July/August 2009

July/August 2009A Special Interviewwith ADAA President,Stephen E. SpadaroJ/A 09.indd 1 7/13/09 1:52:00 PM

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FEATURES Air Force/ADAA 12 Developing Dental Airmen by CMSgt. Tom Davis How the U.S. Air Force encourages professional development in dental assisting. 14 Army/ADAA 26 Challenges & Opportunities by MSG Arnold L. Voigt Overcoming obstacles to provide dental care in the remote regions of Alaska. cover story 4 The Journal features a special interview with ADAA President, Stephen E. Spadaro Clinical 8 Treating the Special Needs Patient with a Sensory Disability — Vision Impairment by Janet Jaccarino How to create a treatment regimen for patients with visual disabilities. 4 Continuing Education 14 Patient Care Coordinator: Are You Ready for the Challenge? by Linda Zdanowicz, CDA, CDPMA FREE CE course exploring the role of the patient care coordinator. Legislative 36 Legislative Update compiled by Rosana Rodriguez, CDA, CDPMA, FADAA A round–up of the latest news in legislative initiatives. 8 DEPARTMENTS 46 Association Bulletin 48 Advertiser IndexAmerican Association of Dental Editors 2 Editor's Desk 4 President’s Page 34 ADAA Annual Session UpdateJ/A 09.indd 3 7/13/09 1:52:08 PM

Editor’s Desk Michi Trota elcome to a special edition of the Dental Assistant, spotlighting our feature interview with the American Dental Assistants Association President, Stephen E. Spadaro. The ADAA is heading in an exciting, new direction, so go to page 4 to see what President Spadaro says the future holds in store for the Association.Speaking of futures, ADAA, with the support of the American Dental Assistants Association Foundation, has produced a shortfeature career video, “Your Future in Dental Assisting,” available to view on the web at ADAA’s website, www.dentalassistant.org. The feature is also available, free of charge, on DVD. Contact [email protected] to order your copy now. To learn more, seethe Association Bulletin on page 46. If you know anyone who may be interested in pursuing a career in dental assisting, this featureis a must–see!In this issue, you'll also find a free CE course covering the ins and outs of the patient care coordinator, how to provide dental care forthe visually–impaired, how the U.S. Air Force supports professional development for dental assistants, a profile of the U.S. Armyproviding dental care to the remote regions of Alaska, and the latest in dental assisting–related legislative updates.On a personal note, this issue marks the end of my first full year with ADAA, and I couldn't be more proud or happy to be a part ofthis wonderful organization. I can't believe how quickly the year has flown by and how much has been accomplished as the ADAAcontinues to adapt and expand to meet the ever–changing needs of its members. I look forward to continuing my work here at theJournal and strengthening the Journal’s relationship with our readers. July/August 2009 Volume 78, No. 4 The Dental Assistant (lSSN-1088-3886) is published bimonthly (every other month). Subscriptions for members are $10 as part of dues. NonmemberADAA President Stephen E. Spadaro subscriptions: $20 in the U.S.; $30 in Canada/Mexico; $75 other foreign. Single copy price is $10. Allow 6-8 weeks for subscription entry andExecutive Director Lawrence H. Sepin change of address. Publisher is the American Dental Assistants Association, 35 East Wacker Drive, Suite 1730, Chicago, IL 60601-2211. PeriodicalsEditor and postage paid at Chicago, IL, and additional mailing offices. POSTMASTER:Communications Director Douglas McDonough Send address changes to The Dental Assistant, 35 East Wacker Drive, Suite 312-541-1550 x203 1730, Chicago, IL 60601-2211.Editorial Director Anna Nelson, CDA, RDA, MA Copyright 2009 by the American Dental Assistants Association. Reproduction in whole or in part without permission is prohibited. The information and opinionsManaging Editor Michi Trota expressed or implied in The Dental Assistant are strictly those of the authors and 312-541-1550 x209 do not necessarily represent the opinion, position, or official policies of the American Dental Assistants Association (ADAA). Authors of published materialsAdvertising Sales Manager Robert E. Palmer are solely responsible for their accuracy. 312-541-1550 x212 Note: The ADAA cannot honor claims for missed copies of The Dental Assistant unless they are made within 90 days of the cover date. For example, requests forDirector of Education Jennifer K. Blake, CDA, EFDA, FADAA missed copies of the January/February issue must be made prior to May 31.& Professional Relations Senior Information Nancy RodriguezSystems Analyst To obtain a copy of our Writer's Submission Guidelines or the Editorial Calendar, The Dental Assistant please see ADAA's website, www.dentalassistant.org. 35 East Wacker Drive, Suite 17302 The Dental Assistant July/August 2009 Chicago, IL 60601–2211 *General inquiries 877–874–3785 (toll–free) fax 312–541–1496 • e-mail [email protected] Website ✇ www.dentalassistant.org ADAA Mission Statement To advance the careers of dental assistants and to promote the dental assisting profession in matters of education, legislation, credentialing and professional activities which enhance the delivery of quality dental health care to the public.J/A 09.indd 4 7/13/09 1:52:11 PM

