March/April 2014

TheDental ASSISTANTJournal of the American Dental Assistants Association March/April 2014Featuring: • A CE course: Proper procedure in maintaining patient dental records • How to pour accurate models • The 90th ADAA Annual Session preliminary guide

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TheDentalCover image courtesy of iStockphoto.com ASSISTANT 6 J o u r n a l o f t h e A m e r i c a n D e n t a l A s s i s t a n t s A s s oocciiaattiioonn March/April 2014 FEATURES 6 Wonderadmix Bubble Buster by Ellen Gambardella CDA, M.Ed. Guidelines and techniques for pouring accurate models. 8 Now That’s SHARP! by Senior Airman Timothy C. Conklin Criteria used by the U.S. Air Force to determine patient care success levels. 12 90th ADAA Annual Session Preliminary Guide A preview of what the 90th ADAA Annual Session in San Antonio, TX, has to offer, including ADAA events and governance, continuing education and registration information. 22 Maintaining Proper Dental Records by Wilhemina Leeuw, MS, CDA A featured CE course on background and procedures for maintaining proper charting and protecting patients’ information. 22 20 The Impact of Business Management on Health Care 12 Delivery of the Armed Forces by First Sergeant Chalawnda M. Kelley Applying business management principles to how the U.S. Army provides dental care for patients. 44 Call for Officer/Trustee Nominations and Council Member Volunteers by Pat Pearson, CDA Have you ever wanted to take part in ADAA as an Officer, Trustee, or Council or Committee member? Here’s what you need to know. DEPARTMENTS 2 Editor’s Desk 42 Association Bulletin 42 Health Beat 4 President’s Page 48 Advertiser Index 18 Student News The Journal is printed using recycled materials and is a fully recyclable product.

Editor’s Desk Michi Trota Managing Editor & Production Manager The Dental Assistant JournalSpring is finally here, and that means it’s time to start planning to attend the 90th ADAA Annual Session inSan Antonio, TX. The Journal’s Preliminary Guide has everything you’ll need to know about ADAA’s governance, eventsand continuing education schedule, as well as registration. ADAA has a great line–up of continuing education courses, andyou can also start planning your schedule for ADAA governance, special forums and events. Once again, ADAA will beheadquartering at the Westin Riverwalk Hotel. Registration opens May 1, 2014 (returning attendees may register two weeksearlier starting April 15, 2014). Don’t wait too long to register, registration fees will increase after September 5, 2014! Thelocation of this year’s Annual Session holds special meaning for me: when I joined ADAA as managing editor for the Journalin July 2008, my very first Annual Session was in San Antonio. I look forward to returning to the city and (hopefully) gettingthe chance to revist the beautiful San Antonio River Walk. After six years, I’ve gotten to know many regular attendees, andI’m excited to be able to see them again.You don’t have to wait for Annual Session to take advantage of continuing education, however! This issue of the Journalfeatures the ADAA CE course, “Maintaining Proper Dental Records,” worth two CE credits and free to ADAA full memberswho take the test online. We also have advice from Ellen Gambardella, CDA, M.Ed., on the proper technique for pouringaccurate models. The U.S. Air Force shares its metrics for determining dental care success, and the U.S. Army describes howit has integrated civilian business management practices into providing military dental care.Have you ever considered becoming an ADAA Officer or joining the Board of Trustees? Pat Pearson, CDA, talks aboutthe duties and responsibilties required of officers and trustees, and how members can become involved by joining ADAAcouncils and committees. ADAA depends on dedicated, enthusiastic members to help keep the Association moving for-ward. Take a look and consider nominating a qualified fellow member, or applying for a position yourself! ❖ DentalThe The Dental Assistant (lSSN-1088-3886) is published bimonthly (every other month). Subscriptions for members are $10 as part of dues. ASSISTANT Nonmember subscriptions: $30 in the U.S.; $40 in Canada/Mexico; $85 other foreign. Single copy price is $20. Allow 6-8 weeks for subscriptionJournal of the American Dental Assistants Association entry and change of address. Publisher is the American Dental Assistants Association, 35 East Wacker Drive, Suite 1730, Chicago, IL 60601-2211.March/April 2014 Volume 83, No. 2 Periodicals postage paid at Chicago, IL, and additional mailing offices.ADAA President Lori Paschall, CDA, CPFDA, CRFDA, FADAA POSTMASTER: Send address changes to The Dental Assistant, 35 East Wacker Drive, Suite 1730, Chicago, IL 60601-2211.Executive Director Lawrence H. Sepin Copyright 2014 by the American Dental Assistants Association. ReproductionEditorial Director Cynthia K. Bradley, CDA, CDPMA, in whole or in part without permission is prohibited. DISCLAIMER: “Authors and advertisers are solely responsible for the accuracy CPFDA, EFDA, MADAA, BA of any and all material provided to The Dental Assistant. Authors and advertisers are also solely responsible for checking that any and all material relevant to dentalEditor and care in a clinical setting meets OSAP standards. The information and opinions expressed or implied in articles and advertisements that appear in The DentalCommunications Director Douglas McDonough Assistant are strictly those of the authors and advertisers. They do not necessarily represent the opinion, position or official policies of the American Dental 312-541-1550 x203 Assistants Association.” Note: The ADAA cannot honor claims for missed copies of The Dental AssistantManaging Editor Michi Trota unless they are made within 90 days of the cover date. For example, requests for missed copies of the January/February issue must be made prior to May 31. 312-541-1550 x209 The Dental AssistantAdvertising Sales Manager Robert E. Palmer 35 East Wacker Drive, Suite 1730, Chicago, IL 60601-2211 *General inquiries 312-541-1550 x 200 fax 312-541-1496 • e-mail 815-990-8069 (cell) / 815-777-6652 (fax) [email protected] www.dentalassistant.orgDirector of Education ADAA Mission Statement& Professional Relations Jennifer K. Blake, CDA, EFDA, MADAA To advance the careers of dental assistants and to promote the dental assistingDirector of Information profession in matters of education, legislation, credentialing and professionalSystems & Meeting Planning Nancy Rodriguez activities which enhance the delivery of quality dental health care to the public.Editorial Review Board Sharon K. Dickinson, CDA, CDPMA, RDA Mary Govoni, CDA, RDH David F. Halpern, DMD, FAGD Natalie Kaweckyj, CDA, CDPMA, COA, COMSA, CPFDA, LDARF, MADAA, BA Linda Kihs, CDA, EFDA, MADAA Linda L. Miles, CSP, CMC John Molinari, PhD Rhonda R. Savage, DDSTploeaosbetagointoatchoepAy oDfAouArwWerbistietre,'swSwubwm.disesniotanlaGssuiisdtealninte.osrogr.the Editorial Calendar,2 The Dental Assistant March/April 2014 www.dentalassistant.org

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President’s PageLori Paschall CDA, CPFDA, CRFDA, FADAAPresident, 2013–2014American Dental Assistants AssociationCultivating 21st Century Workplace SkillsWhat do professional dental assistants need to know in order to succeed?Dental assistants across the country celebrated Dental As- without the dental assistant. This is also known as “Keeping Onesistants Recognition Week over the first week of March. Step Ahead of the Doctor.” Be prepared, have the same set–ups inAs celebrants honored this year’s theme, “Dental Assisting: Em- each room, direct the doctor, know when and how to ask for train-bracing the Changes of the Profession,” this is the ideal moment ing, and tell/show the doctor how your expanded functions createfor dental assistants to consider the tools we will need as our pro- more time and how this relates back to the overall production offession moves forward, even if they are tools that may not have the practice. How you are able to make a difference in the deliverybeen considered as important or relevant to the practice of dental of quality dental treatment is the difference between being a pro-assisting in the past. Workplace skills for dental assistants will re- ductive and valuable member of the dental team or not.quire more than clinical applications and we must start thinkingmore like business people than employees. Mediation—It is important to know how to handle the un- comfortable upsets that inevitably do occur. Know how to iden- Dental practices are companies and companies are in the tify the source of conflicts and resolve the expectations of thosebusiness to make money; therefore, staff must become business involved. Exercising empathy and insight can help avoid lingeringpeople who are invested in the success of the practice, rather than resentment and blame with resolutions.just employees who come to work. Successful business people areconstantly on the lookout for ways to improve their organization. Confidence—Everyone has a unique combination of skills andThey’re interested in growth, not just maintenance. Business peo- experience that makes them valuable members of the dental team.ple hone their skills and knowledge to the best of their abilities and Identify what you bring to the table and be confident in your skills.are always looking to learn. Rather than becoming comfortable in Don’t be afraid to promote yourself and what sets you apart. Profes-one way of doing things, they’re willing to make changes that will sionals take pride in their skills.benefit their company, even if those changes are daunting. Employ-ees are focused on the now, while business people look at what is People Skills—Public speaking skills are an invaluable toolworking in the present, and what changes may be needed in the for professionals in every capacity. One doesn’t need to be a pub-future. Whatever that bigger picture holds, business people know lic speaker in order to cultivate this skill—every time you speakthey must be prepared in order to succeed. with patients and answer their questions, you are effectively giving a presentation. Every time you meet with your local association Given the expectations of professional dental assistants, what and talk about a topic that matters to you, you are speaking inare the 21st century workplace skills that we need to incorporate? public. Start small and you’ll be surprised at how quickly you’ll become comfortable giving presentations. Communication Skills—How are you communicating withyourself and your team? You must be able to understand what you There are a multitude of opportunities for dental assistantswant to achieve in order to articulate yourself and your goals clear- today that were not available a few short years ago. Dental assist-ly, otherwise your message to others may not be as effective. ing professionals are employed not only as chairside assistants and business assistants, but as educators, practice management con- Be Productive—It is often said that dental assistants do not sultants, insurance representatives, sales representatives and re-produce, but in actuality the doctor and hygienist cannot produce (Continued on page 48)4 The Dental Assistant March/April 2014 www.dentalassistant.org

Together We’reHelping Health HappenSPOTLIGHT ON: GLOBAL REFLECTIONS 14DS1013 Green your practice 20 Global and help us support 14 Reflections environmental causes January 6–April 25, 2014Throughout our Global Reflections Program, we are providing See pages 30 & 31 for FREEan opportunity for our customers to incorporate “green” products into CEU Course Credit on Lead-Free Aprontheir practices. A portion of your Global Reflections purchases will bedonated to the Henry Schein Cares Foundation in support JOIN OUR COMMUNITY To Order: 1-800-372-4346 8am-9pm (et)of environmental causes. To Fax: 1-800-732-7023 24 Hours www.henryscheindental.com Look for our Global Reflections flyer or visit http://www.henryscheindental.com/GlobalReflections THINK GREEN THINK WELL THINK CURE Through pa Global Reflections a Calendar of Cariour valued customers have helped raise over $950,000 to help health happen! Thank you for your partnership!GLOBAL CORPORATE SOCIAL RESPONSIBILITY PROGRAM© 2014 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.

ClinicalEllen Gambardella CDA, M.EdEducator and Professional SpeakerADAA Speakers Directory NetworkWonderadmix Bubble BusterUtilizing a proactive solution to pouring accurate modelsPouring accurate models is crucial to the outcome of Wonderadmix by Dental Creations, Ltd.dental treatment and to the health and satisfaction ofpatients. Models are the foundation of the dental project.Inaccurate models affect all subsequent phases of the casewhich results in compromised restorative work. Pouringmeticulous models is your insurance policy for achievingwell–fitting dental appliances. Impressions are routinely sprayed with surfactants priorto pouring, but this technique may produce a hit–or–miss,uneven application which contributes to voids. Moreover, apooling of excess fluid on the surface of the impression maylead to chalky spots on the model. Sometimes this methoddoes not reach the most critical areas of the impression, suchas the detail on and around the prepared teeth. An innovative approach to addressing these issues is toreplace the manufacturer’s recommended amount of waterwith Wonderadmix. Why? Because this product distributesthe surfactant via the stone, thereby ensuring an equal distri-bution of surfactant to the entire impression, including themost critical areas on and around the prepared teeth. Won-deradmix breaks the surface tension and allows plaster orstone to glide effortlessly over the surface of the impression.Your models will exhibit a smooth, strong surface thus resis-tant to chipping and fracturing.6 The Dental Assistant March/April 2014 www.dentalassistant.org

