing .
social .media .can .be .compared .to .picking .a .flavor .of .
ice .cream, .your .dental .society .and .Review .provide .a .
consistent .core .and .tradition .for .dentists .throughout .
Oakland .County .to .remain .connected .
Corrections: .In .the .June .issue .of .the .Dental
Review .the .following .new .dental .graduates .
were .incorrectly .identified . .They .are .Drs . .
Kathryn .Lucas, .Brittney .Cabrerra, .Sarah .Najor .
In Memoriam
Myron Gus, DDS
Tulsa, Oklahoma
Died: December 22, 2010
Age 73
Mark Your Calendar for 2011/2012 Events
dinner / Study CluB MeetingS
November 15, 2011 – Study Club
marCh 13, 2012 – Study Club
bloomfield twp. library - dr. fareS eliaS
bloomfield twp. library - dr. Jeff grabiel
JaNuary 10, 2012 – diNNer meetiNg
may 8, 2012 – diNNer meetiNg
SaN mariNo Club
mda preSideNt, CoNNie verhaegeN
meadowbrook CouNtry Club
AnnuAl SeSSion 2012 – lAnSing, Mi April 18 – 21, 2012
BoArd MeetingS: JaNuary 3, marCh 6, may 1, 2012
4
Members In The News
Dr. Carl Misch
The .Academy .of .General .Dentistry .(AGD), .is .a .professional .association .
of .more .than .37,000 .general .dentists . .At .their .annual .meeting .held .in .
San .Diego .on .July28, .2011, .Dr . .Carl .E . .Misch .was .awarded .the .Albert .
L . . Borish . Award . . This . award . goes . to . dentists . who . demonstrate .
innovation, . leadership, . and . dedication . to . the . advancement . of .
dentistry . .Only .19 .AGD .members .have .received .this .award .
Dr . . Misch . has . lectured . throughout . the . United . States . and . in . 47 .
countries .and .has .published .more .than .220 .scientific .articles . .He .has .
written .four .textbooks .on .implant .surgery, .bone .grafting, .prosthetics, .
and .treatment .of .complications, .which .have .been .translated .into .five .
languages . . .He .has .trained .more .than .3,500 .doctors .over .the .last .25 .
years .at .the .Misch .Implant .Institute .in .Beverly .Hills, .Michigan .
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5
Young Dentists
Oakland Revives Young
Dentist Committee
Last .year, .the .OCDS .Board .
decided .it .was .time .to .revive .the .
young .dentist .division .of .the .dental .
Dr. Marvin Jabero
society . . .The .search .for .young .
leadership .was .initiated, .and .Drs .
Marvin .Jabero .and .Mike .Yuen .volunteered .to .step .up .to .
the .challenge . . . .Both .Drs . .Jabero .and .Yuen .have .taken .the .
brave .first .steps .and .put .a .lot .of .work .into .the .preliminary .organization .of .this .important .component .to .our .
Drs. Sandy Marshall, Mike Yuen, Amanda Boltwod (behind), Amanda Tan,
local .society .
Trond Hegle (behind), Emmanuel Paguio, Simon and Maureen Ghattas
. . .
(both dentists)
. The .first .event .took .place .at .Cheli’s .Bar, .followed . .
by .a .Tigers .baseball .game .on .Wednesday, .Sept . .28 . .
Despite .unfavorable .Fall .weather, .many .young .dentists .
from .Oakland .County .turned .up .to .not .only .support . .
their .home .team .but .also .network .with .other .young .
colleagues .practicing .in .Oakland .County . .
. When .asked .about .taking .on .this .role .Dr . .Jabero .
replied, .“I .am .very .thankful .for .the .opportunity .to .
co-chair .the .young .dentist .division .of .Oakland .County . . . .
It .can .be .very .intimidating .when .finishing .dental .school . .
or .residency .and .you .are .expected .to .have .all .the .answers . . .