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09DS1 President's Page Stephen E. Spadaro This Is Our FutureThe Journal presents a special interview with ADAA President, Stephen E. Spadaro, about taking the ADAA in a new and exciting direction President Spadaro, the next issue of the Journal will carry a by- office at the local, state and national level. We hope to add morelaw change proposal that is bound to cause a great deal of discus- and better benefits for this level of member too.sion and raise many questions from ADAA members. Would youplease tell our readers what they can expect? What will the eMember receive? We’re going to ask this year’s delegates to the Annual Confer- eMembers will enjoy a special online edition of The Den-ence to consider a big change in our organization’s make–up. Spe- tal Assistant and one hour of free online education each year.cifically, we will present a program that creates an additional form They will, of course, be entitled to link to the employment re-of membership in the ADAA. ferral service www.dentalworkers.com, ADAA’s on–line job board. There will be a discussion board for new eMembers and The ADAA has always had a number of membership catego- the privilege of participating in certain member services suchries. What makes this one special? as credit cards, life and medical insurance and hotel and rental This will be what we call an “eMembership” for those who car discounts. They will also be able to manage their member-choose to affiliate with ADAA via the Internet, and receive their ship records on line and print out an eMembership card. Thereinformation and certain limited benefits through the virtual are e–newsletters planned for special interests such as students,world. We want to reach out to the vast under–served popula- educators, administrators and clinicians. Some of these are avail-tion of dental assistants in America who are not currently af- able already to our present members.filiated with any professional organization. We invite them tojoin the ADAA in this special way at no cost. They can enjoy And for the “Professional or Sustaining Member”?certain privileges through this affiliation while they learn about A whole lot more. “Professional or Sustaining Members” willthe ADAA and consider future traditional affiliation. continue to earn a rebate for their states and to hold office at any level and serve as delegates at the annual conference. They will Will you change your traditional membership? get four hours or approximately $60 worth of free CE each year No, the traditional member, referred to in our proposal as a with no grading fee for online education. They’ll also have first“Professional or Sustaining Member” will continue to enjoy all shot at online education before it is made available to anyone else.their current benefits and will retain their exclusive rights to hold And they’ll receive a hard copy of the Journal as well as the ➤4 The Dental Assistant July/August 2009J/A 09.indd 6 7/13/09 1:52:17 PM

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Septoe–Journal with an archive search tool not Because they have chosen to become counted student rate. In addition, we willprovided to the eMember. One of the most a part of the ADAA we will provide them retain our generous discounted dues struc-important member benefits which will be with certain member benefits in recogni- ture for the first three years of a student’scontinued and possibly strengthened is the tion, such as a limited version of the Journal Professional or Sustaining Membership af-professional liability insurance and the acci- online and reduced prices for CE; although ter graduation. We want to keep those stu-dental death insurance that comes as part of not as reduced as those enjoyed by Active dents happy and participating.annual member dues. or traditionally–based members. Where can more information on this pro- That sounds like a pretty solid financial How does this membership — with no posed change be found?benefit package. apparent revenue for the national or state or- It is and there are additional benefits as ganizations — benefit the ADAA? I’m here to help and so are all District Trustees who support and applaud this effort.well. Student members have access to ADAA We foresee many benefits at all levels Write to me at [email protected] orscholarships and Professional or Sustaining principally from non–dues revenue in the contact your District Trustee.Members have exclusive access to members– area of continuing education and specialonly