The Wonderadmix system comes and be sure to keep the stone mov- Ellen Gambardella, CDA, M.Ed., iswith syringes containing a concentrated ing through the anatomical depres- an award–winning educator and profes-solution and an empty bottle. Simply sions from one side, through the sional speaker. In a nationwide search,dispense the Wonderadmix syringe anterior, and into the opposite side. Ms. Gambardella was selected as theliquid into the provided bottle, fill the “Most Effective Dental Assistant Educa-bottle with water, and shake before each • Once the anatomical area is filled, tor in the United States” and is the recipi-use. It’s that easy. Effective planning is es- use larger increments of stone to fill ent of the “Teacher of the Year” Award insential to the pouring process. Don the the entire impression. Massachusetts. She has lectured national-appropriate personal protective equip- ly and internationally and may be reachedment. Inspect the impression for accu- Following this step–by–step ap- at [email protected] and verify that it has been properlydisinfected. Once this has been accom- proach will enhance the quality and us- (Editor's Note: The ADAA Speakersplished, proceed to mix the stone. Directory Network may be found by go- ability of your models. So will using the ing to http://www.dentalassistant.org/ I suggest the following steps: Content/Details/SpeakersDirectory) right products. You do have a solution • Prepare Wonderadmix mixture (water plus syringe ingredients). for pouring accurate models. That solu- • Shake Wonderadmix mixture prior tion is called Wonderadmix. ❖ to each use. It’s hard to picture a member of the • Always place Wonderadmix mix- ture in the bowl first. XXXXXXXXAXDXAXAXXXXXXXXX without one. • Sift stone into the water. Personalize your new • Pause for a few seconds to let the powder collapse into the water on XXXXXXXXXAXDXAAXXXXXXXXX its own. Visa® Platinum Rewards Card. • Mix in one direction at 120 rpm • Points for purchases • Points for billed interest until creamy. • Bonus points at select merchants • Redeem for cash, travel, merchandise and more • Place the bowl on vibrator, which is set on low/medium. • Points for balance transfers • Personalized custom cards • Break air bubbles that rise to the ChohottspeC://hVwyowoiosswuaer.®cyaocoraufdfirrpdcoaifraftainclteiaXr(l.gcXAorDXomAuX/pApXroVXu/iasrXpalp®)X/atcXdoaaXdradaXtayoXtd.XayX. XXX surface. The ADAA Visa card program is operated by UMB Bank, N.A. All applications for ADAA Visa credit card accounts will be subject to UMB Bank N.A.'s approval, at • Remove mix from vibrator. its absolute discretion. Please visit www.cardpartnerpro.com for further details of terms and conditions which apply to the ADAA Visa card program. • Rest the tray handle at an angle on Pro Powered by UMB CardPartner.com. The #1 provider of custom credit card programs the platform of the vibrator. ©2011 UMB Financial Corporation. All rights reserved. UMB is a registered service mark of UMB Financial Corporation • Place a small amount of stone on the spatula and let it flow into the most distal surface of one side of the impression. • Continue adding small increments to the same area. • Rotate the impression to guide the flow of the stone around the archwww.dentalassistant.org 72014 March/April The Dental Assistant

U.S. Air ForceSenior Airman Timothy C. ConklinDental Assistant and Oral Prophylaxis Technician31st Dental Squadron, Aviano Air Base, Italy Now That’s SHARP!Criteria the U.S. Air Force uses to measure success in providing dental servicesHave you ever wondered how the Air Force Den- SrA Conklin providing oral health care to patient A1C Victoriatal Service (AFDS) measures success? Like any or- Loneman.ganization there needs to be a standard. For the AFDS ➤that standard happens to be something referred to as“SHARP–7.” I’ll explain in detail below how it works. If I am the CEO or owner of a business, how wouldI measure success? Very simply, how much profit is mybusiness making and how is the business doing in to-day’s market? That may be fine for an average business,but I think we’d all agree the AFDS is not an averagebusiness. Therefore, the AFDS measures things a littlebit differently. Our mission is to achieve oral health toensure readiness, achieve the best value and achieve ex-cellence in all we do. Therefore we use a system called“SHARP–7” metrics as the performance measurementtool for evaluating the success of the AFDS mission.The “SHARP–7” metrics system is broken down intoseven different categories, each having a very importantrole. Let’s take a closer look at each metric. In the business world, an owner’s biggest concernis how much profit they are making. However, one ofthe AFDS’s biggest concerns is safety, which brings8 The Dental Assistant March/April 2014 www.dentalassistant.org

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us to the first “S” in “SHARP–7” Have you ever called a dental at every base so sometimes it is nec-metrics: Patient Safety. This metric clinic and had to wait a month or essary to send one of our active dutywill track the number of near–miss maybe even longer to get an ap- patient’s off–base to be treated by areports in relationship in the Air pointment? The AFDS tracks how civilian specialist. By tracking theForce Medical Service (AFMS) Pa- many days each of our patients wait cost of sending patients to privatetient Safety Reporting (PSR) tool. before receiving an appointment. sector care, the AFDS can calculateThe PSR is broken down into three This brings us to the next category if it would be more cost–effective todifferent definitions: of the “SHARP–7” metric: Access to add a specialist to the military instal- Care. Upon notification by a patient, lation’s clinic. • near–miss—aneventoccurred,but the AFDS goal is to provide the ap- In summary, both Air Force and did not reach or harm a patient pointment within 21 days. civilian clinics measure success, but it may be in slightly different ways. • no harm—an event occurred Our next “SHARP–7” metric is The Air Force’s focus is always mis- and did reach the patient but no Dental Readiness. Airmen need to be sion first and to make sure our pa- harm was evident ready to deploy on a moment’s no- tients are always ready to “Fly, Fight tice. The AFDS goal is to have at least and Win!” • harm—an irreversible event and 95 percent of active duty personnel ❖ harm was done to the patient ready to deploy at all times and en- sure with utmost certainty that there Senior Airman Timothy C. The PSR is a tool used to report would be no dental complications Conklin is a dental assistant and anall safety events that occur at a clinic. for the duration of their deployment. oral prophylaxis technician assigned Maintaining members in this catego- to the 31st Dental Squadron at Avi- Most customer–oriented busi- ry is no small task. ano Air Base, Italy. He is from Cleve-nesses spend a lot of time researching land, OH, and joined the Air Forcetheir customer’s satisfaction. After all The next category of the in 2008. SrA Conklin is currently en-the time and effort that was put into “SHARP–7” metric is: Performance. rolled at the University of Maryland.making sure your patients received In the Air Force, we provide no–cost He enjoys volunteering at variousthe best dental treatment, it would dental care to our beneficiaries. How- base events over the weekends, includ-be nice to know what they thought ever, despite the fact that our patients ing Airman Against Drunk Drivingabout their treatment. With patient are not receiving a bill, we still need to and the Wounded Warrior Project.satisfaction reporting, the provider keep track of how much we produce. SrA Conklin also enjoys competingcan receive feedback. This information helps determine if in intramural sports teams that boost Air Force clinics are staffed appropri- morale for his squadron. This brings us to the second cat- ately and if personnel are working toegory of the “SHARP–7” metric: Pa- the full extent of their capacity.tient Satisfaction. To measure satisfac-tion, an automated survey is sent to The final category of theevery patient. The goal for this metric “SHARP–7” metric is: Private Sectoris greater or equal to 94 percent pa- Referral Management. Just like in ci-tient satisfaction. vilian dentistry, a patient may require specialty care such as an oral surgeon The next category of the for a complicated extraction or an“SHARP–7” metrics is: Oral Health. endodonist to finish up a root canal.This metric measures the patients In the AFDS, it works the same way.who do not need any dental treat- The AFDS does not have a specialistment for the next 12 months. TheAFDS’s goal is 65 percent or higherof the total active duty members.10 The Dental Assistant March/April 2014 www.dentalassistant.org

What’s inside The CDC strongly recommends single-useyour metal disposable instruments whenever possible.*syringe tip? ® Unlike other leading brands, FlashTips®’ inner tube doesn’t dislodge under pressure. Lock indicatorfor a secure fit, every time. Now, help prevent cross contamination in seconds… with FlashTips®! Your metal tip’s tiny chamber could be home to a nasty buildup from blood, saliva, dental materials and tip corrosion. Over time, that buildup gets harder and harder to properly clean and sterilize. Don’t take the risk anymore! FlashTips® are the fast, easy answer… for you, your practice and your patients. For more info visit www.flashtips.net* Source: CDC Guidelines MWR Dec 19 2003. Guidelines for Infection Control in Dental Healthcare Settings – 2003. sultanhealthcare.com

Welcome to the 90th ADAA Annual SessionSan Antonio, Texas October 9–October 13, 2014The ADAA Annual Session, held in conjunction with ADA 2014 taking place at the Henry B. GonzalezConvention Center in San Antonio, TX, is the perfect time to enhance your education, make your voice heard byattending ADAA governance, network within the dental industry, or renew friendships and acquaintances. A full program isavailable for attendees from Thursday, October 9, to Sunday, October 13.Registration to the general public begins May 1, 2014. Previous year attendees will receive an e–mailwith the registration link allowing them to pre–register beginning April 15, 2014. Attendees register just once,through the ADA 2014 registration system at ADA.org/meeting. You can then choose from among more than 300educational courses, many geared toward dental assistants and the entire dental team. (See page 14 and pages 16–17for dental assisting course descriptions.)Take part in shaping the future of ADAA by attending ADAA governance. Please note that delegates to the ADAA Houseof Delegates must be registered for ADA 2014 in order to be credentialed. ADAA members who are registered but are notcredentialed as delegates may attend any ADAA Forums or Council meetings or may be seated in the guest section of theHouse of Delegates.The ADA Exhibit Hall offers the opportunity to explore the latest products and services while networking with distributorsand manufacturers from over 550 exhibiting companies.You will also have the opportunity to attend the ADA Opening ADA Exhibit HallGeneral Session on Thursday, October 9, featuring 2014 Henry B. Gonzalez Convention CenterDistinguished Speaker President George W. Bush. Advanced Thursday, October 9: 10:30am–6:30pmregistration is required as there is limited seating available.Make yourself at home in San Antonio. The Alamo Friday, October 10: 8am–5:30pm Saturday, October 11: 9:30am–3pmand the River Walk are must–see city attractions, but alsotake a stroll off the beaten path to experience fantastic res- All photos provided courtesy of the San Antonio Convention & Visitors Bureautaurants and local shops in thriving neighborhoods such asPearl and Southtown.12 The Dental Assistant March/April 2014 www.dentalassistant.org

IMPORTANT DATESThursday, October 9 9:30–10:30am Convocation & Awards Ceremony 1:30–2:30pmADA Opening General Session ADAA members who have achieved Fellowship or MastershipDistinguished Speaker and others receiving awards will be recognized.New Delegate Orientation 6pm–7pm Second House of Delegates 2:45–4pm Open to ADAA members only.Pre–Session Board ofTrustees Meeting 5–9pm Installation of Officers Immediately following the Second HOD, the new 2014–2015Friday, October 10 ADAA Officers will be installed.District Caucus & Credentialing 8:30–9:45am Dental Assistant’s Reception 5:30–7pmADAA Keynote Speaker & ADAA welcomes all dental assistants to thisFirst House of Delegates 10:00am–12:00pm reception celebrating their contributions to theThis is the legislative and policy–making body of the ADAA. practice of dentistry.The HOD shall transact all business of the ADAA as stated Ticketed event: $40. This event sponsored inin the Bylaws, and shall elect the general officers. Open to part by a grant fromADAA members and invited guests only.Meet the Candidates Sunday, October 12 Council on Education 7:30–8:30amImmediately following the First HOD, take an opportunity to meetfellow members running for office.Open Hearing: Post–Session Board of Trustees Meeting 8:45–11amAmerican Dental Association (ADA) The ADAAF Silent Auction will take place Friday, October 10Commission on Dental Accreditation— through Saturday, October 11 (details forthcoming).Dental Therapy 1:30–2:30pm Unless otherwise noted, all ADAA governance and events will take place at ADAA headquarters hotel.Reference Committees:Bylaws, Budget & Resolutions 2:45–4:15pm Stay tuned to future issues of the Journal for more informa- tion about continuing education, governance and more.Participate in discussion about issues presented to the HOD. This schedule is subject to change. For the most current infor-ADAA/DANB Forum 4:30–6:00pm mation, check the ADAA webiste: www.dentalassistant.org.This is a forum to provide all interested parties with currentinformation regarding ADAA and DANB’s activities and col-laborations related to the education and credentialing ofdental assistants.Saturday, October 11 7–8:00amDistrict Caucuses Balloting 8:15–9:15am ADAA will headquarter at: The Westin Riverwalk HotelDelegates elect officers and trustees according to balloting pro-cedures as stated in the Bylaws. Open to delegates ONLY— 420 W Market St, San Antonio, TX 78205credential cards and badges are required to ballot. (210) 224–6500Leadership Forum 10am–12pm www.westinriverwalksanantonio.comLearn how to utilize new ideas and innovations for growth, ➤developing leaders within your organization and enhancingyour own leadership skills.www.dentalassistant.org 132014 March/April The Dental Assistant

PLAN YOUR EDUCATIONA ticket is required for ALL ADAA continuing education courses, even if thecourse is “no fee.” Please plan ahead and register for courses today! Ticketsmay be obtained through advance registration online at ADA.org/meeting,or on–site up until the day before the scheduled course (based on availability).Early registration and ticket purchase is recommended, as seats are limited.CE course and event tickets are available on a first–come, first–served basis.Tickets for fee courses, Education in the Round and workshops guaranteeyour seat for the duration of the course. Tickets for no–fee courses hold yourseat until the published start time of the course.All courses will be held at the Henry B. Gonzalez Convention Center(unless otherwise noted). The facility name and room number will be printedon each course ticket. Please make sure to have your tickets for continuingeducation courses with you.Dental Assistant Roundtable Learning, Course Code: 5189 Speaker: Jen Blake, CDA, EFDA, MADAA CE Hours: 3.0Thu., Oct. 9 11:30am–2:30pm After 9/5: $70 Dental AssistantsBy 9/5: $50 Dental Assistants Back by popular demand, this course provides an opportunity to have fun, share ideas with other dental assistants in a small group set-ting, and introduce you to new products and techniques. Leave energized with fresh ideas for your practice and lots of product samples.Each session covers different topics. Sponsored in part by the ADAA FoundationAfter this course, you will be able to: 1. Share ideas to enhance patient care with other dental assistants 2. Choose new products and techniques available for your practice 3. Recognize the role dental assistants play in quality oral health careAlso presented: Thu., Oct. 9, 3:30–6:30pm, Course Code: 5184 Make the Most of Your Image, Course Code: 5210 Speakers: Edwin Parks, DMD, MS and Gail Williamson, MS, RDHThu., Oct. 9 11:30am–2:30pm CE Hours: 3.0By 9/5: $215 Dentist/ $215 Student/ $165 Team After 9/5: $235 Dentist/ $235 Student/ $185 TeamThis course, recommended for all dental professionals—especially hygienists and assistants—is designed to help participants improvetheir technical skills, troubleshooting abilities, methods to reduce patient exposure, and intraoral and panoramic images.After this course, you will be able to: 1. Apply radiation exposure reduction methods to achieve ALARA 2. Utilize optimal techniques to produce high–quality intraoral and panoramic images 3. Identify and correct common intraoral and panoramic image errorsAnatomy of a Winning Team:A Recipe for Success, Course Code 5340 Speaker: Lois BantaThurs., Oct. 9 3–5:30pm CE Hours: 2.5 No FeeThis course is designed to identify team challenges in attitudes and work performance and offer concrete, positive solutions to re–moti-vating and re–energizing one and all. Learn to identify the symptoms of an unhappy practice and underappreciated team and doctor.After this course, you will be able to: 1. Create contagious positive attitudes 2. Simplify systems and protocols for team development 3. Create leaders within the team ➤14 The Dental Assistant March/April 2014 www.dentalassistant.org

Enrich your career.Choose ADA 2014 for dental assisting education. Share ideas with other dental assistants in a small group setting, try new products and techniques, and have fun during the Dental Assistant Roundtable Learning courses led by Jen Blake. You can also select from hundreds of CE offerings for assistants, including a dental assisting track covering topics as diverse as Nutrition, Cariology and Caries Management, Geriatric Dentistry, Business, Technology and more. Registration opens May 1 at ADA.org/meeting.