Guidance .and .support .from .our .mentors .and .seasoned .
colleagues .help .us .early .in .our .careers, .but .ultimately .
we .must .pave .our .own .paths .to .success . .“
Drs. Andrew DeHaan, Michael
Yuen, Emmanuel Paguio
. . “Our .field .of .work .has .undergone .tremendous .
advancements .in .science .and .technology .that .requires .
cohesion .of .young .and .old .to .provide .the .best .patient . .
care . .My .goal .of .the .young .dentist .society .is .to .challenge .
all .the .new .dentists .to .think .of .innovative .and .econom- .
ical .ways .to .improve .patient .care .and .combine .this .with .
the .leaders .who .have .paved .the .way .for .us .in .dentistry .”
. Dr . .Jabero .expressed .that .his .ultimate .goals .for .the .
group .include .quarterly .study .clubs .for .case .discussions, .
community .service .projects, .and .occasional .social .outings .
to .keep .young .dentists .united .for .the .future .
Drs. Sarah Najor,
Chris McWatters
. Drs . .Jabero .and .Yuen .are .extremely .enthusiastic .about .
re-launching .this .much .needed .group .within .our .dental .
society .and .are .also .looking .for .motivated .helpers .who .
want .to .take .part .in .its .new .beginning .
Drs. Trond Hegle, Marvin Jabero, Amanda Boltwood
and spouse
6
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Clinical
Life Changing Dentistry
by Jeffrey S. Haddad DDS
Jeffrey S. Haddad DDS received his Bachelor of Arts degree in Psychology from the University of Michigan in
1997. He completed his dental education at the University of Michigan in 2001. Dr. Haddad is a fellow at the
Las Vegas Institute for Advanced Dental Studies. Dr. Haddad lectures nationally on cosmetic dentistry, TMJ
disorders, and practice marketing.
. Sometimes .we .as .dentists .get .the .opportunity .to .
truly .make .a .difference .in .our .patient’s .lives . .When .
Bob .presented .to .my .office, .I .knew .that .this .was .going .
to .be .one .of .those .times . .He .was .referred .to .me .for .
a .consultation .by .an .orthodontist .colleague .with .the .
specific .request .of .accommodating .this .patient’s .busy .
work .schedule . .Bob .was .searching .for .a .cosmetic .
solution .for .his .smile, .and .he .was .told .by .several .
other .dentists .that .he .was .not .a .veneer .candidate . . .
Therefore, .it .was .necessary .to .figure .out .the .proper .
dental .approach .that .would .give .this .patient .what . .
he .desired .
. As .can .be .seen (Figs 1 and 2), .this .50 .year .old .
patient .presented .with .an .entirely .collapsed .bite .and .
generalized .severe .wear, .
and .was .looking .for . .
options .to .improve .the .
aesthetics .of .his .smile . . .
This .case .was .very .complex, .involved .several .
different .modalities .in .
dentistry, .and .necessitated .
proper .planning .due .to . .
the .patient’s .50 .minute .
commute .and .busy .
schedule . .The .following .
article .will .explain .the .
treatment .approach, .
procedures .performed, .
and .overall .appointment .
planning .in .order .to .
efficiently .reconstruct .this .
man’s .entire .occlusion .
. Our .diagnostic .workup .
included .a .comprehensive .
8
exam, .full-mouth .series .of .
x-rays, .panoramic .x-ray, .
corrected .tomograms, .
diagnostic .photographs, .
diagnostic .impressions, .and .
neuromuscular .questionnaire . .
Despite .the .patient’s .extremely .broken .down .
dentition .and .severe .clenching .and .grinding .habits, .
he .exhibited .no .headaches, .jaw .pain, .or .any .other .
TMD .issues . .During .the .treatment .consultation, .the .
patient .was .made .aware .that .in .order .to .complete .
his .full .mouth .reconstruction .he .would .need .osseous .
crown .lengthening .on .his .maxillary .anterior .teeth, .
followed .by .extractions .of .teeth .#23-26 .and .the .
placement .of .dental .implants . .in .positions .#23 .and .
#26 . .Later, .the .implants .
would .be .restored .with .a .4 .
unit .bridge . .However, .the .
most .important .element .of .
the .diagnosis .and .treatment .
planning .was .to .locate .the .
optimal .bite .for .the .fullmouth .reconstruction .
Figure .1: . .(Top) .Pre-op Smile (Above)
Figure .2: . (Bottom) Pre-op Retracted
Determining the Bite…
where do you begin?