content on the ADAA website. Plus they events. The old adage “Strength in numbers” What’s the bottom line with this proposedwill enjoy all the member benefit discount has never been more truthful. Although change? Is this just a numbers game?programs offered to every category of mem- states won’t receive dues for eMembers, they The bottom line is like the top line of thisbershipaswellasmessageboardcapabilityfor will receive the contact information they’ll interview: This is our future.Professional or Sustaining Members only. need to invite those new eMembers to lec- There are 250,000–plus dental assistants in the United States. It is the duty of the ADAA to work toward educating all dental assistants in order to support the dental team and pro-There are 250,000–plus dental assistants in the United States. It vide optimal dental health to the Americanis the duty of the ADAA to work toward educating all dental consumer. We can only do this if we reach out beyond the faithful core of those currentlyassistants… We can only do this if we reach out beyond the counted in our membership. We need to con-faithful core of those currently counted in our membership. tact these dental assistants and attract them to the ADAA so that we can offer them education and in turn educate them about our member benefits in order to attract them to Professional We don’t want any current member to feel tures and meetings and to demonstrate the or Sustaining Membership participation.that they are being overlooked. Sustaining value of traditional membership. As our numbers grow we will attract the recognition and respect deserved by aMembers will be recognized with Life or 25– After states have established contacts, strong profession represented by strong as-year seniority pins and certificates and free what happens next? sociation. As our numbers increase, our voiceJournal service at retirement as well as the in-vitation to participate in the Fellowship/Mas- These contacts will provide opportunities is strengthened, our outreach and resourcestership program and to enjoy the networking, for states and locals to reach out and recruit grow and the goal of improved oral health forcamaraderie and life–long friendships built eMembers as active members and to gain rev- all moves closer to becoming an achievablefrom personal interaction with their profes- enue from the eMembers who participate in goal with ADAA doing its part.sional association. events and CE. And don’t forget the strength We feel that we are going back to the B To brighten the picture, there will be pe- in numbers when it comes to legislative influ- roots of the ADAA’s formation with Julietteriodic bonuses for renewing and new Profes- ence. Your state’s eMembers can be counted Southard who reached out to everyone in ev-sionalorSustainingMembers,suchassenior- when talking with legislators about matters of ery way possible to grow dental assisting as aity pins, discount coupons and incentives. concern to dental assistants. profession to be respected and regarded. Why are you calling the new category Have Students been overlooked? Thank you for taking the time to discuss“members”? Aren’t they really more like these developments, President Spadaro.“associates”? Not at all. Just read the headline of this Thanks for the opportunity to speak out. I article. This Is Our Future... and that’s just Not really. We are calling them eMembers what the Students are. We plan to provide look forward to hearing from our members.because we value their relationship to us and all Students with professional liability in-we want them to know that they are included surance and all the benefits that our profes- ❖in our organization, not peripheral to it. sional members receive at our deeply dis-6 The Dental Assistant July/August 2009J/A 09.indd 8 7/13/09 1:52:22 PM

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Clinical Janet Jaccarino, CDA, RDH, MA Vision Impairment: Treating the Special Needs Patient with a Sensory Disability Patients’ loss of vision need not impede their dental care here is no doubt that making care available to the patient • Explain various methods of communication specific for with disabilities requires extra effort on the part of the visual impairment. entire dental team. Special accommodations that helpmake your office more accessible, deciding what modifications • List guidelines for seating and dental management.are needed, and treating the patient, all require a set of special • Explain strategies to improve oral self–care.skills. It is important for dental professionals to recognize the Numbersmental and physical aspects of having a sensory disability in orderto use your resources and imagination to help furnish care. More than 20 million Americans report having loss of vision including trouble seeing, even when wearing glasses or contact Sensory disabilities alone do not require changes in treatment lenses. Of the 20 million there are those