PLAN YOUR EDUCATIONYour Role in Ensuring the Safest Dental Visit, Course Code: 6331 Speaker: Fiona Collins, BDS, MBA, MAFri., Oct. 10 8:30–11am CE Hours: 2.5 No FeeInfection control breaches, while rare, do occur in dental office settings. This course will provide breach prevention tips, including howto follow CDC guidelines, meet OSHA requirements, and develop a culture of safety that contributes to an effective infection controlenvironment. Sponsored in part by OSAPAfter this course, you will be able to: 1. Identify and describe infection control breaches 2. Understand the major elements of a culture of safety 3. Implement key procedures in infection controlNutrition Update for 2014, Course Code: 6362 Speaker: Warren Karp, PhD, DMDFri., Oct. 10 8:30–11am CE Hours: 2.5 No FeeThis course will focus on translating scientific nutrition principles into practical diet and nutrition recommendations for patients. Learnhow to implement sound and effective recommendations and evaluate their success rates. The role of popular nutrition in society willalso be discussed.After this course, you will be able to: 1. Translate dietary and nutritional guidelines into everyday language that patients can understand 2. Review applied dietary guidelines from major U.S. health organizations 3. Differentiate between healthy foods and health foods Caries Risk Assessment for Allied Dental Professionals,Course Code: 6335 Speaker: Connie Kracher, PhD, MSDFri., Oct. 10 1–3:30pm CE Hours: 2.5 No FeeCaries risk assessment helps identify patients susceptible to biologic, lifestyle and behavioral factors that can influence the probabilityof developing caries. This course will present the most current information for allied dental professionals. Sponsored in part by theADAA FoundationAfter this course, you will be able to: 1. Understand and explain the risk assessment process 2. Learn the risk factors associated with dental caries 3. Teach your patients how to better help you with this processBambi vs. Godzilla:How to Deal With Difficult People, Course Code: 6378 Speaker: Bruce ChristopherFri., Oct. 10 1pm–3:30pm CE Hours: 2.5 No Fee Difficult people are everywhere. They can be patients, staff and fellow clinicians. This course humorously reveals the six difficult personal-ity styles that can drain you and your practice of vital energy. Learn what they do, why they do it, what you can do about it, and how tostay empowered.After this course, you will be able to: 1. Better understand why people behave the way they do 2. Discover how to not react to reactive people 3. Increase your ability to deal with difficult personality typesWork Would Be Great if It Weren’t for the PeopleCourse Code: 7374 Speaker: Mary Govoni, CDA, MBA, RDA, RDHSat., Oct. 11 8–9:30am CE Hours: 1.5 No FeeDifficult people (not just patients) are a part of life and cannot be avoided, no matter how hard we try. This course allows you to take asometimes serious, sometimes humorous look at the issues that doctors and dental team members face on a daily basis.After this course, you will be able to: 1. Appreciate differences in the ways men and women communicate 2. Recognize toxic behaviors and know how to diffuse them 3. Differentiate between leadership and management skills16 The Dental Assistant March/April 2014 www.dentalassistant.org

PLAN YOUR EDUCATIONPeriodontal Risk Assessment for Allied Dental Professionals,Course Code: 7397 Speaker: Connie Kracher, PhD, MSDSat., Oct. 11 8–9:30 am CE Hours: 1.5 No FeePeriodontal risk assessment helps identify patients susceptible to biologic, lifestyle and behavioral factors that can influence the probabilityof developing periodontal disease. This course will present the most current information for allied dental professionals. Sponsored in partby the ADAA FoundationAfter this course, you will be able to: 1. Understand and explain the risk assessment process 2. Learn the risk factors associated with periodontal disease 3. Teach your patients how to better help you with this processCAD/CAM Proficiency, Course Code: 7368 Speakers: Angelia White CE Hours: 2.5 Sat., Oct. 11 1–3:30pm No FeeThis course will take an in–depth look at a successful, efficient CAD/CAM appointment from start to finish. Understand the value ofmotivation and proficiency, and learn key tips that can be applied to any CAD/CAM practice. This course will be fun, relatable and moti-vational. Sponsored in part by Ivoclar Vivadent, Patterson Dental and SironaAfter this course, you will be able to: 1. Effectively prepare for an efficient CAD/CAM appointment 2. Apply a systematic approach to CAD/CAM dentistry 3. Implement successful tips applicable to any CAD/CAM practiceOral Health Issues for Baby Boomers and Beyond,Course Code: 8340 Speakers: Annette Wolfe, RDH, BSSun., Oct. 12 8:30–11am CE Hours: 2.5 No FeeOlder adults make up one of the fastest growing segments of the world population. No matter our age, we want to feel young and retainfully functional teeth. This course will cover prevalent oral conditions and concerns affecting older patients. Sponsored in part by ColgateAfter this course, you will be able to: 1. Identify physiologic changes in the aging dentition related to oral and dental diseases 2. Better prevent and manage erosion, caries and dentin hypersensitivity 3. Understand the relationship between oral inflammation and systemic conditionsCourse Handouts: To minimize paper waste, traditional course handout materials will be available online beginning Tuesday,September 9 (not all courses will have handouts). These materials will not be printed for distribution on–site. If you wish to have thesematerials to reference during the course, please be sure to download them in advance. Visit ADA.org/meeting for details.REGISTER TODAYOfficial registration opens May 1, 2014! 2013 attendees will be able to register beginning April 15,2014, two weeks earlier than the general public! ADA will handle all registration for ADAA members, students andother dental assistants through ADA.org/meeting. Book your hotel room, choose your CE courses, order special events tickets andmore! Hurry, fees increase after September 5, 2014, 5pm, CDT. Advance registrants receive their ADA 2014 badge and ticketsprior to the meeting, which means no waiting in registration lines!The dental assistants’ registration fee of only $50 ($100 after September 5, 2014) includes ADA 2014 registration, ADAA AnnualSession registration (for ADAA members only), and access to the ADA Exhibit Hall and education courses not requiring an additional fee.Be sure to reserve your seat for the Opening General Session featuring President George W. Bush when you register. Dental assistingstudents can register free of charge.You can also access the lowest room rates in San Antonio at ADA hotels during official annual meeting dates. For a complete list of ADAhotels in San Antonio, go to ADA.org/meeting. Dental assistant registrants are welcome to register for tours and events offered byADA for an additional fee.Questions? Call Experient at (800) 974–2925 (toll–free U.S.) or (847) 996–5876www.dentalassistant.org 172014 March/April The Dental Assistant

Student News Marina Cooke, CDA Student Trustee, 2013–2014 American Dental Assistants AssociationAs CDAs, we are multifaceted members of the I urge my fellow student members and seasoned pro-dental team who must not only work closely with fessionals alike to embrace their positions as assistantsthe dentist and care for our patients directly but with the knowledge that it is not only the front officemust also perform many business administrative manager’s job to perform business administrative tasks.tasks. We do this through the type of care and recall we As assistants, our patients often confide in us and expectprovide through periodic medical history updates, rec- that we will provide them with the answers that theyognizing the signs and symptoms that our patient may seek when they are curious or worrisome. It is up to usexhibit in our care, dental charting, treatment planning how we utilize this time to help them to develop con-and patient scheduling. In this regard, the dental assis- cise treatment plans, deliver well–informed diagnostictant who is able to perform these duties and maintain a assistance to our dentists, and care for our patients inhigh level of patient satisfaction and recall in doing so is the best way that we possibly can.one of a practice’s greatest assets. Continually educating ourselves on proper adminis- As business administrators and representatives of trative tasks is a vital part of being an effective memberboth our profession and practice, it is of the upmost of the dental team. Please do be sure to take advantageimportance that we possess and strive to exhibit great of the continuing education course offered to full ADAAcustomer service delivered with compassion while members in this issue of the Journal: “Maintaining Prop-maintaining efficient computer software and telephone er Dental Records” (page 22). This course is worth twoskills with a broad understanding of the technicalities (2) CE credits and is free if you take the test online.surrounding dental insurance and billing. This seemslike a tall order but when we maintain a strong work- A well–versed assistant who can perform their du-ing knowledge of practice procedures and a high level ties with confidence and a smile is the person your pa-of education, these tasks simply become easy to deliver tient wants to return to. In order to do that effectively,and truly are the epitome of our standard of care. we must be constantly prepared and allow ourselves the opportunity to participate fully in both our duties During our daily professional lives as assistants, and the care of our patients. Lastly, we must realize thatour knowledge of dental terminology is of utmost although we are individual members of a dental team,importance when notating charts and in working we have the potential to be so much more if we alwaysdirectly with a dentist because it provides us with continue to be mindful of the needs of both our practicemore accurate chart history to look back upon. It also and our patients.gives us the opportunity to perform our job more ef-ficiently through a more detailed understanding of ❖the diagnostics and procedures we assist on a dailybasis. Further, possessing good communication skillsand interpersonal skills with both our coworkers andpatients are needed to work with patients who maybe nervous, have special needs or medical issues, andwith dentists during stressful conditions.18 The Dental Assistant March/April 2014 www.dentalassistant.org

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U.S. ArmyFirst Sergeant Chalawnda M. KelleySenior Enlisted Noncommissioned OfficerFort Bliss Dental Activity (DENTAC), El Paso, TX The Impact of Business Management on Health Care Delivery of the Armed ForcesBusiness management models have a positive impact on military dental care What separates the military profession from dental clinics are aligned with their medical counterparts.other professions in American society is that mili- Hence, as the tri–service dental organizations of the MHStary leaders must be prepared to engage in deadly began the strategic transition to providing a “system offorce to accomplish the Armed Forces’ primary health,” it became apparent that improved business man-mission—to fight and win our nation’s wars. The de- agement practices were necessary. Two of the businesscisions made by senior military leaders have the potential management models that have positively impacted mili-to result in grave consequences that directly impact service tary dental communities are: the successful establishmentmembers and their families. Initially, one may view mili- of and transition to the Defense Health Agency, and thetary dental professionals and civilian dental professionals utilization of balance scorecards to measure performance.as polar opposites with two intrinsically different roles inour communities; however, upon closer examination, one Established in October 2013, the Defense Healthwould realize that military and civilian dental profession- Agency (DHA) manages the business activities of theals share the same goal of strengthening the overall health MHS to achieve medical and dental readiness, improveof our nation by improving the oral health of our number overall health, enhance the patient experience of care, andone stakeholder: our patient. reduce healthcare costs (Defense Health Agency, 2013). The shift to DHA has provided the platform for merging Providing cost–efficient patient care without sacrific- the different Armed Forces delivering global health careing quality is another commonality shared among mili- while lowering costs of clinical operations.tary and civilian providers. Historically, those dentistswho were able to adopt the best business management In order to effectively accomplish the business activi-policies resulted in profitable dental clinics capable of pro- ties previously mentioned, military leaders are requiredviding state–of–the–art dental care and applying creative to understand and execute budget analysis, financialfinancial practices to meet budget constraints. The same oversight, and management controls at all levels of lead-concept applies to the military dental system. ership. Consequently, the successful, seamless transition from Tricare Management Activity (TMA) to the DHA In an effort to maximize financial resources within the at various military installations worldwide was a result ofMilitary Health System (MHS), Army, Navy, and Air Force focused financial management combined with joint mili-20 The Dental Assistant March/April 2014 www.dentalassistant.org

