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Helping You Be a Better Dentist

ADA Institute for Diversity in Leadership seeks applicants for 2015-16 class

Class of 2014-15: The 16 members of the Institute for Diversity in Leadership 2014-15 class attended their first session Sept. 4-5 at ADA Headquarters. From left to right (front row) Drs. Robin Nguyen, Trinity, Fla.; Carliza Marcos, San Carlos, Calif.; Xochitl Anderton, Lubbock, Texas; Amanda Hemmer, Phoenixville, Pa.; Christina Meiners, San Antonio; and Zellisha Quam, Albuquerque, N.M.; (center row) Drs. Rico Short, Smyrna, Ga.; Mark Limosani, Weston, Fla.; Malieka Johnson, San Diego; and Abe Abdulwaheed, Cambridge, Mass.; (back row) Drs. Inna Piskorska, San Antonio; Kevin Bolden, Waco, Texas; Deryck Pham, Mays Landing, N.J.; Darwin Hayes, Bronx, N.Y.; Paul Hsiao, Fresno, Calif.; and Shane Murphy, Anchorage, Alaska.

Class of 2014-15: The 16 members of the Institute for Diversity in Leadership 2014-15 class attended their first session Sept. 4-5 at ADA Headquarters. From left to right (front row) Drs. Robin Nguyen, Trinity, Fla.; Carliza Marcos, San Carlos, Calif.; Xochitl Anderton, Lubbock, Texas; Amanda Hemmer, Phoenixville, Pa.; Christina Meiners, San Antonio; and Zellisha Quam, Albuquerque, N.M.; (center row) Drs. Rico Short, Smyrna, Ga.; Mark Limosani, Weston, Fla.; Malieka Johnson, San Diego; and Abe Abdulwaheed, Cambridge, Mass.; (back row) Drs. Inna Piskorska, San Antonio; Kevin Bolden, Waco, Texas; Deryck Pham, Mays Landing, N.J.; Darwin Hayes, Bronx, N.Y.; Paul Hsiao, Fresno, Calif.; and Shane Murphy, Anchorage, Alaska.

The American Dental Association Institute for Diversity in Leadership is accepting applications through April 30 for its 2015-16 class.

Dr. Amanda Hemmer, 2014-15 class member of the Institute for Diversity in Leadership

Dr. Amanda Hemmer

The Institute is designed to provide education and leadership skills to dentists who are members of racial, ethnic and/or gender groups that have been traditionally underrepresented in leadership roles within the profession and their communities.

Sixteen applicants will be selected for the program which includes attendance at three leadership training sessions conducted by faculty from Northwestern University Kellogg School of Management at ADA Headquarters in Chicago on Sept. 10-11, Dec. 7-8, and Sept. 8-9, 2016. Participants will be reimbursed for their hotel and travel expenses.

(From left) Drs. MarkLimosani, DeryckPham and Abe Abdulwaheed

(From left) Drs. MarkLimosani, DeryckPham and Abe Abdulwaheed

The Institute for Diversity in Leadership is made possible by generous support from Henry Schein Dental and Procter & Gamble.

To learn more about the Institute and how to apply, visit ADA.org/diversityinstitute or contact Leadership Team Services at IDL@ada.org or call the ADA toll-free number at ext. 2600.

When interacting with challenging patients, behavior awareness can help

As my patient pool grows, the dentistry doesn’t change much, but the person in my chair changes every day. I connect with most patients pretty well, but every now and then I am presented with a challenge. What I would call a difficult patient has nothing to do with the dentistry required in their mouth. The difficulty comes from the patient interaction. I know myself, I know the dentistry, but there is something missing in my understanding of the patient.

Dr. Carolyn Norton

Dr. Carolyn Norton

Luckily, I received some insights from one of my attendings who comes to my GPR program one day a month and who is an instructor at The Pankey Institute. He discussed with me this concept of social styles models, which is something they teach at Pankey when discussing relationships based dentistry. In addition, our discussion led me to find this TRAMCOM Group website, which further elaborates my understanding on the social styles model to dentistry.