who reported they aremethods, just modifications in provisions. Title III of the 1992 blind or unable to see at all. Approximately 6.2 million are seniorsAmericans with Disabilities Act requires medical and dental of- age 65 and over. As the baby boom generation ages the numberfices to be made free of barriers to physical access and effective of seniors with vision loss will increase substantially.2 Legal blind-communication. For example, removing barriers for a blind per- ness is defined as a visual acuity of 20/200. A person who is legallyson may involve adding raised letters or Braille to elevator con- blind, even with optical correction, can see at 20 feet what a per-trol buttons. Effective communication may include auxiliary aids son with normal vision can see at 200 feet.such as sign language interpreters, telecommunications devicesfor deaf persons (TTY and TDD), readers and Braille and large Not all visual impairments carry the same degree of blindness.print materials.1 As with all disabilities preparation, patience, flex- Some individuals who may be considered blind may not be to-ibility and consideration are essential and as valuable as technique tally without sight. They may be able to distinguish images, light,in providing care. colors, and may even be able to read large print. Low vision is dif- ferent than legal blindness and covers a wide range of conditions.3 After reading this article the reader should be able to: Low vision can interfere with a person's ability to perform every- • Define blindness and low vision. day activities like reading, walking unassisted and cooking.4 • Describe the incidence of visual impairment in the United Causes States. • Discuss the statistics and causes of blindness in children Blindness in children may result from infection such as rubella and adults. or syphilis passed from mother to child during birth, neoplasm and • Describe oral clinical findings. complications of premature birth. Children who are blind often • Describe the personal and dental implications for care. have multiple developmental disabilities such as epilepsy, cerebral8 The Dental Assistant July/August 2009J/A 09.indd 10 7/13/09 1:52:23 PM

palsy or deafness. Two percent of people Most Common Causes of Age–Related Vision Loss3–6with severe visual impairments are under 18years of age. The majority of those who are Normal Visionblind lose vision after age 20. Accidents ac-count for less than 3 percent of blindness.3, 5 Table 1 Macular DegenerationThe greater part of reported cases may be re- (age–related) AMDlated to age such as those described in Table1 (right).3–6 Other causes may be associated • Leading cause of vision impair-with tumors, systemic diseases such as dia- ment and legal blindness in in-betes, hypertension, atherosclerosis, leuke- dividuals 50 years and older.mia, SjÖgren’s syndrome, a virus, hereditarydegeneration and prolonged use of certain • Damage to the central visualdrugs to treat disease.3, 5, 7 area—the macula—which al-Oral Clinical Findings lows you to see fine detail. Vision impairment does not have any • Sharp central vision is blurred.direct effect on oral health; however, some • Difficulty with straight–aheadmay find it difficult to maintain a balanceddiet or even visit the dentist. They may not activities like reading, sewingdetect dental disease symptoms at an early and driving.stage that are typically recognized through • No pain.vision. Incidents of dental disease may begreater due to poor oral self–care because Glaucomathe patient is not able to see or has not re-ceived effective instruction.6–8 Individuals • Second most common leadingmay have impairment as a result of disease cause of blindness in the U.S.such as diabetes and hypertension that canaffect dental treatment more than the im- • Normal fluid pressure in the eyepairment. Other oral symptoms that have rises resulting in optic nervebeen noted include lesions due to lip and damage.cheek biting, occlusal wear due to bruxism,trauma due to accidents and increased car- • May result in vision loss andies in the patient with Sjogren’s syndrome blindness.because of lack of saliva. Different types ofvisual impairments may contraindicate ad- • Can usually be controlled withministration of certain dental drugs, for ex- medication.ample, dispensation of atropine for patientswith glaucoma.7 CataractPatient Factors • Clouding of the lens prevents Visually–impaired children, especially light from passing through.those who are totally blind, are deprived ofthe opportunity to learn by imitation. They • Vision is blurred or hazy.must adjust to a world they have not seen • Treatment involves surgical re-or experienced because they do not havea workable visual image in their memory. moval of the lens, and replace-Some parents may be overindulgent and ment with a man–made lens.protective that may foster emotional depen- • By age 80 more than half of alldence. Blind children may learn to speak Americans either have a cata-later and have an educational level behind ract or have had surgery.that of a sighted child of the same age ➤ 92009 July/August The Dental AssistantJ/A 09.indd 11 7/13/09 1:52:25 PM