tary efforts to combat the rising costs AbouttheBalancedScorecard/ First Sergeant Chalawnda serves asof health care. tabid/55/Default.aspx the Senior Enlisted NoncommissionedThe other business management Officer for the Fort Bliss Dental Activ-tool used by military dental organi- Defense Health Agency. (2013). ity (DENTAC) located in El Paso, TX.zations is the balance scorecard. By Defense Health Agency. Retrieved She is responsible for the health, welfare,definition, a balance scorecard is a from DHA: http://www.tricare.mil/ professional development, training andmanagement system that provides tma/SiteMap.aspx safety of 233 military and civilian per-strategic planning to support business sonnel. The Fort Bliss DENTAC has anactivities with the vision and strategy Views expressed in the articles are operating budget of $8.1M and providesof the organization, and improves in- those of the author and do not neces- oral health care to over 34,000 activeternal and external communications sarily represent the established policy duty soldiers and coordinates mobiliza-by measuring performance against of the Department of Defense, the De- tion and demobilization of over 14,000strategic goals (Balance Scorecard partment of the Army, the Army Medi- Army National Guard and Army Re-Institute, 2014). Balance scorecards cal Department, or the United States serve Components in support of ongoinghave been exceptionally beneficial in Army Dental Command. contingency operations worldwide.military dental organizations becausethey provide “dashboards” of per-formance measures that are used tovalidate government funding as wellas personnel evaluations. Addition-ally, balance scorecards provide seniormilitary leaders with a framework toactively identify ways to improve dailyoperations and a means to measurethe improvements.Whether managing a civilian ormilitary dental clinic, understanding Paying too much for your prescriptions?and applying the right business man-agement model for your organiza- As a member of American Dental Assistants Association you aretion is vital to its overall success. The automatically eligible for a FREE prescription discount card.management tools mentioned in thisarticle are only two among thousands • Save an average of 22% on prescriptions not coveredof models that are effectively executed by insurance for conditions such as heart disease,throughout the military health system weight loss, and smoking cessation.and in the civilian sector. What one • All commonly prescribed medications are covered.also has to bear in mind is that suc- • Accepted by 9 out of 10 pharmacies nationwide.cessful business management requires • Save on uninsured visits to MinuteClinic®, whichflexibility and the ability to be adaptive are in select CVS/pharmacy locations.in an ever–changing world. • Savings for the whole family – even your pets. ❖ Visit http://adaa.rxsavingsplus.com to print your card and get started saving TODAY!Works Cited Balance Scorecard Institute. (2014,March 03). Balance Scorecard In-stitute. Retrieved from https://bal-ancedscorecard.org/Resources/ Operated by CVS Caremark.www.dentalassistant.org 212014 March/April The Dental Assistant

View this course on your mobile phone or tablet.Maintaining Proper Dental RecordsWilhemina Leeuw, MS, CDAClinical Assistant Professor of Dental EducationIndiana University Purdue University, Fort Wayne This course presents guidelines for proper patient record–keeping, documentation and protecting patient information.Maintaining complete and accurate patient records is a Important records are valuable to the operation of the office.sign of quality care and an integral part of our duty to care Examples of these documents will include accounting informa-for the patient. Living in a highly litigious society, all health care tion, inventory records and federal regulatory paperwork. Theseprofessionals face the very real risk of being the target of a mal- documents must be kept for five to seven years.practice claim. As such, the dental profession must implementprocesses to minimize the risk of such actions. A properly docu- Useful records are harder to define as each office may decidemented record is the best defense against malpractice litigation, differently on what is and is not important. Examples of theseand every member of the dental team is equally responsible for may include employment application, petty cash receipts andrecording pertinent facts about a patient’s visit on the chart and bank reconciliations. When an office considers a document to beprotecting vital patient information. This course provides dental useful, it is usually stored for one to three years.health care professionals with the necessary background and pro-cedures for proper charting and protection. Unimportant paperwork will consist of outdated memos, an- nouncements and meeting reminders. Common sense dictates Although this course presents guidelines to minimize legal when these items should be disposed of.risks, it is for guidance purposes only and is not intended to belegal in nature. Legal counsel should be sought any time a practice The need to maintain good dental recordsdecides to change and/or implement new forms, record–keeping A dental record is a combination of any written, oral, diag-procedures or privacy safeguards. An attorney will be able to in-form and advise on the specific laws, rules and regulations that nostic artifact or other transmission of information that identifiespertain to specific states and in specific situations. the patient and relates to his or her health care. Components of the patient record may include the patient chart, radiographs andCategories of records dental casts, and certain documentation required by law. There are many different types of records in the dental office. The primary goal of keeping good dental records is to main-How a record is stored and used depends on its type. Generally, re- tain continuity of care. Diligent and complete documentation andcords canbecategorizedas vital,important,usefulandunimportant. standardized charting procedures are essential. The patient record documents all patient visits and the treatment that occurred, in- Vital records are essential documents that cannot be replaced cluding examinations, diagnoses, treatment options, correspon-and are therefore highly protected. The patient record falls within dence and chosen treatment courses with financial arrangements.this category along with the office deed and mortgage paperwork. The record documents treatment history and offers a basic mea-These documents should be maintained in fireproof cabinets for surement for evaluating the quality of care provided.utmost safety. If the office has electronic records, these must bebacked up often for document safety and integrity. In addition, the record provides a means of communication between the treating dentist and any other health care provider called upon to contribute to the care of a patient. Keeping ad-22 The Dental Assistant March/April 2014 www.dentalassistant.org

COURSE OBJECTIVESUpon completion of this course, the dental professional should be able to:✓✓ Understand the importance of and the reasons for properly documenting and maintaining patient records.✓✓ Differentiate between types of data that should be included or excluded from the complete record.✓✓ Explain ownership of the physical dental records, radiographs and information found in patient charts.✓✓ Avoid potential charting errors by learning to use objective and legible entries to properly document perti- nent patient information.✓✓ Enumerate important criteria when recording treatment procedures.✓✓ Demonstrate how to properly revise an incorrect entry.✓✓ Explain the difference between a correction and an alteration of an entry in the patient chart.✓✓ Understand contributory actions and their necessary documentation.✓✓ Discuss the risks involved if documentation is inaccurate.✓✓ Gain a better understanding of dental malpractice, Standard of Care and the importance of communicat- ing with patients.✓✓ Suggest ways to improve record documentation in the practice setting.✓✓ Understand the HIPAA privacy and security rules.equate records entails charting enough in- can be reasonably expected from a dental pro- used by attorneys and judges involved in aformation to allow another provider—even fessional. Referred to as Standard of Care, this malpractice case, leading to a negative im-one who has no prior knowledge of or ex- legal duty requires the dentist to exercise the pact during the investigation phase.perience with the patient—to know the pa- degree of skill and care that would be exhibitedtient’s total dental history while in that prac- by other prudent dentists faced with the same Ownership of the dental recordtice. Clinical entries are often too abridged patient–care situation. Dental associations and The dentist owns the physical record(s)and abbreviated to cover the clinical treat- state dental boards promulgate standards andment properly. Dentistry as a culture has recommendations that typically determine pertaining to the patient and is the legalhistorically erred towards brevity, which is the Standard of Care. When considered in a guardian of the chart and records. In theoften turned against the office in legal mat- broad sense, errors may be actions of commis- situation where a dentist is an employeeters concerning neglect. sion, oversight or completion, and any one of of a group practice, ownership usually lies these can be brought into question when ex- with the practice. The ownership in this Thepatientrecordwillbeusedsupplemen- amining Standard of Care as a legal duty. case depends on the contract negotiatedtally as verification. Third–party carriers may between the individual dentist and therequest information concerning treatment to The Health Insurance Portability and practice. Ultimately, the state’s dental lawsdetermine adequate, eligible services before Accountability Act (HIPAA) of 1996 re- dictate dental record ownership.making payment. The Internal Revenue Ser- quires all dental offices as “covered entities”vice (IRS) may use it in an audit to verify treat- to maintain the security and privacy of all Patients do not have the right to pos-ment services. A forensic odontologist may patient records and electronic transactions. sess their original record, but the patientneed vital documentation or radiographs to Civil and criminal penalties can be charged does have the right to see, review, inspect,identify something otherwise unrecognizable. to any person or dental office that does not request and obtain a copy of their record follow the law. Each dental office must give a components. Dental professionals are ad- Also, because dental records are consid- copy of their privacy practices to each patient vised to become familiar with the laws ofered legal documents, each component will and in return, the patient or guardian signs a their particular states governing patienthelp protect the interests of the dental team receipt to be kept in the patient record to ac- record ownership. Upon request, a patientand/or the patient by establishing the details knowledge that they have received it. must be able to gain access to their recordsof the care that was rendered. In malpractice within a reasonable time frame.cases, an expert witness usually helps the Finally, poorly maintained records con-court decide if a dentist did or did not per- vey a poor overall impression. A practice fail- When asked by the patient, or patient’sform in accordance with the accepted norms, ing at basic record keeping suggests addition- guardian, to copy any portion of the pa-guidelines and degrees of competence that al problems office–wide. This factor could be tient dental record, offices may charge a reasonable fee for the labor, supplies, ➤www.dentalassistant.org 232014 March/April The Dental Assistant

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and postage incurred. The dental office is The form used must be valid, signed and The registration formto refer to applicable state laws, as this fee on hand before any information is released This form will contain the patient’s fullis often defined within the state’s privacy to the patient, the patient’s representativelaws. A practice cannot refuse to release any or another provider. Verify the signature on name and demographic information asportion of a patient’s record because of an the form with the one on file (either on the well as their employment and insuranceoutstanding financial account, especially if Medical History Form or the Patient Reg- information. Omissions on this form cananother dentist is requesting the informa- istration Form). Document on the original complicate account collections and impedetion or the patient is transferring to another record the date as well, as where and to the ability of expected patient communica-practice for care. At all cost, any interrup- whom the copies were sent. tions and recare. This form contains vital in-tion in patient care should be avoided. formation such as a social security number If mailing the records, they should be and must be protected. Radiographs are a vital part of a patient’s delivered via certified mail so a return re-clinical record, and only a licensed dentist ceipt can be obtained. This can be added to This form will need to be reviewed andcan interpret them. When radiographs are the patient record to provide proof of deliv- updated whenever the patient changes resi-obtained, the patient is paying for the inter- ery and that the record was delivered safely dence, obtains new contact phone num-pretation of the radiograph(s) and not the to the destination. Members of the dental bers, changes employment or their currentactual film itself. Therefore, in most states team should never send anything out of the employer changes their insurance carrier.dentists typically maintain ownership of office without the dentist’s knowledge and Figure 1 (opposite page) is an example of apatient radiographs. (Consult the state’s approval no matter how formal the request. registration form.laws to verify ownership regulations). Acknowledgement of HIPAA practicesHowever, patients have the right to obtain Components of the clinical recordcopies of their radiographs. Some offices maintain a personal in- All patients, or their legal representa- tive, must sign a form verifying their receipt Original records are never to be re- formation sheet, or “tickler file.” This file of the office’s HIPAA practices. This formleased, including radiographs, to any par- contains bits of conversational information is required as part of the HIPAA Act andty. No matter how formal a request for the about the patient’s interests, latest trips or must be kept in the patient’s records for sixoriginals may seem, only copies should hobbies, but such information should be years. This written policy must inform thebe sent. The one exception to this rule is kept to a minimum. The vast majority of patient that the office will not disclose PHISubpoena Ducus Tecum, which requires the information in dental documentation for any purposes other than treatment,that the dentist or representative present should be clinical in nature. diagnosis and billing. Figures 2 (page 28)original records to a court of law. In such and 3 (page 29) are examples of a HIPAAan event, copies of the original records Financial information should not be statement and a form to acknowledge themust be kept in the dental office. kept in the clinical chart. Ledger cards, insur- receipt of the HIPAA statement. ance benefit breakdowns, insurance claims, The Medical/Health History Form Due to the confidential nature of the and payment vouchers are not part of thedental record, permission must be received patient’s clinical record and should not be in- The Medical History Form is of primarybefore sending any patient information. Un- cluded in or on the front cover of the clinical importance. This form provides necessaryder HIPAA, this refers to an “acknowledg- chart. Financial information must be record- information that will aid the dental teamment” or “authorization” form. A HIPAA ed, tracked and kept with the other accounts in providing safe and quality care. Failureregulation that went into effect in 2013 will receivable for the office. on the part of the office to update a Medi-further regulate the restrictions of patient cal History Form or obtain proper medi-treatment information that has been paid in Thepaperworkoftherecordsmustbekept cal information from a patient constitutesfull by the patient out–of–pocket. A general in a file folder. The outside cover of the chart malpractice. Because this history may takerelease form to authorize the release of the should only display the patient’s name and/ exra time to complete for a new patient, thispatient record will include basic elements: or the account number. Because the patient form can be mailed to the patient before the chart contains confidential information, nota- appointment so they can take time to com- • Patient name and identification tions of medical conditions, treatment plan or plete it accurately. They should be asked to • Identity and address of the owning correspondence should not be written on the arrive approximately 10 minutes early to outside folder where others can see. All medi- complete the new patient record forms. office cal notations belong inside the record and, • A description of the information be- if the record is electronic, computer screens With patient diversity increasing, it may must be directed for authorized personnel be necessary to provide a health history in a ing released only to see. If the chart must be flagged, use different language. The University of Pacific • Basic statement that details release of an abstract system (such as color– or sym- Dental School in California and MetLife bol–coding) so that only the dental health- Dental has free downloadable forms in 39 the information care workers know its relevance. • Patient signature to verify release26 The Dental Assistant March/April 2014 www.dentalassistant.org