In the 1960s Roger Reid and John Merrill created the Social Styles Model to help predict human interactions in business relationships. They identified three variables that determine a person’s social style: assertiveness, responsiveness, and versatility. Within these behavioral dimensions four social styles emerged: analytical, amiable, driving, and expressive.

Responsiveness is determined by how much you control or reveal your emotions. Assertiveness is based on where you fall in the spectrum of ask versus tell, or lead versus follow.

No one social style is better than the others, and each style has its own pros and cons. Once you get familiar with each social style, you will begin to pick up on clues that tell you which style your patient uses. Here are four unique behavioral patterns recognized in the Social Style Model, according to The TRACOM Group:

ADA New Dentist guest blogDriving style patients control their emotions and speak assertively. These people want to know the facts about their treatment. Be direct and practical regarding their problems and treatment options. They are focused on the end result and want to know you have a plan.

Amiable style patients show their emotions and prefer to ask questions than give orders. These patients are friendly and ask questions because it makes them feel more comfortable. Take the time to talk with them and get personal. It will definitely pay off.

Analytical style patients control their emotions and prefer to ask questions than give orders. They ask questions because they want to know all of the details. They want to understand each step, the cost, and maybe even the number of appointments. They appreciate precision and accuracy. Take time to develop their treatment plan to show that you care about these things too.

Expressive patients show their emotions and speak assertively. These patients will share their thoughts and feelings regarding their dental problems, but may need your direction. Let them speak, you listen, and then help them focus on their needs.

The next time you have a challenging or difficult patient, look at this social style chart and see where they belong. If you understand why a patient is behaving a certain way, then this may help you alter your social style to make the interaction successful and prevent frustration. This is where versatility comes in. Versatility is primarily the responsibility of the dentist in the patient-doctor relationship. A versatile dentist can alter their social style to make the patient more comfortable. This requires a certain level of awareness and compassion for the patients social needs, not just their dental needs.

I can easily recall patients that fit each social style. Seeing them through this lens makes me like them better as people, and I will definitely change how I interact with them at our next appointment.

 

Dr. Carolyn Norton is a New Dentist Now guest blogger and a 2014 graduate of the University of Florida College of Dentistry. She is in a 12-month general practice residency at the North Shore University Hospital in Evanston, Ill., affiliated with the University of Chicago. Dr. Norton was a contributing editor for the American Student Dental Association from 2012-14.

10 steps to Medical-Dental collaboration

Looking to work and collaborate with local physicians? Seeking to encourage members in the medical field in your community are the importance of oral health as part of the overall health?

NegotiationHere are 10 steps to help you with your outreach effort, courtesy of the ADA’s Action for Dental Health, a nationwide, community-based movement aimed at ending the dental health crisis facing America today.

  • Step 1: Contact a local physician or county medical society director to attend a meeting of the local medical society. Discuss with the medical society officers the possibility of an opportunity to present dental issues to the membership.
  • Step 2: Contact your local hospital continuing education coordinator to offer a “Grand Rounds” or “Dental 101” CE offering. An alternative is to have an introductory “Dental Issues” CME course for local physicians and chiropractors.
  • Step 3: Invite the president of the local medical society and/or hospital board president to a local dental society meeting for communication/networking opportunities.
  • Step 4: Invite the dental director and executive director of the local community health center to a dental society meeting to meet local dentists and specialists. Discuss the possibility of local dentists serving on health center committees to ensure cross collaboration between medical/dental departments.
  • Step 5: Schedule a dinner meeting with local OB-GYN physicians/staff to share information about the importance of oral health for pregnant women. Offer written materials and support to encourage their patients seek dental care during their pregnancy.
  • Step 6: Visit a local pediatrician’s or family practitioner’s office and schedule a luncheon in-service with office staff. Bring oral hygiene educational materials to reinforce the opportunities for medical staff to encourage the importance of oral health as part of overall health.
  • Step 7: Schedule a luncheon in-service with hospital Radiation/Oncology staff. Discuss the role of oral hygiene with restorative/rehabilitative needs for patients with cancer.
  • Step 8: Schedule a luncheon or dinner in-service with local periodontists and internal medicine specialists. Discuss the role of periodontal disease in maintaining optimal hemoglobin A1C levels for diabetic patients.
  • Step 9: Meet with local physician assistants/nurse practitioners to perform a “Dental 101” type continuing education meeting. Discuss dental emergencies/oral cancer and the role they can play in collaboration with the dentist in facilitating resolution of patient’s dental pain needs.
  • Step 10: Attend a hospital ER department/senior nurses’ meeting to discuss dental issues. Advise them on the role they can play in collaboration with dentists with regard to dental disease management.