Unique Tips for Communication3, 9–11, Internet Resources the person who accompanies the patient, but if necessary you may include a caregiver. ✓✓ Ask the patient how he or she prefers to communicate. Avoid speaking to adults as if they are chil- ✓✓ Face the patient and speak slowly. dren; if necessary repeat instructions. Keep ✓✓ Keep conversation simple. it simple; stick to one topic or ask one ques- ✓✓ Provide a well–lit room. tion at a time. ✓✓ Indicate when you move from one place to another or leave The room should be well–lit; however, the room. standing in front of strong back lighting from ✓✓ Avoid startling patient by speaking or touching. a window or light can interfere with any re- ✓✓ Avoid distractions. sidual vision and make it difficult for the ✓✓ Use large print material with 16–18 point type size or larger. patient with limited vision to see you. Let ✓✓ Use simple font, not thin, italic or fancy typefaces. the patient know when you move from one ✓✓ Double–space lines. place to another or leave the room. Try not to ✓✓ Contrasting words on paper (yellow or off–white paper has startle patients. Try gaining their attention by lightly touching their arms before speaking. less glare than plain white paper). The visually impaired patient needs to con- ✓✓ Give clear, concise instructions slowly. centrate to understand directions or instruc- ✓✓ Consider alternative ways of presenting information. tions so limit distractions. Keep the number of people in the operatory at one time to aBox 1 minimum and control noise by turning down the radio or closing a window.because they may take longer to cover the concept will be understood easily if the per-same amount of material, or they have start- son is told about it in detail.3, 5 Use of large print material is helpfuled school later. Individuals who are blind for the partially sighted patient. Type sizefrom birth or at a very early age quickly Communication should be 16–18 point or larger in simpleadapt to their condition; it becomes part of Communication and exchanging infor- font, not thin, italic or fancy typefaces, andwho they are. lines should be double–spaced. Use yellow mation between patient and operator is not or off–white paper as those shades have less The persons who experience visual dis- only necessary for good clinical practice but glare than plain white paper. Contrastingability later in life often adjust better to the essential for rapport and trust. Medical his- words on paper are easier to see; for example,world around them, but because they can tory, receiving instructions for oral self–care blue letters against a yellow background. Us-remember what has been lost they may and even making an appointment all de- ing blue, green and purple together makes ithave feelings of depression and helpless- pend on understanding without misinter- more difficult to distinguish words.ness. They must integrate the condition into pretation. The act of sending, receiving andtheir identity, family life and career. Eventu- interpreting messages is complicated and Depending on the type of disability,ally with acceptance and rehabilitation the often depends on seeing or hearing or both. you may also consider alternative ways ofperson may gain a sense of confidence and presenting information, such as audio cas-independence. All persons with visual dis- For the patient with sensory disabilities sette or CD, Braille or the use of a desig-ability tend to develop and use their other this process can become time–consuming nated reader. Box 1 (upper left) offers tipssenses more. For example, they may rely and frustrating. Visually impaired patients for communication.3, 9-11, Internet Resourceson tone of voice to interpret what a sighted may not pick up on nonverbal cues such Guiding and Seating the Patientperson may understand from a facial ex- as body posture, gestures or facial expres-pression. Being neat and orderly allows an sion, and may be at a disadvantage. First A dental visit starts at the front door toindividual to know exactly where things are ask patients what their preferred methods the office. Physical access is mandated bylocated, and doing things deliberately and of communication are. Face the patient and the Americans with Disabilities Act and hasslowly helps them to gain perception and speak slowly and directly in a normal tone been discussed in previous articles (see Box 2prevent accidents. Any new experience or of voice. Give clear, concise instructions on page 30). Allow extra time for the appoint- slowly. Speak directly to the patient, not to ment and have the room ready before the pa- tient arrives. Make sure the dental chair is at the proper height for seating. When you meet the patient, introduce Continued on page 3010 The Dental Assistant July/August 2009J/A 09.indd 12 7/13/09 1:54:03 PM