Due .to .the .patient’s .
extreme .overclosure, .it .
was .necessary .to .open .
his .vertical .dimension .
significantly . . .In .order .
to .predictably .build .the .
patient .to .a .comfortable .and .
asymptomatic .jaw .position, .
we .utilized .specialized .
instrumentation . .The .K7 .
Clinical
instrumentation .from .Myotronics .allowed .
us .to .establish .a .baseline .to .record .the .
location .of .his .habitual .bite .and .indicate .
where .his .new .bite .needed .to .be .according .
to .physiologic .rest .position, .proper .path .
of .closure, .and .the .EMGs .of .his .jaw .
musculature .
After .establishing .the .baseline, .a .
Myomonitor .ULF .TENS .unit .(Myotronics) .
was .used .to .pulse .his .muscles .into .a .
more .relaxed, .untorqued .position .to .
establish .the .physiologic .rest .position .of .
his .mandible . . .At .this .point, .the .proper .
Figure .3: . .Mounted Case to
path .of .closure .was .established .using .
Neuromuscular Bite
Figure .4: . .Diagnostic Wax up to
Neuromuscular Bite Front View
Figure .5: . . (Right View)
the .CMS .jaw-tracking .capabilities .of .the .K7 . .with .
simulataneous .monitoring .of .the .patient’s .EMGs . .
Once .this .jaw .position .was .determined, .this .ideal .bite .
was .registered .with .Futar .rigid .bite .material . .After .the . .
bite .registration .was .complete, .the .case .was .mounted .
to .the .new .bite .(figure 3), .and .then .a .diagnostic .fullmouth .wax .up .was .fabricated .to .the .new .mandibular .
position .(figures 4-6) with .accompanying .surgical .
stents .for .osseous .crown .lengthening .
Treatment Performed
Dr . .Steven .Wolf .performed .osseous .crown .
lengthening .on .the .maxillary .10 .anterior .teeth .in .
order .to .improve .crown .to .root .ratios .and .idealize .
gingival .contours .in .the .aesthetic .zone .(figures 7 and
8). .Surgical .stents .made .from .the .diagnostic .wax .up .
were .utilized .and .the .patient .was .allowed .to .heal .for .
8 .weeks .
. . . . . . .For .phase .1 .treatment .in .all .of .
my .full .mouth .cases, .a .mandibular .
repositioning .orthotic .(removable .or .
bonded) .is .fabricated .for .the .patient .
to .wear .for .a .minimum .of .3 .months .
(a .critical .step .to .stabilize .the .patient .
and .ensure .they .are .symptom-free .
before .moving .on .to .Phase .2 .definitive .
treatment) . . .All .treatment .performed .
in .phase .1 .is .completely .reversible . . .
The .patient .is .given .the .opportunity . .
to .either .continue .with .an .orthotic, . .
but .on .a .limited .basis, .or .move .on .to . .
a .permanent .orthodontic .or .restorative .
change .in .their .dentition . .
.
.
Figure .6: . (Left View)
. In .this .case .due .to .the .large .increase .in .vertical .
dimension .(6 .4mm), .the .patient .being .asymptomatic, .
and .the .patient’s .immediate .cosmetic .concerns, .we .
chose .to .prepare .the .upper .arch .and .place .the .patient . .
into .an .immediate .bonded .orthotic .supporting .our . .
new .idealized .bite .position . .Two .weeks .later, .
permanent .Empress .porcelain .restorations .were .
bonded .in .with .Variolink .veneer .cement .on .all .
maxillary .teeth .and .the .bite .adjusted .accordingly .while .
maintaining .this .new .vertical .and .AP .position .(figures
9 and 10) . .This .approach .also .gives .the .patient .the .
benefits .of .having .his .smile .transformed .even .though .
the .entire .case .is .not .complete . .We .are .able .to .adjust .
the .bite .accordingly .while .the .patient .enjoys .his .new .
smile .throughout .the .process . .
(figures 11 and 12).
. In .order .to .maximize .the .patient’s .appointment .
time, .and .to .allow .proper . .
continued on page 10
9
Clinical
(Left) .Figure .13 .: . . Before
Portrait
.