To read the full 10-step process, click here. For more information about the ADA’s Action for Dental Health, visit ADA.org/action.

Tips for controlling upper back pain

As a dentist, you do many procedures that require a close visual field and fine, controlled movements of your hands for long periods of time.

Center for Professional SuccessThese procedures also require sustained postures and twisting and bending of your neck and upper back.  These postures and movements can place stress on your upper back and neck, contributing to the development of or aggravation of upper back pain.  This can impacts your well-being and the efficiency and productivity of your office.

As always, consult a physician for any persistent problem, but here are some tips for controlling upper back pain from the ADA Center for Professional Success.

  • Maintain proper posture.
  • Use magnification, such as loupes, and adequate lighting to bring your field of vision closer and decrease the extent to which your neck is held forward and flexed down.
  • Position the patient’s head at a level that gives you access to the oral cavity while being able to hold your shoulders in a relaxed, neutral position (rather than a hunched up position) and you are able to hold your elbows at about a ninety degree or less flexion.
  • When possible, use chair arms to support your upper arm or forearm when doing fine, precision work with your hands.
  • Wear properly fitting gloves.
  • Keep equipment in good working order.  Improperly maintained equipment can cause you to use unnecessary pressure and extra time when performing certain procedures.
  • Position equipment within easy reach and visibility to reduce repeated twisting of your neck or torso.
  • Take a break in between or during long or difficult cases.
  • When possible, set up your schedule to rotate long, difficult cases with short, easier cases.

Seek medical consultation for upper back pain, especially in the following instances:

  • After recent significant trauma, such as a fall, a motor vehicle accident or other such accidents.
  • When sleep is disrupted or pain is worse at night.
  • With a history of prolonged steroid use.
  • With a history of osteoporosis.
  • With a recent history of infection or a temperature over 100 degrees F.
  • Numbness or tingling in arms.
  • Severe, sudden headache.
  • Dizziness.

To read the full CPS article, which includes information on symptoms and causes, click here. The article is only available to ADA members.

Other resources on the topic include the American College of Sports Medicine, American Academy of Orthopedic Surgeons, American Physical Therapy Association.

It’s flu season: What to know about influenza prevention and control

We’re at the peak of flu season.

Since many symptoms of influenza are non-specific, it’s possible that the patient you are treating may have the flu virus without any noticeable symptoms. The spread of the flu can occur among patients, your dental team and yourself.

Cold Here are five major components that should be part of your infection control program, according to the ADA Center for Professional Success.

  • Education and training: Annual education and training around occupational exposure to potentially infectious agents and infection-control procedures is an important aspect of an infection control program. The Centers for Disease Control and Prevention has a PowerPoint available online called Guidelines for Infection Control in Dental Health-Care Settings.
  • Immunization: Annual vaccinations are a critical part of limiting exposure and deciphering from other communicable diseases. Consider covering the cost of vaccination for your team, or providing vaccinations in the office during work hours.
  • Sterilization: Proper and consistent sterilization practices of all materials in contact or in close proximity to patients are paramount. Verify that your sterilization methods and equipment meet compliance standards.
  • Exposure prevention and post-exposure management: Make sure your practice is screening symptomatic patients. Develop etiquette regarding respiratory hygiene and coughing. Placing cough etiquette reminders in the waiting area and the staff operatory can be helpful.
  • Policy on work-related illness: Encourage patients to seek preventative and curative care, and to report signs or symptoms of illness. Create a work environment that does not punish employees for illness.