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U.S. Air Force CMSgt Tom Davis Developing Dental Airmen How the U.S. Air Force provides training and advancement opportunities for dental assistants et’s face it, when someone is deciding on whether or not to later this year giving students the opportunity to complete two of make a career out of their current job a lot rides on wheth- the three tests required for national certification. Graduates of the er or not there are opportunities for professional growth 48–day academic dental assisting program then move to their firstand advancement. Well, imagine joining the Air Force (AF) to assignment at one of 80 worldwide AF dental facilities.serve your country. You may or may not have been allowed to pickyour occupational specialty. For the latter that means someone At their first assignment dental assistants enter the secondchose your career path for you. How would you know what to ex- phase of their professional development. In this phase they com-pect and what opportunities lay ahead? plete a correspondence course in dental assisting through the Such is the case for many new AF dental assistants every year. AF’s Air University and complete a 12– to 24–month on–the–The AF Dental Service, which is comprised of approximately job training program to further develop dental assisting skills and3,000 auxiliary personnel including 2,400 dental assistants, uses knowledge. Most AF dental clinics are multichair practices witha deliberate approach to ensure all Airmen, even those who did between four to 30 dentists assigned offering dental assistantsnot necessarily choose dental assisting as a career, have an equal a lot of opportunities to experience working with different pro-opportunity to reach their full potential. There is a visible path for viders, including specialists such as oral surgeons, periodontists,education, training, experience, and advancement for all AF den- prosthodontists, and orthodontists, among others.tal assistants. It all begins with education. The AF trains about 300 dental Following this second phase of professional developmentassistants a year at its schoolhouse at Sheppard Air Force Base in dental assistants are encouraged to challenge DANB’s ChairsideWichita Falls, Texas. This first phase of professional development Assisting examination and gain national certification. Further, theis accredited by the American Dental Association and employs the AF offers dental assistants 100 percent tuition to cover the costslatest in technology and instruction methodology. A premium is associated with seeking an Associate’s Degree in dental assistingplaced upon hands–on training in such areas as digital radiology, technology and earning a Bachelor and Master’s Degree if a dentalinfection control, and general chairside assisting. Students learn assistant so desires.about the requirements of gaining national certification and actual-ly challenge the Dental Assisting National Board’s (DANB) Infec- A third phase of professional development focuses on dental clin-tion Control Examination prior to graduation. There are plans to ic management, supervisory, and leadership skills. This third phasestart including DANB’s Radiation Health and Safety examination of development generally starts between the fourth and sixth year of service and actually continues for the rest of a dental assistant’s career. Just like in a civilian practice, AF dental assistants are expected to per- form all jobs associated with running a dental practice.12 The Dental Assistant July/August 2009J/A 09.indd 14 7/13/09 1:54:04 PM

Given the relatively large size of most SSgt Hernandez teaches a course on dental anatomy to Air Force dental assisting students.AF dental facilities, this creates a number ofopportunities for dental assistants to worka wide variety of jobs including general as-sisting, specialty care, appointment/recordsclerk, oral preventive assistant, treatmentteam coordinator, and practice manager.An assistant will often move back and forthamongst these jobs to keep all their skillssharp and to prevent job stagnation. Professional development does notstop there. AF assistants can volunteer toserve in a variety of special assignmentssuch as being an instructor at the Sheppardschoolhouse, working at our dental supplyand equipment evaluation and researchcenter, or helping to manage the AF DentalService from our central office. Finally, to help ensure all dental assistantsmeet the same standard, a recent policy wasenacted mandating continuing education. By2011 all AF dental assistants will be requiredto obtain 12 credit hours of continuing edu-cation annually. Aside from the educationbenefit this provides, it is our hope this policywill encourage even more AF dental assis-tants to seek national certification. The AF Dental Service is dedicated toproviding for the