.
.
.
(Right)
Figure .14:
After Portrait
Figure .7 .: . . (Top) Before Crown Lengthening
Figure .8: (Bottom) After Crown Lengthening
Immediate .temporaries .were .
placed .using .the .original .
bonded .orthotic .stent . .
. . . . . .The .patient .reported .feeling .
very .comfortable .with .his .new .
bite, .with .no .discomfort .or .
difficulty .in .function .
Maintaining the bite
. . . . .Over .the .next .four .
months, .three .coronoplasty .
adjustments .(with .TENS) .
on .the .bonded .mandibular .
orthotic .were .performed, .bite .
stabilization .was .confirmed .
and .final .measurements .
.
Figure .11 .: . .
(Top)
Before
Smile
Figure .9 .: . . (Top) Maxillary Final Restorations with
of .vertical .dimension .in .
.
Figure .12: (Bottom) After Smile with
Mandibular Bonded Orthotic
both .posterior .and .anterior .
Mandibular Bonded Orthotic
Figure .10: (Bottom) Maxillary Final Restorations
areas .were .recorded . .Final .
with Mandibular Bonded Orthotic
mandibular .position .was .
registered, .and .a .new .modified .wax .up .with .a .bite .
healing .of .implants .while .his .bite .was .being .
transfer .stent .was .made .for .preparation .of .the .lower .
stabilized, .the .patient .returned .2 .weeks .later .for .the .
arch . .In .order .to .properly .manage .and .maintain .
first .occlusal .adjustment .with .TENS, .extraction .of .
the .bite, .the .lower .posterior .teeth .were .prepared .
teeth .#23-#26, .and .immediate .placement .of .dental .
(excluding .the .second .molars) . . .
implants .#23 .and .#26 .by .my .partner, .Dr . .Kurt .Doolin . .
10
Clinical
Before Smiles (right, center, left views
. . . . . . .This .maintained .a .“tripod” .to .support .the .bite .
between .second .molars .and .mandibular .anteriors . .
Digital .calipers .were .used .throughout .the .preparation .
verifying .numbers .as .the .bite .was .registered . .These .
measurements .were .also .confirmed .in .the .lab .with .the .
mounted .case . .Two .weeks .later, .the .patient .returned .
for .bonding .of .lower .arch .Empress .restorationsincluding .implant .supported .bridge .#23-#26 .with .
zirconia .abutments .Two .coronoplasty .appointments .
were .completed .post .operatively .at .2 .weeks .and .4 .
weeks . .These .adjustments .were .very .minor .due .to .the .
precise .management .of .our .proven .comfortable .bite .
prior .to .final .reconstruction .of .mandibular .teeth . .The .
K7 .instrumentation .was .used .at .this .final .adjustment .
appointment .to .ensure .that .there .was .no .increase .
in .EMGs .when .the .patient .was .in .his .new .centric .
occlusion . .Chew .cycle .recordings .were .also .made .
to .identify .and .remove .any .working .or .balancing .
interferences .during .function .
Succeeding with our goal
Proper .treatment .planning, .maximizing .
appointments, .and .utilizing .the .latest .dental .
technology .and .techniques, .not .only .results .in .a .
successful .dental .outcome, .it .minimizes .patient .time .
and .maximizes .patient .experience . .Not .only .has .this .
patient’s .occlusion .been .restored .(Figures 13, 14) page
15, .his .entire .facial .aesthetics .have .been .improved .
with .the .new .supporting .jaw .position . .By .increasing . .
After Smiles (Right, center, left views)
Before Retracted (Right, center, left)
this .patient’s .vertical .dimension .to .its .proper .
physiological .position, .we .have .also .restored .his .soft .
tissue .facial .support . .Giving .credit .to .his .new .smile, .
Bob .reported .significant .increases .in .his .confidence .
and .in .his .business . . .
. This .is .the .type .of .dentistry .that .changes .people’s .
lives . . .I .was .always .taught .that .there .are .only .three
reasons .why .people .don’t .go .to .the .dentist: .Fear, .time, .
and .money . .In .this .case, .time .was .the .biggest .concern .
for .this .patient .and .it .was .imperative .that .we .were .
as .efficient .and .precise .as .possible . .With .the .proper .
planning .and .combining .of .dental .modalities, .we .
succeeded .in .giving .this .patient .exactly .what .he .was .
looking .for .