Federal grant helps dental school grads provide care for underserved in Alabama

A federal grant is helping recent dental school graduates pay down their loans in exchange for treating Medicaid patients in some of the most underserved parts of Alabama, according to Action for Dental Health.

Action for Dental HealthThe program is a collaborative effort between the Alabama Dental Association and the University of Alabama School of Dentistry, which received the three-year federal grant from the Health Resources and Services Administration (HRSA) in 2013, according to Dr. Allen Conan Davis, who serves as a principal in managing the grant and is the assistant dean for community collaborations and public health at the dental school.

“The school of dentistry and the association have had a great relationship, because we’ve had a mutual interest in addressing access to care issues,” said Dr. Davis. “I think that relationship helped us secure the HRSA grant.”

A total of nine dental graduates – three each year – receive $100,000 apiece to pay down loans if they devote 30 percent of their practices to Medicaid patients and agree to stay in their communities for at least four years.

Six graduates were placed in dentally underserved areas in Alabama by the end of 2014, said Dr. Davis. Three more are expected to take part in the program this year.

To read the full story, click here.

Action for Dental Health, launched by the ADA, is a nationwide, community-based movement aimed at ending dental health crisis facing America today. To learn more, click here.

Learn how to identify drug-seeking patients in upcoming webinar

An upcoming webinar aims to educate dentists on how to interview patients with addiction problems and identify those who are just seeking drugs.

prescription drugsInterviewing and Counseling Patients with Substance Use Disorders and Drug-Seeking Patients is scheduled for Feb. 18 from 2-3 p.m. Central time. Michael O’Neil, Pharm.D., professor of pharmacy practice at South College in Knoxville, Tennessee, will lead the webinar and review basic interview and counseling skills that help optimize patient care and protect dentists from patients who may have criminal intent.

Dentists may find themselves the targets of prescription drug diversion scams and schemes and the webinar will provide tips on how to talk to patients about their intentions and counseling that will help minimize risks to the patient and dentist.

To register, contact Alison Siwek at siweka@ada.org. Registration closes Feb. 16.

Integrating checklists into your practice is key to get things right

Time outs are performed minutes before a procedure begins. In dentistry, this is commonly done before an extraction or a root canal. Do I have the right patient? Is the correct radiograph displayed? Is the necessary equipment present? Do I know which tooth? How often do we breeze through this checklist or not read it at all?

Dr. Carolyn Norton

Dr. Carolyn Norton

The Checklist Manifesto by Atul Gawande shows how checklists which identify critical steps or points of failure can make up for our own human inadequacies. Checklists don’t stop at the example above. As the volume of dental procedures I preform increases every day, I have developed my own mental checklists to make sure I’m working efficiently and producing quality dentistry. Even your morning huddle is a checklist.

In 2001, a central line placement checklist was implemented at Johns Hopkins Hospital by critical care specialist Peter Pronovost. Nurses were allowed to intervene if they saw a doctor not following the checklist. After two years of data collection, the central line infection rate went from 11 percent to zero. Dr. Pronovost found that checklists, “establish a higher standard of baseline performance, help with memory recall, and set the minimum necessary steps in a process.”

When the World Health Organization (WHO) contacted Gawande in 2006 to help create a solution to prevent death and/or harm in surgery throughout the world with no funding, Gawande went to visit a master of checklists, Daniel Boorman from the Boeing Company. Aviation heavily relies on checklists. “Only 1 in 500,000 flights ever suffers an accident of any kind.” Was your last flight delayed for 45 minutes due to maintenance? Someone was using a checklist.

Mr. Boorman says checklists must be “precise and to the point. They do not try to spell out everything — a checklist cannot fly a plane.” He suggests keeping the list between five and nine items. It should take no more than 60 to 90 seconds to run the list. “You must define a clear pause point at which the checklist is supposed to be used.” My favorite part of this book: a checklist for making checklists is provided in the appendix.