languages. These are available at: http:// Figure 1: Registration Form (Courtesy Patterson Office Supplies, Champaign, IL. Fromwww/dental/pacific.edu/Professional_ Finkbeiner BL, Finkbeiner CA: Practice Management for the Dental Team, ed 7, StServices_and_Resources/Dental_Prac- Louis, MO, 2011, Elsevier.)tice_Documents.html. oral habits and patient reactions to treatment, is given by competent adults when they Medical history questions are included to including anesthesia methods. Along with an are given sufficient knowledge (in under-help the dental team professionals evaluate oral history, dental offices are also beginning to standable terms) about a specific proce-the patient’s health and identify possible treat- use an intraoral camera to document the con- dure, including the benefits, risks (if any)ment risks (see Figure 4, page 32). A patient’s dition of the oral cavity at the patient’s first ap- and expected outcomes. The informedmedical history contains essential informa- pointment. The name(s) of previous dentists consent process also involves allowingtion for protecting the patient and the treating should be noted if the patient offers them. the patient to ask questions about recom-dentist. The dentist should review and discuss Once this baseline Dental History Form is mended treatments and available treat-the information on the completed form with completed, the patient should sign the form. ment options. For patients who are minorsthe patient to ensure that the information was This form should never be altered and should or mentally compromised, an adult guard-understood and the responses complete. be kept in the clinical notes as a reference to ian must sign on their behalf. previous treatments. Clinical situations when written con- All questions must be answered and The Informed Consent Form sent is required include:the form must be signed by the patient orthe patient’s guardian. Dentists must either Before beginning any dental treatment, • use of general anesthesia;sign or initial the form to show that they it is prudent to obtain a signed Informedreviewed it with the patient at every visit. It Consent Form from the patient. Figure 5 • new drugs being prescribed;has been recommended that a new Medical (page 33) shows an example of a TreatmentHistory Form be completed approximately Plan Estimate that aids in the informed con- • experimental treatments or clinicalevery three years. Each form must have an sent process. It is especially recommended testing;identifier on it (either the patient’s name or for treatment that requires the use of anes-account number). If there are no changes, a thesia, is risky or invasive. Informed consent • minors being treated in a publicnotation is made to that effect. program; It is the dentist’s responsibility to discern • treatment that is expected to lastapplicable new medications for treatment more than one year.and the assessment of using an anesthesia ➤that contains epinephrine. There have beennumerous cases of malpractice where thepatient was prescribed a medication thatwas clearly contraindicated by the patient’scurrent medical condition. A complete listof medications must be obtained at eachvisit and questions as to reason of use needto be discussed. It is difficult to know everymedication and the reason it is being pre-scribed. If the dental team has questions,they should not hesitate to contact the pa-tient’s physician for answers.The Dental History Form Dental offices often make an error inchoosing not to complete a Dental HistoryForm (see Figure 4, page 32) for each new pa-tient. As dental records are not required tobe transferred between dentists, each dentistshouldobtainadentalhistoryfromthepatient.This document should include informationoffered by the patient about current fears andconcerns, as well as any recalled previous res-torations, extractions, orthodontic treatment,www.dentalassistant.org 272014 March/April The Dental Assistant

Figure 2: HIPAA Statement (Courtesy Patterson Office Supplies, Champaign, IL. From dental professionals can understand. This isFinkbeiner BL, Finkbeiner CA: Practice Management for the Dental Team, ed 7, St Louis, important to show consistency should theMO, 2011, Elsevier.) records come into question, or when they have been transferred to a new dentist of Consent for treatment can also be given Clinical progress notes record. (See Figure 6, page 36)verbally. For example, when a patient makes This portion of the record offers a his- Additional components ofan appointment for an examination and the patient recordprophylaxis, the consent to treatment is im- torical account of all treatment services.plied. This type of consent is very popular Basic charting procedures are employed to Depending on the office preferences,in dentistry but is not as reliable in a court document diagnostic, preventive and re- additional forms may be included in theof law as an Informed Consent Form. storative treatment. Entries should include patient record. detailed information such as: preoperative Informed Refusal Forms should be vital signs, the procedure performed on the • periodontal screening—used for adultobtained when a patient refuses a recom- tooth/teeth numbers and surfaces, type patients who are showing signs ofmended treatment plan or necessary com- and amount of anesthesia, dental materi- gingiva and bone recessionponent of treatment (for example, refusal of als used and how the patient tolerated thediagnostic radiographs that are necessary to procedure. Additional entries can include • treatmentplan—usedtoexplainandpri-provide an acceptable Standard of Care). It details of telephone conversations, missed oritize work that needs to be completedshould also be noted if any educational bro- appointments and home care instructions.chures or materials are given to the patient. More details about these entries are dis- • signature on file—allows the officeThis informed refusal must be documented cussed later in the course. to submit information for insuranceas it protects the office against the allegation claim processing; having this formof not fully disclosing the consequences of This information is always managed on file eliminates the need for therefusing or receiving treatment. The pa- in a chronological format beginning with patient to sign every form for the pa-tient’s reason for refusal should be docu- the first date of service to the latest contact tient or familymented on the signed form. made with the patient. These entries must use dental terminolgy and references that • correspondence log—used to docu- ment any written or oral correspon- dence with that patient, or treatment that concerns that patient As patients receive comprehensive den- tal treatment according to the Standard of Care, peripheral components also become a part of the complete patient record. These components include the previously men- tioned, and purposefully separate financial records, all of the patient’s radiographs, in- traoral and extra–oral photographs, and any study models created for patient treatment. When a patient remains with the prac- tice for several years, radiographs will accu- mulate. All radiographs are documentations of growth and treatment and they must be maintained. As space in the clinical chart may become limited, the office may keep these ra- diographs in a separate location in the office. These will often be filed by name or num- bered and cross–referenced for easy retrieval. Study models may also be created for a variety of purposes and should also be kept as part of the record. As these larger compo- nents will not fit into a standard clinical chart, they are boxed and kept in a separate office location and cross–referenced by number or alpha order for easy retrieval. As they are cre- ated, the models are labeled with the patient’s28 The Dental Assistant March/April 2014 www.dentalassistant.org

name and date. Reference should be made inthe chart as to the location of any models.Steps in documentation Figure 3: Receipt of the HIPAA statement (Courtesy Patterson Office Supplies, Cham- The patient chart is a legal representation paign, IL. From Finkbeiner BL, Finkbeiner CA: Practice Management for the Dental Team, ed 7, St Louis, MO, 2011, Elsevier.)of dental services. Information noted mustbe accurate, comprehensive, concise and The following information should always other diagnostics used; for example, studycurrent. During routine appointments, data be recorded with any patient contact. Many casts, pulp test findings and photographs.entered includes all conditions present and offices use abbreviations when making en-dental treatment provided. Dental SOAP tries. This is a common practice but should Examination—Provide a complete ac-notesarewrittentoimprovecommunication not ultimately decrease the quality or neces- count of the oral cavity and document theamong the entire team treating the patient sary amount of information to make a com- findings. “Oral exam” is not descriptiveby standardizing evaluation entries made in plete sequence of events. The following de- enough as most dentists examine more thanthe dental charts. Each letter in “SOAP” is a tailed list of information should be included just the teeth. The charting should specifyspecific heading in the notes: in each clinical entry: the tongue, lips, cheeks, palate and other soft tissues examined with the findings detailed. S—refers to subjective, the purpose of Date—This entry is always started with Include oral cancer screenings and periodon-the patient’s dental visit. This is not meant the full date in a month/day/year format of tal probings, noting tooth mobility patternsfor subjective statements from the dental each patient visit. and any abnormal conditions present. This isteam member. This section includes the de- the “O” of the SOAP documentation.scription of symptoms in the patient’s own Reason for the visit—Document the chiefwords including: pain, what triggers the dental complaint, as well as any other con- Document all diagnoses and discover-discomfort, what causes the discomfort to cerns of the patient or guardian. This is the ies stated by the dentist. All positive anddisappear, and the duration of symptoms. “S” of the SOAP documentation. Listening negative results of treatment found duringThis patient history will help when writing to the patient is part of the Standard of Care; the examination must be noted. This is thethe objective statement. documenting these discussions supports the “A” of the SOAP documentation. delivery of quality dental care. O—refers to objective, unbiased observa- Treatment rendered—According to thetions by the dental team. Included under this Radiographs and other diagnostic tools— steps already done, a treatment plan willheading would be things that can actually be felt, Describe all radiographs taken. Include all be created. This plan will be discussed ➤heard, measured, seen, smelled and touched. A—refers to assessment, the diagnosisof the patient’s condition done by the den-tist. The diagnosis may be clear or there maybe several diagnostic possibilities. P—refers to the plan or proposed treat-ment, and is decided upon by the patientand the dentist. The plan may include radio-graphs, medications prescribed, dental pro-cedures, patient referral to specialists andpatient follow–up care instructions. A SOAP notation is usually not as de-tailed as a progress report and the usage ofabbreviations is standard. Abbreviationswill vary slightly from one practice to an-other, so it is important to use notationscommonly used within the practice. Every-one within the practice should use the sameabbreviations for continuity. Including detailed information in theclinical chart whenever patient contact ismade ensures the dental team provides thebest care possible and reduces questionsconcerning the treatment provided.www.dentalassistant.org 292014 March/April The Dental Assistant

with the patient. This is the “P” of the inform, and document any possible side likely accept some of the responsibility forSOAP notes. effects to show that the patient was made an unsatisfactory treatment outcome. aware of any ill effects. As procedures are completed, each step Other important documentationshould be dissected as much as possible Laboratory Reports—Always keep cop- There is much debate among attorneysduring documentation. When a tooth is ies of the instructions given to the dentalrestored, simply noting “#3 MOD” is in- laboratory concerning the fabrication of and dentists regarding who should makesufficient. Include details on whether an- patient appliances. This information will the entries in the dental record compo-esthetic was used (include the type, quan- be used as reference to know chosen tooth nents. Each member of the dental team istity in number of carpules and applicable shades and special instructions. responsible for portions of the documenta-epinephrine ratio). If nitrous oxide was tion. The business assistant will documentadministered, note the concentration and Results—Document when patients are telephone calls; prescription changes; andduration of administration, including the satisfied or happy with a certain outcome. canceled, changed and failed appointments.patient’s reaction. Note the type of restor- Conversely, document if the patient is dis- The clinical assistant and/or hygienist willative material used, including the type of satisfied with the treatment rendered, and enter the patient’s comments, concerns,base, liner or varnish if used and noting a note any steps taken to alleviate patient con- and disposition; vital signs; medical his-shade if a tooth colored material was used. cerns or discomfort. tory notations; exposed radiographs and other diagnostic tools used; details of treat- Document how the patient tolerated Referral—Simply noting a patient was ment performed; instructions given to thethe procedure and describe any other inci- “referred out” is insufficient. Instead, ref- patient; and any other notes relevant to thedents that were pertinent to the procedure. erence the consulting specialist by name patient’s time in the dental chair. All entriesTo illustrate an extraction appointment, and cite the reason for the referral. Usually, must be initialed and/or signed by the re-simply noting “Tooth #17 Ext.” is insuffi- when a general dentist refers a patient to a sponsible dental team member. Charting ofcient. Notations should include applicable specialist, the referring dentist is not held the actual treatment rendered is ultimatelyinformation such as ease of extraction accountable for any negligence on the part the responsibility of the dentist.(regular, dento–disection, surgical), gingi- of the specialist, provided the referrer hasval tissue flap required, bone recontouring no control over and provides no direction When dentists decide not to make theiron buccal or lingual, kind and number of on the mode of treatment used by the spe- own entries, they should dictated what is tosutures placed and whether there is need cialist. Follow–up with the specialist, and be written. Regardless of whether the entryfor removal. Always include notation on include all reports from consulting special- is dictated or not and which dental teambleeding and coagulation. ists in the patient chart. member composed the entry, the dentist must review the contents of all entries for Instructions—Outline any instructions Telephone calls—As a general rule, never accuracy and then sign and/or initial them.given to the patient. Preoperative instruc- talk to patients over the phone without firsttions may include what the patient is to do accessing their applicable record component Documenting in the clinical recordprior to a particular dental appointment, so conversations can be immediately docu- The dental health care professionalsuch as refraining from eating six to eight mented. Use quotation marks (“ ”) as muchhours prior to a surgical procedure in which as possible when making a documentation of must always think before making a perma-general anesthesia will be used. Never an actual conversation and enter the name of nent entry in a patient’s financial or clinicaloverestimate the ability of the patient to thepersonbeingquoted.Alwaysgivepatients record, especially if the documentation isunderstand instructions, no matter how the opportunity to talk to or see the dentist; complex in nature. All hand–written en-simple they may seem. Instructions are to never dismiss their concerns. To maintain tries should be made in permanent, prefer-be delivered verbally and in writing, and confidentiality, the patient, or legal guardian ably black ink. Preliminary notes may bedocumented in the chart. If a pamphlet is of the patient, must be addressed directly and written on a separate sheet and arrangedprovided, note it in the chart as supportive always hold telephone conversations out of for organization, then transcribed into theto home care instructions. Even simple di- earshot of other patients. proper record component. The separaterections on brushing and flossing should be sheet must then be destroyed according tocited, as should any instructions for a phone Recare/Recall—Document when and HIPAA regulations if it contains obviousfollow–up or a recare visit. why the patient is returning for treatment. If patient identified information. It is best to the patient fails to return for regularly sched- document while the patient is still in the Prescriptions—Always document the uled prophylaxis or continuing treatment as office, because as time passes, memory offull name of the drug prescribed, dosage instructed, it must be noted in their chart. the treatment or conversation may be for-amount, strength, duration, administration In the event of a claim against the dentist, gotten. A dental record is the single mostand number of refills, if any. If a prescription evidence of patient’s non–compliance may important source of evidence in a liabilityis called in, this information must be en- be labeled as “contributory negligence” by claim. Most attorneys contend that if ➤tered in the patient’s clinical chart. Discuss, a court. This establishes that the patient has contributed to the alleged injuries and must30 The Dental Assistant March/April 2014 www.dentalassistant.org