11
Meeting
OCDS Hosts
Dinner Meeting
at Somerset Inn
September 20, 2011
Speaker, Emily A. Hay, held
everyone’s attention as she
described how “Social Media”
can improve and increase the
practice of dentistry.
Drs. Jerry Dietz Jr. and James Nowicki
Drs. Craig Spangler and Dan Briskie
New graduate, Dr. Kathryn Lucas
12
Drs. Adam Garfinkle, Erin Deal, Nisha Yusaf
Drs. Leslie Metzger and Martha Zinderman
Former editor of the Dental
Review, Dr. John Greig
Trustee Report
Celebrate MDA Successes
by Dr. Scott Meldrum
The .Michigan .Dental .Association .is .a .success .oriented, .
efficient .and .effective .organization . .They .have .done .a .
great .deal .to .satisfy .their .mission .statement .of .“helping .
member .dentists .succeed .” .Here .are .some .of .the .
accomplishments .to .celebrate:
• . .Governor .Snyder .has .expanded .the .Healthy .Kids .
Dental .Program .to .four .new .counties; .Mason, .
Oceana, .Newaygo .and .Muskegon, .with .the .hopes . .
of .expanding .it .to .all .counties .within .Michigan . . .This .
would .greatly .improve .access .to .care .for .children .on .
Medicaid .
. • . .The .MDA .has .successfully .lobbied .for .laws .which: .
. . o . . .Give .immunity .to .dentists .who .provide .care .
under .a .special .volunteer .license .(This .was .a .
House .of .Delegates .resolution)
. . o . .Prevent .genuine .expressions .of .sympathy .or .
compassion .from .being .used .as .an .admission . .
of .liability . .
. . o . .Allows .dentists .to .have .access .to .their .prescription .
writing .history .on .the .MAPS .
. • . .The .MDA .has .increased .grass .root .membership .
involvement .in .legislative .activity .through .the .hiring .
of .Lynn .Aronoff .and .the .launch .of .“Capwiz” .which .
provides .MDA .members .an .easier .way .to .become .
involved .in .legislative .advocacy .at .the .grass .roots .
level .
. . o . .Larry .DeGroat, .Bruce .Ryding, .Lynn .Aronoff .
and .I .met .with .representative .Gail .Haines .
(R-Waterford) .who .is .chairman .of .the .House .
Health .Policy .Committee .to .discuss .various .
legislative .issues .of .concern .to .the .MDA . . .Many .
meetings .with .members .and .legislators .have .taken .
place .as .well .as .fundraisers .hosted .by .dentists . .
. • . .The .MDA .plans .on .reintroducing .the .non- .
covered .services .“insurance .bullying” .legislation .
. • . .The .MDA .is .lobbying .the .Michigan .Department .of .
Community .Health .to .maintain .a .state .oral .health .
program, .headed .by .a .licensed .dentist .
. • . .The .MDA .has .administered .an .amalgam .separator .
grant .from .the .DEQ .that .has .resulted .in .515 .grants .
totaling .$155,000 .in .payments .to .Michigan .dentists . . .
The .grant .was .established .to .encourage .dentists .to .
.
.
.
.
.
.
.
.
.
install .amalgam .separators .
prior .to .the .mandatory .
December .31, .2013 .deadline .
Dr. Scott Meldrum
date .
• . .The .MDA .has .successfully .
supported .the .Detroit .District .Dental .Society .through .
their .financial .hardships .
• . .The .MDA .has .been .working .closely .with .other .
organizations, .such .as .the .Michigan .Association .
of .Endodontists, .Michigan .Society .of .Oral .and .
Maxillofacial .surgeons, .Points .of .Light, .Head .Start .
and .local .components .to .help .them .with .their .CE .
events .and .providing .an .opportunity .to .bring .
general .and .specialty .dentists .together .
• . The .MDA .Insurance .and .Financial .Groups .(IFG) .