Dr. Gawande’s WHO safe surgery checklist included seven checks before anesthesia, seven checks before the first incision, and five checks before removing the patient from the operatory. The effect of their safe surgery checklist was studied in eight hospitals around the world. In every hospital, complication rates fell 36 percent and deaths fell 47 percent. Seventy eight percent of hospital staff “actually observed the checklist to have prevented an error in the operating room.” When asked if they wanted the checklist used if they were to have surgery, 93 percent of hospital staff said “yes.”

After reading Dr. Gawande’s book I see checklists all around me, and I believe they work. No one is perfect, and checklists are great tools to help even doctors to get things right. “The volume and complexity of what we know has exceeded our individual ability to deliver its benefits correctly, safely, or reliably. Knowledge has both saved us and burdened us.”

How do you use checklists in your dental practice? Share your best ideas and checklists with us below.

 

Dr. Carolyn Norton is a New Dentist Now guest blogger and a 2014 graduate of the University of Florida College of Dentistry. She is half way through a 12-month general practice residency at the North Shore University Hospital in Evanston, Ill., affiliated with the University of Chicago. Dr. Norton was a contributing editor for the American Student Dental Association from 2012-14.

 

Know anyone who has volunteered internationally?

Do you know a dentist who has generously given their time, talents and skills by volunteering internationally?

Int'l Volunteer Svc LogoApplications are due April for the Certificate for International Volunteer Service, a program that recognizes ADA members who have volunteered in developing countries to improve the oral health and overall health of individuals.

Criteria for applying for and receiving the certificate include:

  • Be an active, life, student or retired member of the American Dental Association.
  • Have served in an international location with a program sponsored by a dental school or recognized nonprofit organization for a minimum of 14 days, either in one period or in several visits, in any 24-month period.
  • Have provided clinical dental service and/or taught local dental personnel or assisted in training initiatives to improve the local oral healthcare infrastructure.
  • Supply evidence of the dates of the service with a comprehensive, detailed breakdown of activities and the value of the contribution by means of a letter or testimonial from the director of the program or other appropriate official (for student members working in a dental school program this requirement shall be the responsibility of the dean or director of the outreach program).
  • Be nominated by a component or constituent society, federal dental service or dental school.
  • Be verified in writing to be a member in good standing by the component society, if such exists, or by the constituent society, commanding officer or dean of the dental school as appropriate.

Nominations are reviewed by the ADA Board of Trustees at the June meeting. Recipients will be announced within 30 days of the meeting and the certificates will be distributed to the recipient, or to the nominating component or constituent societies upon request. A certificate may be awarded to the same individual more than once.

For more information on the Certificate for International Volunteer Service or to submit a nomination, click here.

Know the difference between accidents and signs of domestic violence?

In a year where high-profile accusations of family violence have rocked the National Football League, the ADA House of Delegates streamlined Association policy on family violence during its meetings at ADA 2014 — America’s Dental Meeting in San Antonio, according to ADA News.

An employee crying

Resolution 89H-2014, Educating Dental Professionals in Recognizing and Reporting Abuse, states that “the ADA supports educating dental professionals to recognize abuse and neglect across all age groups and reporting such incidences to the proper authorities as required by state law.” The House rescinded policies from 1993 and 1996.

“Family violence has been a hot topic in the news media as high-profile players in the NFL have been accused of violence against children or partners,” said Dr. Lynn Douglas Mouden, chief dental officer for the Centers for Medicare & Medicaid Services. “There is a universal mandate for U. S. dentists to report suspected cases of abuse or neglect of children, but dentists should also be aware that some states also mandate reporting cases that deal with adults and elders as well.”

Are you able to discern the difference between accidents and intentional injuries or signs of violence? Do you know what your state’s law in regards to reporting family violence?

If your answer is “no,” Dr. Mouden suggests attending the 7th Biennial National Conference on Health and Domestic Violence, set for March 19-21, at the Renaissance Washington, D.C. Downtown Hotel.

“With training, dentists are better able to discern the difference between accidents and intentional injuries, or between otherwise normal conditions and the signs of violence,” Dr. Mouden said. “Because laws vary from state to state, dentists should work with their state dental association to learn more about the laws regarding reporting of family violence and about opportunities to learn more about preventing family violence.”

For more details on the conference, hotel accommodations or to register, click here.