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Figure 4: Medical/Health History Form (Courtesy Patterson Office Supplies, Champaign, • Write the correct entry on the nextIL. From Finkbeiner BL, Finkbeiner CA: Practice Management for the Dental Team, ed 7, available line in the chart.St Louis, MO, 2011, Elsevier.) ❒❒ Maintain the current spacing in the chart for legibility and uniformity.an occurrence is not cited in the chart, it to provide continuity of care. Accurate and ❒❒ The new entry must be dated andnever happened, and juries are not inclined legible records discourage litigation. Illeg- initialed.to trust the memories of the dental team. ible and incomplete entries can compro- mise the defense of the dentist. Consistency The important factor in making a change As noted previously in the SOAP notes, is also very important. If abbreviations are is that the original entry can still be read. Anall entries from the dental team must remain used they must be standard or universal. entry should never be obliterated. Markersobjective in nature. Only enter what hap- Otherwise, charted abbreviations are open or correction fluid should never be used inpened and do not include subjective infor- to interpretation by attorneys and the defi- any part of an entry.mation or opinions. Limit all comments to nitions they suggest may not be in the bestnecessary information about the patient’s interest of the dental practice. A correction becomes an alterationtreatment, and avoid making unnecessary when the author, in hindsight, makes a cor-negative comments. The patient can request When a mistake is realized, it becomes rection to try to enhance or add to the origi-copies of their complete record at any time necessary to make a correction to an entry nal entry to his or her own benefit. An alter-and, should the record appear in a court in the patient clinical chart. When handled ation of any component of the record alsocase, disparaging remarks could alienate the properly, corrections do not compromise the may be defined as damaging, destroying,judge or jury. For example, do not write, integrity of the patient record. The following concealing, or obscuring a record, whether“Patient seemed angry.” A better choice of steps are to be followed in a correction: knowingly; willfully; or neither. The dentalwords would be, “Patient said, ‘I am tired of team must avoid leaving empty lines be-dealing with this sensitive tooth’.” • A single line is drawn through the in- tween entries; it may be too tempting to correct entry with an ink pen. add something at a later date that could be Part of the legal duty to the patient is ❒❒ Date and initials of the team mem- construed as an alteration. The team mustto maintain a neat, legible patient record ber(s) are included for verification. also avoid squeezing in words or phrases which may invite suspicion and damage credibility, even if done without malice. If an addition needs to be entered at a later date, the entry should be made as others are chronologically entered and then referred to the date of the visit in question. If a court suspects an alteration of the record, expert document examiners may be called upon to study the entries. These professionals can discern if an entry was made at a later date, even if the same author and pen was used. They look at factors such as the dryness of the ink (which identifies entries that were made at different times), the pressure used while writing, differences in surfaces where the entry was written and the slant and speed of writing. Dental records and the computer Computers are now an integral part of most dental offices. When utilized properly, computerized dental record software in a window or tabbed–typed format can aid in efficiency. Record components can be print- ed accurately and efficiently to aid in patient education and obtaining proper consent. Issues of chart space for all paper docu- mentsand radiographscan be resolved with32 The Dental Assistant March/April 2014 www.dentalassistant.org

digital, computerized documents. Easily Figure 5: Treatment Plan Estimate (Courtesy Patterson Office Supplies, Champaign, IL.stored within the office computer, the need From Finkbeiner BL, Finkbeiner CA: Practice Management for the Dental Team, ed 7, Stfor separate storage space and cross refer- Louis, MO, 2011, Elsevier.)encing is not an issue. Transfer and copyingto and from other dental professionals is creation of scans, microfilms or microfiches dental team is responsible for the quality ofalso streamlined. from paper records. If a practice opts to em- the patient relationship. Cases have been re- ploy a company to properly and legally dis- ported in which patients decided not to file a According to the American Dental As- pose of old, inactive charts, these companies claim against the dentist simply because theysociation, dental offices that rely on com- should furnish a “Certificate of Destruction.” liked a staff member or felt that the dentalputers and “paperless” dental records must team was polite. Patients do not expect theirperform daily backups of system data. It is Dental malpractice dentists to be perfect, but they do expectimportant to employ a reliable backup sys- All practitioners are open to the possibil- them to show compassion and honesty rath-tem for all patient records. Automated elec- er than indifference. Most medical and dentaltronic backup of information can be used to ity of claims that question the quality of their malpractice claims arise from an unfavorableprotect information every day and the of- work. Dental malpractice is the common interaction with the dentist and not necessar-fice/dentist will receive automatic alerts ev- term used to describe professional negligence ily from a poor treatment outcome.ery time the process is completed. It is best involving a dentist. Positive and effective pa-if data and application backups can be at tient communication is the key to reducing As reported in RDH Magazine, the ADAoffsite locations, protected from fire, flood, the risk of malpractice claims and a vital tool questioned several major malpractice carri-and violent impact. Additionally, HIPAA for preventing errors. Dental professionals ers concerning frequent areas of complaint.security requirements include provisions must not guarantee results or make promises The number one record–keeping error theyconcerning backup. about treatment outcome. identified was the absence of a treatment plan, and the number two error was a fail- Electronic communications for patient– Also, patients tend not to file claims ure to update medical history forms. Ancare purposes must meet HIPAA standards. against people they like, so developing a good interesting fact, also included, was that oneConfidentiality remains a primary concern, relationship with patients may actually help of the top reasons that malpractice cases ➤and certain steps must be taken to ensure protect against litigation. Everyone on thethat patient information is neither sharednor accessible to unauthorized parties. Also,the authenticity of the original record mustbe maintained with electronic transmis-sions. The dental office must make surethat their dental software package providesconfidentiality and the ability to retain theintegrity of the original records. When selecting a computerized chart-ing program, the inability to change entriesat a later date must be considered. Once anentry is made, the only way to change thatentry should be to amend it in the form ofan addition;it shouldnotbepossibletoalterexisting entries once they’ve been entered.Retention of records Regardless of any particular state’s lawsregarding record retention, it is recom-mended that all dental records, includingradiographs, be kept indefinitely. If space isa concern, consider alternative methods ofstorage. Old, inactive record componentscan be committed to microfilm or micro-fiche or scanned into electronic documents.Some companies specialize in record re-tention; they can help with storage or thewww.dentalassistant.org 332014 March/April The Dental Assistant

are lost by a practice is that someone in the ity provision is meant to guarantee that an countability Act, familiarize team memberspractice went back and altered the chart—a employee can still receive health insurance with its rules, and be certain that all staffserious error in judgment because this can coverage should they change jobs. The ac- members know how it is implemented inbe detected by professional analysts. countability section states who is respon- their practice setting. sible for specific healthcare activities. If any team member is notified that they HIPAA complianceare involved in a lawsuit, they must imme- This act was designed to improve por- Regardless of whether an office is “pa-diately inform the dentist. The patient must tability and continuity of health insurancenot be contacted in any way. The patient re- coverage in both group and individual mar- per only,” the office must comply withcord must not be altered no matter what. If kets; to combat waste, fraud, and abuse in both HIPAA’s Privacy Rule and its Secu-anything is remembered that a staff member health insurance and health care delivery; rity Rule. If a billing service is used thatbelieves would be important to add, an ad- to promote the use of medical saving ac- converts the paper forms to electronic ver-dendum can be created on a separate sheet counts; to improve access to long–term sions for processing, the dentist must haveof paper. Again, copies of any record com- care services and coverage; and to simplify an agreement with that service to protectponent must never be sent to anyone with- the administration of health insurance. the patient health information. A signedout first informing the dentist and verifying Participating Provider Agreement must bethat there is a signed Release of Information Administrative simplification was cre- obtained with an insurance company thatform in the chart. The dentist must be aware ated to make the business practices behind must be HIPAA–compliant. Penalties forof all copies of the patient records that are the healthcare easier by the development of noncompliance may range from monetarytransferred or sent out, regardless of the rea- standards for transaction code sets, privacy fines to jail time.son. Documentation of conversations with of PHI, and national provider identifiers.attorneys and/ or the malpractice insurer HIPAA intent Due to the confidentiality of medical in-should be maintained in a file separate from formation and the dentist–patient relation-the clinical chart, as should any lawsuit cor- The intent of HIPAA is to protect patient ship, all requests for medical consultationrespondence or letters from attorneys and/ privacy and provide security of health records information on patients should be madeor the malpractice insurance company. without impeding patient care. It was not in- in writing, with the patient’s signature au- tended to discourage smaller dental practices thorizing the release of the information. In Itisimportanttobeawarethatifamalprac- from utilizing electronic transactions. some cases, the release form may be sent totice suit is filed, members of the team other the physician with the patient or throughthan the dentist may also be named. Although Because violation penalties can be signifi- the mail. In other cases, to save time, themost malpractice policies carried by the den- cant, dental offices must understand how to form may be sent by facsimile (fax) and re-tist have limited coverage of team members, protecttheprivacyandsecurityofPHI.Dental turned in this manner.it is imperative for all clinical team members team members should also familiarize them-to carry individual liability coverage. selves with state privacy regulations. Federal The electronic transmission of PHI is HIPAA privacy and security regulations usu- covered by HIPAA and the dental practice The statute of limitations for filing a lawsuit ally preempt state law, unless state laws require must have a one–time consent form signedvaries from state to state. Each dental practice greaterpatient protection than HIPAA. by the patient for the transmission of thisshould know the limitations enforced in their information, in addition to the release thatstate. Generally, plaintiffs must file within five The implementation of HIPAA has been must be signed for the physician to releaseyears of the last date of service or within three an opportunity for many entrepreneurs to information to the dental practice. Whenyears of the date of discovery. As a point of ref- present the dental office with costly con- sharing patient information between dentalerence, it takes approximately seven years to sultations and forms for compliance. The and medical professionals, it is best to adoptsettle a claim. (See Editor’s Note page 38.) purchase of these services and materials is a “minimum necessary” policy. This meansHIPAA not necessary to comply with HIPAA. The that only the information pertinent and American Dental Association has a compact necessary for patient treatment should be The rules and regulations of the federal and reasonable publication designed to en- shared and secondary information shouldHealth Insurance Portability and Account- sure compliance. The ADA’s HIPAA Priva- remain confidential.ability Act (HIPAA) apply to health care cy and Security Kits can be ordered from theproviders (including dentists) who submit American Dental Association (http://www. Standard transactionsclaims electronically to health plans, and ada.org/productguide/p/1070/Practice- Standard electronic transactions cov-to health care clearinghouses for which the Management/HIPAA-Privacy-Documen- ered by HIPAA include:U.S. Department of Health and Human tation-Kit-for-Healthcare-Providers) or byServices has established a standard. telephone at 1–312–440–2500. • claims or equivalent encounters; As stated in the title, it focuses on por- As the best way to ensure compliance, • claim attachments;tability and accountability. The portabil- every U.S. dental office should have a copy of the Health Insurance Portability and Ac- • claim status inquiries; • eligibility inquiries; ➤34 The Dental Assistant March/April 2014 www.dentalassistant.org

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Figure 6: Clinical Progress Notes (Courtesy Patterson Office Supplies, Champaign, IL. From Finkbeiner BL, that, on behalf of the office, performs or assistsFinkbeiner CA: Practice Management for the Dental Team, ed 7, St Louis, MO, 2011, Elsevier.) in the performance of a function or activity in- volving the use or disclosure of PHI. • payment or remittance advice; • protectpatientprivacybyadheringtothe • coordinationorexplanationofbenefits; “minimum necessary” rule when using HIPAA considers a BA to be any third • first report of injury for Worker’s and disclosing patient information; party that a health care provider shares PHI with so that the associates may complete Compensation; • trainstaffinprivacypolicyandpractices; the services for which they have been hired. • enrollment or disenrollment in a • enter into business associate agree- Further, any role of a third party with ac- cess to PHI must be clearly documented. health plan; and ments, if necessary (see below); and In 2013, a HIPAA regulation went into ef- • notice of premium payment. • implement the necessary physical and fect that further regulates any entity that is considered a BA to the dental office. ThePrivacy rule compliance technical safeguards to protect patient following are not considered to be Business In order to be HIPAA–compliant, den- information. Associates: a member of the staff such as an Patient clinical records are often pulled employed dental associate, assistant, recep-tal offices must: from the filing cabinet or retrieved from the tionist or hygienist; the U.S. Postal Service; • adopt a written privacy policy; computer database and reviewed before the or a janitorial service. • designate a Privacy Officer; patient arrives. These files should be protect- • designate a Privacy Contact person ed from the view of other patients as they Examples of a BA include: (often the same person who serves as move through the office. This information • dental/medical labs Privacy Officer); must be displayed only where authorized • attorney • develop the required forms (the personnel have viewing access. Computer • accountant American Dental Association and monitors should never be directed toward • billing service other sources offer these materials); the patient’s view in the treatment room or • answering service • display the office’s Notice of Privacy the business office areas. • computer support staff Practices; The daily schedule should not be on dis- • provide copies of the Notice of Pri- play in the treatment area nor should it be left Security Rule compliance vacy Practices to patients; up on the screen. Just as with the patient’s re- The HIPAA Security Rule defines • make a “good faith” effort to receive cord, appointments times should not be on written acknowledgement from pa- public display. This is an often overlooked highly–detailed standards for the integrity, tients that they received the office’s aspect of protecting patient’s privacy. availability and confidentiality of electronic Notice of Privacy Practices; protected health information (EPHI), and • protect patient privacy by taking rea- Business associates addresses both external and internal secu- sonable precautions to prevent against HIPAA allows for the dental office to des- rity issues. inadvertent disclosure; ignate business associates (BA) to aid in the Entities covered by HIPAA are required to: care of the patient. The BA is a person or entity • assesspotentialrisksandvulnerabilities; • protect against threats to information security or integrity, and guard against unauthorized use or disclosure; • implement and maintain security mea- sures that are appropriate to their needs, capabilities, and circumstances; and • ensure compliance with these safe- guards by all staff. The Security Rule comprises three sepa- rate standards: Administrative safeguards: This first standard, which makes up half of the com- plete standard, limits information access to appropriate parties and guards information from all others. The office policy must in- clude documented policies and procedures for day–to–day operations; address the ➤36 The Dental Assistant March/April 2014 www.dentalassistant.org