.
glove .program .has .grown .to .11 .state .dental .
association .endorsements .and .3 .medical .association .
endorsements . . .This .has .generated .record .sales .on .
track .to .hit .over .$1 .7 .million .this .year .
• . We .have .successfully .negotiated .several .peer .review .
.
matters .helping .many .MDA .members .avoid .costly .
legal .fees .
• . .Increased .efficiencies .at .the .MDA .central .office, .
reducing .the .size .of .our .budget .with .the .guidance .of .
our .Executive .Director .Drew .Eason .
• . .On .track .to .have .the .new .MDA .headquarters .in .
Okemos .fully .paid .for .in .two .more .years .
• . .The .MDA .has .won .four .ADA .Golden .Apple .Awards .
for .two .years .in .a .row . .No .state .organization .has .
won .more .than .three .awards .in .a .year .prior .to .the .
MDA . . .
.
.
• . .Completion .of .“A .United .Voice .for .Oral .Health” .has .
made .the .MDA .a .national .leader .in .the .access .to .care .
issue .
• . .Our .public .relations .and .advertising .campaign .has .
been .emulated .by .other .state .dental .associations . . .
. . I .believe .we .are .members .of .one .of .the .strongest .
most .respected .state .dental .associations .in .the .nation . .
Members .of .our .MDA .staff .have .been .recruited .by .
outside .organizations .for .their .expertise . .Join .me .in .
celebrating .the .wonderful .successes .of .the .Michigan .
Dental .Association .
13
Guest Editorial
Talk, Look, Listen
by Eric K. Curtis, DDS
The .only .way .to .entertain .some .folks .is .to .listen .to .
them . .—Frank .McKinney .Hubbard
One .of .the .pleasures .of .being .the .father .of .a .boy .scout .
lies .in .the .opportunities .I .have .to .expand .my .social .
circles . .The .only .problem .is .that, .unlike .a .cocktail .party, .
there .is .no .bathroom .to .excuse .myself .to .when .the .
conversation .around .the .campfire .gets .dull . .The .other .
evening .I .found .myself .trapped .with .another .scout .dad, .
a .franchise .electronics .merchant .who .had .met .his .sales .
quota .and .recently .returned .from .a .company-sponsored .
trip .to .Switzerland . .He .couldn’t .stop .talking .
“We .just .got .back .from .Switzerland,” .he .announced .
glumly . .“The .soda .pop .there .was .more .expensive .than .
the .wine . .Can .you .believe .it?”
“I .can .believe .it,” .I .answered . .“I .used .to .live .in .
Switzerland .”
There .was .no .acknowledgement .at .this .point, .not .
even .an .automatic .“Really?” .He .just .went .on . .“There’s .a .
place .called .Bemburg—”
“Ballenburg,” .I .corrected .politely .
“Yeah, .Ballenburg,” .he .said .without .blinking, .“this .
museum .place .where .you .can .look .at .a .bunch .of .old .
chalets .”
“I .know .”
He .was .just .getting .warmed .up . .“And .the .food! .It’s .
nothing .but .cheese, .cheese, .cheese!”
“Like .fondue,” .I .offered .
“They .have .this .stuff .called .fondue .where .you .dip .
bread .into .melted .cheese .”
“Did .you .try .raclette?”
“—And .there’s .this .other .thing .called .raclette, .
where .you .melt .cheese .and .scrape .it .on .to .potatoes . .
Bo—ring .”
I .tried .a .positive .tack . .“I’ll .bet .the .trains .were .on .time .”
“The .one .good .thing .in .that .country .is .that .all .the .
trains .are .exactly .on .time .”
“Weren’t .the .mountains .nice?”
“We .went .to .the .Matterhorn . .Didn’t .look .like .
14
Disneyland . .You .have .to .take .a .train .to .get .there .”
. “No .cars .allowed .in .Zermatt, .huh?”
. “There’s .no .cars .allowed .in .Zermatt . .That’s .the .
town .below .the .Matterhorn . .Hard .to .get .to, .but .it .was .
worth .it . .The .only .place .in .the .whole .darn .country .
where .I .found .a .good .old .American .cheeseburger .and .
fries .”