GLOSSARYallege—to assert without proofalteration—a change or revisionbreach of contract—failure to act as required by a contract (for example, failure of a patient to pay a reasonable fee for services provided is a breach of contract)chart—a portion of the complete patient record; the chart receives documentation, including dates and reasons for visits, treatments rendered, radiographs, instructions provided, medications prescribed, laboratory prescriptions and results, referral information, telephone support provided and recare recommendedclinical—pertaining to the disease and treatment of the patientconceal—to hide, to prevent disclosureconfidential—information to be kept secretcontract—a written or oral agreement between two or more parties that is enforceable by law (for example, a contract to deliver the Standard of Care is implied and initiated when a dentist assumes responsibility for examining and treating a patient)defendant—a person, company, etc., against whom a claim or charge is brought in a courtexpert witness—a person with knowledge not normally possessed by the average person concerning the topic on which he or she is to testify in a court of lawforensic odontologist—a dentist who studies teeth and their bite mark patterns to make identifications and diagnosis.HIPAA—acronym for Health Insurance Portability and Accountability Act of 1996informed consent—voluntary agreement by a person in the possession of sufficient information to make an intelligent choiceinformed refusal—voluntary denial of recommended services or treatments by a person in the possession of sufficient infor- mation to make an intelligent choicelitigation—engaging in legal proceedingsmalpractice—negligence and/or misconduct on the part of a professionalNotice of Privacy Practices—required under HIPAA; written notification informing patients of the office’s policies related to the use and disclosure of their protected health informationobjective—factual information; not influenced by opinionobliterate—to destroy completely, leaving no tracePHI—stands for protected health information.plaintiff— a person who files a lawsuit against another person, group, or businessprecedent—a judicial decision that may be used as a standard in subsequent similar casesPrivacy Contact—required under HIPAA; the designated individual in the office responsible for providing information, receiving complaints, and handling the administration of patients’ rightsPrivacy Officer—required under HIPAA; the designated individual in the office responsible for developing and implementing the policies and procedures necessary for HIPAA compliancePrivacy Rule: HIPAA—national standard to protect patient records and other personal health information; applies to all dental officesprofessional liability insurance—also known as malpractice insurance; insurance covering the insured against losses arising from injury or damage to another personpromulgate—to make known, proclaim or teach publiclyrecords—the patient record is comprised of the clinical chart, treatment forms, financial transactions, radiographs, and study modelsscrutiny—a searching examination or investigationSecurity Rule: HIPAA—national standard to protect and ensure the confidentiality, integrity and security of electronic protected health informationStandard of Care—legal duty of a dentist to exercise a degree of skill and care that would be exhibited by other prudent dentistsstatute of limitations—amount of time during which a lawsuit may be filedsubjective—information that is influenced by personal feeling or opinionsubpoena—a written order to appear and testify in court with a stated penalty for failure to complywww.dentalassistant.org 372014 March/April The Dental Assistant

conduct and access of workforce members complete documentation and charting pro- Practice Management for the Dental Team, 7th. ed.to EPHI; and describe the selection, devel- cedures are essential to fulfilling the Stan- St. Louis: Mosby Elsevier.opment, and use of security controls. dard of Care. Secondly, because dental re- cords are considered legal documents they FreshPatients.com.August6,2009. http://www. Physical safeguards: Physical safe- help protect the interest of the dentist and/ freshpatents.com/-dt20090806ptan20090198514.guards prevent unauthorized individuals or the patient by establishing the details of php (accessed Jan. 10, 2010)from gaining access to EPHI. the services rendered. Gaylor, L. J. (2012) The Administrative Dental Technical safeguards: This third stan- Patients today are better educated and Assistant, 3rd ed. St. Louis: Saunders Elsevier.dard involves using technology to protect more assertive than ever before and dentistsand control access to EPHI. must be equipped to protect themselves Glasscoe–Watterson, D. (July 2009) Documen- against malpractice claims. Every record tation Dilemma, RDH. Pg. 40. For information on the various compo- component must be handled as if it could benents of each of these Security Rule stan- summoned to a court room and scrutinized HIPAAdvisory: the HIPAA Security Ruledards, visit http://www.hhs.gov/ocr/ by an attorney, judge or jury. Complete, Overview. http://www.citadel-information.com/privacy/hipaa/administrative/securi- accurate, objective and honest entries in a wp-content/uploads/2010/12/HIPAA-regs-Sum-tyrule/index. patient record are the only way to defend mary-Analysis_-The-Final-HIPAA-Security-Rule. against any clinical and/or legal problems pdf. (accessed February 2013) A HIPAA rule went into effect March that might arise. Most medical and dental26, 2013. The regulations: malpractice claims arise from an unfavor- HIPAA Security Rule FAQ; www.ADA.org. able interaction with the dentist and not (accessed July 2005) Knowledge based clinical den- • enhance HIPAA enforcement from a poor treatment outcome. By imple- tal records management systems. • expand many HIPAA requirements menting the suggestions mentioned in this course, dental health care professionals can Palmer, Craig, New HIPAA rules issued. ADA to “business associates” such as con- minimize the legal risks associated with the News. January 28, 2013. http://www.ada.org/ tractors and subcontractors that re- delivery of dental care to promote greater news/8198.aspx. Access on February 28, 2013. ceive protected health information understanding for patients of their rights • expand individuals’ rights to receive and privileges to their complete record. Weil, S. HIPAA Security Rule; www.securityfo- electronic copies of their health infor- cus.com/infocus/1964 (accessed August 2005) mation and to restrict disclosures to a ❖ health plan concerning treatment for Wilhemina Leeuw, MS, CDA, is a Clini- which the provider has been paid out (Editor’s Note: Professional Liability Insurance is cal Assistant Professor of Dental Education at of pocket in full provided as part of ADAA membership in most Indiana University Purdue University, Fort • modify rules that apply to marketing categories. Please visit www.dentalassistant.org Wayne, IN. A DANB Certified Dental Assis- and fundraising communications and to learn more about Professional Liability Insur- tant since 1985, she worked in private practice the sale of protected health information ance and membership in the ADAA.) over twelve years before beginning her teach- • expand the definition of “health infor- ing career in the Dental Assisting Program mation” to include genetic information References at IPFW. She is very active in her local and • clarify when data breaches must be Indiana state dental assisting organizations. reported to the HHS Office for Civil ADA Council on Dental Practice (2010) Dental Prof. Leeuw’s educational background includes Rights Records. http://www.ada.org/sections/profession- dental assisting—both clinical and office “Much has changed in health care since alResources/pdfs/dentalpractice_dental_records. management—and she received her Master’sHIPAA was enacted over fifteen years ago,” pdf. (accessed February 2013). & Baccalaureate degrees in OrganizationalHHS Secretary Kathleen Sebelius said in a Leadership and Supervision. She is also thenews release. “The new rule will help protect ADA Council on Dental Practice (2003) Emer- Continuing Education Coordinator for thepatient privacy and safeguard patients’ health gency Planning & Disaster Recovery in the Dental American Dental Assistants Association.information in an ever expanding digital age.” Office. http://www.ada.org/sections/profession- alResources/pdfs/ada_disaster_manual.pdf. (ac- Test begins on page 40Summary cessed March 2013). Answer sheet on page 41 Referred to as Standard of Care, the le- ADA Legal Adviser—April 2003. HIPAA “20gal duty of a dentist requires exercising the Questions:” Answers to Your Inquires About The Pri-degree of skill and care that would be exhib- vacy Regulation; www.ADA.org. (accessed June 2003)ited by other prudent dentists faced withthe same patient–care situation. Primarily, Bird, D. L. & Robinson, D. S. (2012.) Torres &the goal of keeping good dental records is Ehrlich’s Modern Dental Assisting., 10th ed. St. Lou-to maintain continuity of care. Diligent and is: Saunders Elsevier. Coleman H. & Stannard D. (2006) For The Re- cord. Clinical Risk. The Royal Society of Medicine Press, (12) 53–55. Finkbeiner, B.L. and Finkbeiner, C.A. (2010)38 The Dental Assistant March/April 2014 www.dentalassistant.org

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1307—Maintaining Proper Dental Records FOR OFFICE USE ONLY Date Received:___________________Approved for TWO (2) continuing education credits. Date Graded: ____________________ Pass Fail: _______________________*Only current ADAA members are eligible to take this course for continuing education credit. Tests submitted by non-members and E–Members will not be graded or returned.THERE IS NO GRADING FEE FOR THIS TEST ONLINE. Grading fee for processing paper tests is $10. Tests not accom-panied by #10 self–addressed stamped envelope or correct fee WILL NOT BE GRADED OR RETURNED.DEADLINE for tests to be submitted to ADAA for grading is May 31, 2014.To access course and exam online and for immediate grading and certificate, go to www.adaa1.com, until May 31, 2014.All ADAA members have an account on the site, but if you don’t know your log–in info, contact ADAA’s Central Office at 877–874–3785(toll–free).Post–Test: Choose the one best answer and fill in the circles on the answer sheet (opposite page)1. The Standard of Care includes: 6. It is important to maintain complete dental records because: a. listening to the patient’s complaints a. it will help maintain continuity of care if the patient decides to b. giving the patient an appointment the same day they call leave the practice c. taking the patient home because they missed the bus b. it provides a means of communication between the dentist and d. all of the above any other health care provider for proper patient care c. the records are a legal document and may be needed in a lawsuit2. A patient walks into the office and demands his/her radio- d. all of the abovegraphs. The protocol is to : 7. If needed, dental entries should be corrected by: a. give them to the patient since they own them a. a thick black line covering the incorrect information b. obtain a release and give them a copy of the radiographs b. in red marker c. tell them they cannot have them because they belong to the dentist c. with correction fluid d. none of the above d. with a thin line through the incorrect information3. The________belongs in the patient’s clinical dental record. 8. To ensure that the dental record is kept in proper order: a. only the dentist should write in ita. ledger card b. insurance payment vouchers b. only one person should be responsible for proper documentation c. everyoneisequallyresponsibleforproperdocumentationc. laboratory report d. all of the above d. all entries should be made in the same color4. It is known for a fact that Patient X never showed up for 9. It is best to document patient treatment in the patient’s dentaldental appointments, even after receiving a confirmation call. record:The protocol is to: a. at the end of the day when there are no distractions a. pull the chart and document if they fail to show b. immediately following treatment before patient dismissal b. pull the chart only if they show this time c. as billing is processed c. document in the chart that the patient is a chronic “no show” d. in pencil for easy correction and that the dentist can’t stand this behavior d. book an additional patient during this appointment time5. _______ is NOT a safeguard of the HIPAA Security Rule.a. Technical safeguards b. Physical safeguardsc. Practice safeguards d. Administrative safeguards40 The Dental Assistant March/April 2014 www.dentalassistant.org

10. The_______is a component of the patient dental record. 13. The owner of the patient record is: a. HIPAA b. the patient or guardiana. clinical chart b. patient’s radiographs c. the courts d. the dentistc. periodontal screening d. all of the above11. The outside cover of the chart should only display the pa- 14. An attorney requests original records because he’s repre-tient’s name and/or the account number. All medical notations senting a patient of record. The protocol is to:belong inside the chart for authorized dental team membersonly to see. a. send the originals as requested and keep copies b. call the patient to ask if originals are necessary a. The first statement is true. The second statement is false. c. send copies regardless of the demand b.Thefirststatementisfalse. Thesecondstatementistrue. d. ask the attorney if this is due to formal complaint against the c. Both statements are true. dentist d. Both statements are false. 15. Dental offices that submit insurance claims on paper do not12. Patient Y has not received treatment since their last recare need to be concerned with the HIPAA regulations. The dentalappointment six months ago. The dental team must: practice must have a one–time consent form signed by the pa- tient for the electronic transmission of personal information. a. inquire about their medical history b. make no changes to the medical history unless an issue is a. The first statement is true. The second statement is false. mentioned b.Thefirststatementisfalse. Thesecondstatementistrue. c. ask the patient to update the medical history, inquire about the c. Both statements are true. changes and record findings about the updated history d. Both statements are false. d. take a whole new medical history every 6 months(Use pen or pencil to completely fill in the circle of your chosen answer.)1. A B C D 6. A B C D 11. A B C D2. A B C D 7. A B C D 12. A B C D3. A B C D 8. A B C D 13. A B C D4. A B C D 9. A B C D 14. A B C D5. A B C D 10. A B C D 15. A B C DName:Address: City, State, Zip:Daytime Telephone Number: (_­ __)_______________ *ADAA Membership Number:*DO NOT use CDA or RDA #. Membership # can be found above your name on the address line of the magazine cover. ☐ Check or money order enclosed ☐ #10 SASE enclosed Return to American Dental Assistants Association, Continuing Education Department 35 East Wacker Drive, Suite 1730, Chicago, Illinois 60601–2211www.dentalassistant.org 412014 March/April The Dental Assistant