. The .campfire .had .to .die .down .before .this .guy’s .
soliloquy .did . .I .had .been .simply .a .foil, .a .mirror .for .him .
to .talk .to .himself . .“Most .of .us .talk .more .than .we .need .
to,” .communications .consultant .and .Reagan .advisor .
Roger .Ailes .said .in .his .book .You .Are .the .Message . . . .
“Most .of .us .tell .people .more .than .they .need .to .know .” .
The .world .is .full .of .people, .as .the .saying .goes, .who .tell .
you .how .to .build .a .clock .when .all .you .asked .for .was .
the .time .of .day . .Certainly, .more .than .half .of .talking .
should .be .listening . .But .it .has .to .be .quality .listening . .
as .well . .When .we .listen .to .patients, .are .we .just .waiting .
for .them .to .finish .talking? .Do .we .sound .like .the .guy .at .
the .campfire, .bulldozing .the .conversation .through .our .
listeners’ .sensibilities?
. Former .Secretary .of .State .Madeleine .Albright .
reportedly .mounted .a .“listening .tour” .to .help .her .
decide .whether .to .run .for .president .of .the .Czech .
Republic . .We .should .be .on .a .listening .tour .every .day .
in .our .offices . .Ailes .advises .to .not .only .listen, .but .study .
the .people .you .talk .with . .Concentrate . .Watch .for .signals .
from .their .eyes, .face .and .posture . .Pull .your .mask .aside .
so .they .can .see .your .expressions .too . .Listen .for .intent .as .
well .as .content . .The .payoff .comes .with .not .only .better .
rapport .but .enhanced .understanding . .“A .good .listener .
is .not .only .popular .everywhere,” .Wilson .Mizner .said, .
“but .after .a .while .he .knows .something .”
From Inscriptions, Journal of the Arizona Dental Association,
14(10):27, April 2000. Dr. Eric Curtis is author of Hand to
Mouth: Essays on the Art of Dentistry, Quintessence, 2002.
Reprinted with permission.
Mel Reminisces
The “Fee” Thing
Have .you .ever .lost .a .patient .due .to .your .fees? . .
Say .“no” .to .that, .and .I .will .call .you .a .prevaricator .of .
the .highest .degree . . .I .am .a .firm .believer .that .there .are .
some .people .out .there .who .would .complain .if .you .
did .the .work .free .
I .had .not .been .in .practice .very .long .before .I .
experienced .an .irate .mother .of .one .of .my .patients . . .
She .insisted .on .giving .me .some .motherly .advice .
“Young .man, .you .are .not .going .to .last .long .in .this .
town .because .you .charge .too .much . . .You .think .
because .the .citizens .of .Birmingham .have .a .reputation .
of .having .above .the .average .income, .you .can .over .
charge .” .(At .that .time .a .class .II .amalgam .went .for .
$4 .00) .
I .thought .to .myself, .“Okay, .lady, .you .said .it; .but .
I’ll .convince .you .my .fees .are .very .fair . . .And .when .I’m .
through, .you .will .still .be .a .patient .of .mine .”
I .stated .in .a .calm .and .pleasant .voice, .“I .think .you .are .
being .unfair . . .Do .you .have .any .idea .what .expense .I .
went .through .to .establish .this .office? .Do .you .have .
any .idea .what .my .rent .is? .Do .you .have .any .idea .what .
the .supplies .cost? .Do .you .have .any .idea .what .my .
payroll .is .? . .Do .you .have .any .idea .what .my .utilities .
cost? . .Now .be .truthful .with .me . . .How .can .you .say .my .
fees .are .too .high .without .considering .these .facts . . .Let .
me .put .it .another .way . . .What .basis .would .you .use .to .
establish .a .fee .if .you .were .me?”
Instead .of .a .calming .effect, .she .became .more .
emotional .and .said, .“You .sound .like .Detroit .Edison .”
My .reply: .“Thanks .for .the .compliment . . .I .consider .
Edison .an .efficient, .successful .operation .”She .turned .
without .a .word, .left .and .NEVER .CAME .BACK . .
I .look .back .with .much .trepidation, .thinking .of .
what .would .happen .if .you .reduced .your .fees .every .
time .someone .complained .