Association BulletinADAA Life Member Nita Irene Bramble Linda Miles co–founds foundationpasses away at 87 to fight oral cancer Nita Irene Bramble, 87, died Friday, March 7, 2014, at Linda Miles and Robin Morrison have founded OralMary Lanning Healthcare in Hastings, NE. Nita was born Cancer Cause (OCC), in memory of Charlotte Estep,to Elmer Ray Clark and Annamae (Talbott) Clark on April Linda Miles’ sister–in–law, and Mike Collins, Robin Mor-2, 1926 in Hastings. On December 26, 1943, she married rison’s brother, who both passed away in 2012 from oralDallas Bramble. She earned Dental Assisting Certificates cancer that was detected too late for effective treatment. Byfrom the University of North Carolina and Central Com- blending the knowledge of early detection and treatment;munity College in Hastings. She graduated in 1977 from the comprehensive oral exams along with dedicated dental/University of Nebraska at Kearney with a Bachelors of Sci- medical professionals; sponsoring partners; and dental/ence in Vocational Education/Health. As a life member of medical associations, Ms. Miles and Ms. Morrison hopethe American Dental Assistants Association and Nebraska that OCC will make a difference in the lives of many oralDental Assistants Association (NDAA), and member of the cancer patients and their families. OCC’s mission state-Mid–State Dental Assistants Society, she held many offices, ment says the foundation’s goal is “to improve the qualitycommittee memberships and chairmanships. Nita won the of life for oral cancer patients through financial support soAloise B. Clements Achievement Award from the NDAA in that they may face the world with peace and dignity during1965 and 1981. Nita previously had an article, “Evacuation and after medical treatment.” For more information, pleaseTips,” published in The Dental Assistant. visit oralcancercause.org.Health BeatADA fights high cavity rate in children CSA previously recommended using water to brush the teeth of children younger than two years old and to brush the teeth ofwith fluoride toothpaste children two to six years old with a pea–size amount of fluoride To fight cavities in children, the American Dental Association’s toothpaste. CSA updated the ADA’s guidance based on a review of scientific evidence.(ADA) Council on Scientific Affairs (CSA) has updated its guid-ance to caregivers that they should brush their children’s teeth with The report, “Fluoride toothpaste use for young children,” and thefluoride toothpaste as soon as the first tooth comes in. This new results of the systematic review, “Fluoride toothpaste efficacy andguidance expands the use of fluoride toothpaste for young children. safety in children younger than six years,” are published in the Feb- ruary 2014 issue of The Journal of the American Dental Association. “Approximately 25 percent of children have or had cavities beforeentering kindergarten, so it’s important to provide guidance to care- The new guidance is intended to provide children with the fullgivers on the appropriate use of fluoride toothpaste to help prevent benefit of cavity protection while limiting their risk of developing flu-their children from developing cavities,” said Edmond L. Truelove, orosis, which is a mild discoloration of teeth usually appearing as faintD.D.S., chair of the Council on Scientific Affairs. lines. Based on a systematic review of the evidence, CSA concluded that using just a “smear” of toothpaste for children younger than three Dental decay is the most common chronic childhood disease years old and a pea–size amount for children three to six years helpswith more than 16 million children suffering from untreated tooth prevent cavities and is less likely to cause fluorosis. Children shoulddecay in the U.S, according to the U.S. Centers for Disease Control. spit out toothpaste as soon as they are old enough to do so.Oral disease causes children to miss 51 million school hours andtheir parents to lose 25 million work hours annually. Additionally, The ADA encourages caregivers to take their child to the dentistoral disease disproportionately affects children from low–income when the first tooth appears or no later than the child’s first birthday.families and these children have almost twice the number of de-cayed teeth that have not been treated by a dentist as compared to ❖others in the general population.42 The Dental Assistant March/April 2014 www.dentalassistant.org

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Membership MattersPat Pearson, CDAChair of the Nominating Subcommittee of the Council on Annual SessionAmerican Dental Assistants Association Call for Officer/TrusteeNominations and Council Member VolunteersWhat you need to know about serving on the ADAA Board of Trustees, Councils and CommitteesThe American Dental Assistants Association is planning for • Vice President—one–year termthe future and requests your assistance in nominating po- • Secretary—one–year termtential leaders for the coming year. All of us probably know anADAA member who is highly motivated, organized and thoughtful The major responsibilities of these offices are:with a passion for dental assisting and the ADAA. These are all quali-ties that are necessary for successful leaders. President–Elect • Succeed to the office of President without further election at the Please thoughtfully consider nominating a qualified member next Annual Session of the ADAA.(or yourself) to serve as an Officer, State District Trustee or Student • Succeed to the office of President in case of vacancy in that office.Trustee. Your thoughts, concerns and vision regarding dental assist- • Assist the President as requested.ing will help to move the Association forward and provide enhanced • In the absence of the President, the President–Elect shall as-benefits to its members. All nominations must be received by the sume the duties of the President.ADAA Central Office by June 30, 2014. • Serve as a member of the Board of Trustees, Executive Commit- tee and Council on Finance and attend all meetings. If you would like to nominate someone for an Officer or Trustee • Serve as Chairman of the Council on Annual Session.position, please be sure that they are willing to serve. Self–nomina- • Serve as Council on Governance, Subcommittee Chair on thetions are welcomed and are encouraged. If the time is right for you to New Officer and Trustee Manual Committee.serve, do not hesitate to nominate yourself. • Plan the Installation Ceremony.Elected officers President Active, life and special members are eligible to serve as elected offi- • Serve as chief elected officer and official spokesperson of the Association.cers. There are two pathways for which candidates may qualify to serve: • Serve as chairman of the Board of Trustees and supervise all1) The candidate must have served as an ADAA State District Trustee; Board activities.or 2) the candidate must have served a term as an ADAA Council • Preside at all meetings of the House of Delegates, the Board ofmember AND a full term as an elected officer of a State Association. Trustees, and the Executive Committee.Nominations are being accepted for the following offices for 2015: • Appoint chairmen and council and special committee members. • ProvidePresident’sMessagesinissuesofTheDentalAssistant. ➤ • President–Elect—This office has a three–year commitment. The member serves as President–Elect for one year then will serve as President the next year, and as Immediate Past Presi- dent the third year.44 The Dental Assistant March/April 2014 www.dentalassistant.org

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• Serve as an ex–officio member to all or special Board of Trustees meetings delegates during caucus meeting in Councils and Special Committees, ex- and send to the Board of Trustees, Ex- accordance with the Credentials Sub- cept the Nominating Subcommittee. ecutive Director and appropriate staff committee guidelines. members within two (2) weeks of the • Initiate and maintain liaison with oth- • Serve as a member of the Council on meeting. er allied health organizations. Finance. • Record and prepare minutes of all • Attend all meetings of the Board of meetings of the Board of Trustees, Trustees • Represent the Association at dental Council on Finance, Executive Com- • Attend all meetings of the House of and dental related meetings when fis- mittee, Executive Session, and House Delegates and district caucuses sched- cally feasible. of Delegates. uled during the Annual Session. • Prepare electronic mail ballots at the • Visit each state within the districtImmediate Past President President’s direction. once a year as allocated in the budget • Assist the President as required. • Prepare the Board of Trustees Annual and address the membership. • Act as a resource for the President. Report to the House of Delegates. • Send a copy of the current State As- • Act as a liaison between the Past Presi- sociation Officers form and Local Or- dents’ Council and the ADAA Board Elected State District Trustees ganization Officers form to the State of Trustees. A State District Trustee shall be a legal Associations within the district. • Serve as a member of the Board of • Attend major regional dental meet- Trustees, Executive Committee and resident of the district which they repre- ings in their district and assist with the Council on Finance and attend all sent. The State District Trustee shall be an the organization and staffing of the meetings. active, life or special member and shall have ADAA membership booth and any • Serve as a member of the Subcommit- served a term as a member of an ADAA ADAA educational programs as re- tee to Review Annual Session Minutes. committee or council or as an officer of a quested by the ADAA President. • Participate in the video/phone con- State Association. ference call interviewing candidates Appointed Student Trustee for Student Trustee. The ADAA is also seeking nominations • Plan the Past Presidents’ event held for the following State District Trustees. Any active, life, or special member of during Annual Session. Trustees serve a three–year term and may the ADAA, a Student Chapter, Local or serve two consecutive full terms. State Organization, or a Trustee DistrictVice President may nominate candidates for Student • Assist the President as requested. • Second District—New Jersey, New Trustee. The Student Trustee must be a • Serve as a member of the Board of York, Pennsylvania Student member of the ADAA, a member Trustees, Executive Committee and of a SADAA Chapter, and graduate or have Council on Finance and attend all • Third District—Delaware, Washing- graduated from a dental assisting program meetings. ton DC, Maryland, Ohio, Virginia, of at least 800 hours within 12 months of the • Serve as member of the Council on West Virginia application deadline. The Student Trustee Annual Session. is a one–year term with a maximum of two • Serve as Chair of the Council on Stra- • Sixth District—Illinois, Indiana, consecutive terms. The Student Trustee tegic Planning. Michigan represents all SADAA chapters and student • In consultation with Central Office members in all districts. staff, oversee the purchase of the • Ninth District—Arkansas, Louisi- The Student Trustee is responsible for pins, guards and awards that will be ana, Oklahoma, Texas the following duties: presented to recognize the incoming President, retiring President, Officers The primary duties of the State District • Serve as a member of the ADAA and Trustees. Trustee are as follows: Board of Trustees and attend all meetings.Secretary • Serve as a member of the Board of • Serve as a member of the Board of Trustees and act as advisor and liaison • Serve as the Chair of the Council on Trustees, Executive Committee, and to the State Associations and Local Student Relations. Council on Finance and attend all Organizations within the district. meetings. • Read and respond to Association e– • Complete Motions, Directives and • Communicate with members within correspondence on a weekly basis. Consensuses with upcoming dead- the Trustee’s district after each Board line dates from all of the regular and/ meeting to transmit Board actions and • Establish and maintain contact with ADAA activities within 30–60 days. all SADAA Chapter Presidents and/ or Advisors. • Conduct a caucus at the Annual Ses- ➤ sion to review, discuss and explain the issues which will be acted upon by the House of Delegates. Credential46 The Dental Assistant March/April 2014 www.dentalassistant.org



Call for Nominations List of Advertisers(continued from page 46)• Maintain and update records of all SADAA Chapters. 3M ESPE 3• Write an article for the student page in the ADAA Journal. ADA 2014 15• Write a Trustee Report for each Student Newsletter. ADAA Credit Card 7• Work with ADAA staff to oversee the Student Newsletter. Burkhart Dental 31• Nomination forms for officers and trustees may be found on Crosstex 19 Dental Creations 47 the ADAA website at: http://www.dentalassistant.org/ Dux Dental 35 Content/Details/TrusteeOfficerForms Henry Schein Dental Hu–Friedy 5Appointed members: Kerr Impressions C4 Kerr TotalCare 39Councils and Committees Patterson Dental 45 Patterson Dental 9Active, life, student, and special members are also needed to serve RxSavings Plus 24–25on ADAA Councils and Committees. A listing of current Councils and Septodont 21Committees and an application form may be found at: http://www. Procter & Gamble C2dentalassistant.org/Content/Details/CouncilsCommittees. Sultan Healthcare C3Any qualified ADAA member who is interested in serving as a Sultan Healthcare 11member of an ADAA Council or Committee is encouraged to sub- 43mit the ADAA Council Application Form and Commitment toServe Form by June 30, 2014. The incoming president will be ap-pointing members to fill vacancies on existing councils and Com-mittees by mid–October 2014. ❖ Pat Pearson, CDA, is the ADAA Chair of the Nominating Subcom- DISCLAIMER: “Authors and advertisers are solely responsible for themittee of the Council on Annual Session. Ms. Pearson was an adjunct den- accuracy of any and all material provided to The Dental Assistant. Authorstal assisting faculty member at IVCC from 1978–1983 before becoming and advertisers are also solely responsible for checking that any and allDental Assisting Program Director at IVCC from 1983–2007. She has material relevant to dental care in a clinical setting meets OSAP standards.served as Illinois Dental Assistants Association Vice President, Treasurer, The information and opinions expressed or implied in articles and adver-and President. Ms. Pearson has been the Illinois Mission of Mercy Dental tisements that appear in The Dental Assistant are strictly those of theAssistant Lead and has served on most ILDAA committees. authors and advertisers. They do not necessarily represent the opinion, position or official policies of the American Dental Assistants Association.”President’s Message Next Issue: The Journal brings you new(continued from page 4) dental products on the market in Product Report. Also, more information about thesearchers as well. Being confident and self–assured is what promotes upcoming Annual Session in San Antonioprofessionalism in the workplace. Do not assume anything; there- and how to use a CAD/CAM implant pro-fore, do not be afraid to ask the doctor what a good job looks like; visional to reshape gingival tissues.have a checklist in place during the learning process and keep notes;ask questions and be willing to listen and accept that there may be adifferent way of achieving the desired results. It is time for us to elevate our own profession. Be organized, becreative and inventive, stay educated, ask questions, be committed,take charge where appropriate, and know enough about everyoneelse’s position in the practice to be supportive. Ask yourself as a den-tal assistant professional where do you want to see yourself and yourprofession? If you don’t like the answers you’re getting, you need tostart asking better questions. Celebrate being a professional dentalassistant and you’ll elevate your profession at the same time! ❖48 The Dental Assistant March/April 2014 www.dentalassistant.org