The Envelope Caper
All .of .us .are .dependent .on .others .to .some .degree . . .
But .there .is .a .great .mass .of .people .who .feel .that .the .
world .owes .them .a .living .and .that .they .must .be .
catered .to .
. I .have .always .felt .that .when .I .
treated .a .patient, .I .was .obligated .
to .do .the .best .dentistry .that .my .
ability .allowed . . .When .I .extended .
credit, .they .should .be .obligated .to .
me . . .After .all, .I .was .not .a .financial .
institution . . .I .didn’t .charge .
interest; .they .should .consider .
that .fact .a .favor .and .appreciate .it . . .
Most .did . . .I .cared .for .them; .they .
cared .for .me .
. Occasionally, .there .was .that . .“you .must .do .
everything .for .me” .type . . .Hiam .Ginott, .in .his .book, .
Between .Parent .and .Child, .states, .“Where .there .is .
dependence, .there .is .hostility .” . .In .one .such .case, .I . .
can .prove .his .point .
. A .new .patient .came .to .my .office .and .I .completed .
all .the .necessary .treatments . .The .child .was .placed .on .
my .recall .list .and .a .statement .sent .at .the .end .of .the .
month .
. Payment .was .made .promptly, .but .accompanying .
the .check .was .a .curt .note .stating .”Send .return .
envelopes .with .your .statements .” . .
. I .felt .that .the .return .envelope .was .his .obligation .
(after .all .I .had .extended .him .enough .courtesy), .so .I .
ignored .the .note .
. After .the .six .month .recall .visit, .another .statement .
was .sent, .and .again .without .a .return .envelope . . .Once .
again, .a .note .came .with .the .check .stating, .“Evidently .
you .wish .to .ignore .my .request .for .return .envelopes”
I .felt .compelled .to .answer .that .one . . .So, .with .pen .in .
hand, .I .responded .
. Dear Sir:
You and I have something in common. We hate to
supply envelopes for each other. So, I have a plan whereby
you need not use an envelope of yours nor do I have to
supply one of mine. It is a very simple plan: Pay before you
leave the office. Not only will each of us save an envelope,
but also postage.
Hopefully, you will agree to this
Sincerely,
. In .this .case, .Ginott .was .correct . . .His .dependence .
on .me .created .hostility . .THEY .NEVER .CAME .BACK .
Editor’s Note: After retiring from his pediatric dentistry practice, Dr. Noonan was Executive Director of the Oakland County Dental Society from 1987
to 1997. His motto was, “Keep everyone laughing.” In 1999 he turned these stories into a book titled: “They Never Came Back: How to Lose Patients”.
With permission .we .reprint .some .of .his .stories .which .are .his .legacy .to .us . . .Dr. Melvin A. Noonan (1918-2010)
15
Classifieds
Member Focus
North . Oakland . County . Drs. Jeffrey Roeser . and . Bryan
Johnson .decided .to .test .their .endurance .and .bow .hunting .
skills . in . the . rugged . San . Juan . Mountain . Range . last .
September . . .Located .in .Colorado .(83%) .and .northern .New .
Mexico .(17%), .the .San .Juan .Mountains .top .out .at .14,309 .ft . .
and . include . some . of . the . highest . peaks . known . to . the .
Rockies . . .Both .Drs . .hiked .all .day .and .battled .tough .weather .
conditions . . .They .are .photographed .here .with .an .Elk .they .
harvested . . .
U.S.PostalOwnershipPapers2011
ExPERIEnCED DEnTAl
HYgIEnIST
Experienced .Dental .Hygienist .looking .for .work . . .
2 .- .3 .days . .Salary .negotiable . .
Call 248 376-6481 .
or .e-mail .alexaniandenise@gmail.com
The editorial staff of the “Dental
Review” met in August to plan
the next season.
Left to right: Drs. Franziska
Schoenfeld, managing editor,
David Thompson, staff, Nick
Fontana, staff, Craig Duhaime,
editor, Larry Palmer, OCDS
president, Denise Maihofer,
designer, and Brigitte Boyungs,
executive director. Not pictured,
Dr. James Wright.
16
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Dr. Katranji

Fall 2011 - Oakland County Dental Society

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