professional growth of itsdental assistants. Through its deliberate ed-ucation and training platforms the AF offersall its dental assistants the same opportunityto achieve their career goals and have a re-warding career in dental assisting. ❖ CMSgt Tom Davis is the Career Field (left to right) AB Provot, AB Hamann and AB Surrate examine digital radiographsManager for Air Force Dental Services. He while in dental assistant training at Sheppard AFB, Texas.has been in the Air Force for over 27 yearsand serves as the senior dental enlisted consul-tant to the Air Force Surgeon General. He isalso responsible for the training, utilization,and professional development of 2,400 dentalassistants, 500 dental laboratory technicians,and 100 hygienists. In addition to an Associ-ate of Applied Science in Dental Assisting,Chief Davis has earned a Bachelor of Sciencedegree in Management from the University ofPhoenix. 132009 July/August The Dental AssistantJ/A 09.indd 15 7/13/09 1:54:06 PM

Free CE Course Patient Care Coordinator: Are You Ready for the Challenge? BY Linda Zdanowicz, CDA, CDPMA s dental assistants remain in the profession longer they COURSE OBJECTIVES amass a large amount of knowledge concerning oral conditions, treatments and how dental procedures are Upon completion of this course, the dental pro-accomplished. After years of working chairside, some begin to fessional should be able to:wonder if there is more that they can do. A very interesting and extremely helpful position is emerging ✔✔ Understand how the Patient Care Co-for the assistant as a patient care coordinator (PCC). The PCC is ordinator interacts with patients dur-an adjunct to the dentist, patient and staff, and can improve the ing the preclinical consultations.service and productivity of the practice. Years of working withpatients and procedures gives the dental assistant a wide variety ✔✔ Identify legal scope of responsibilityof knowledge of those dental procedures. Also acquired is the and limitations during the clinical partunderstanding of the many differences in patient personality and of charting and record gathering.attitudes, as well as the ability to interact with both the patientand the dentist in a compassionate and objective manner. ✔✔ Discuss existing conditions and pos- Working side by side with a dentist allows a dental assistant sible treatment recommendations thatto learn and understand the dentist’s treatment philosophies and the dentist may suggest.modalities, and to be able to discuss treatment with patients ina way that complements the style of the dentist. As a staff mem- ✔✔ Review treatments plan with patients.ber dedicated to the PCC position, the dental assistant has thetime to fully educate the patient about patient needs and the sug- ✔✔ Learn to compile and present informa-gested treatment. tion that will facilitate an understand- While the PCC is assuming these responsibilities, the den- ing of the oral condition of the patienttist and clinical assistant are free to provide clinical dentistry to and the treatment plan that has beenother patients, all the while confident that the PCC is providing prescribed by the dentist. ✔✔ Discuss various available financial ar- rangement options. ✔✔ Track treatment progress and keep both the patient and dental team informed.14 The Dental Assistant July/August 2009J/A 09.indd 16 7/13/09 1:54:07 PM

accurate information and thoroughly ad- edgeably and enthusiastically introduce the the patient, the PCC prepares a treatmentdressing the questions or concerns of the attributes of the dentist and team. The PCC plan and fee sheet to discuss with the pa-consult patient as well as gathering infor- exhibits self–control and discretion. As a re- tient once the dentist is finished with themation to pass along to the dentist during sult, patients trust the PCC to represent pro- exam. The dentist and PCC must have athe PCC’s portion of the comprehensive spective patients’ anxieties, fears, and condi- good rapport so that the PCC can priori-examination. Although the specific respon- tions with other staff in a respectful manner. tize the patient’s needs and treatment. Forsibilities of a PCC may vary from practice more extensive treatment plans, the PCCto practice, this course is a general outline THE ROLE OF THE PATIENT may ask the patient to return for a follow–of responsibilities.* CARE COORDINATOR up consultation appointment. This allows time to discuss treatment plan options *Always refer to the state practice act to This dental team member, the PCC, with the dentist, prepare a review of find-verify delegation of duties allowed. will be the patient’s first experience with ings and put together an information pack- the practice. The PCC will greet and bring et for the patient. The PCC will then assistEDUCATION patients into a private area and get to know the patient with scheduling appointmentsAND EXPERIENCE them before the comprehensive oral exami- and payment. nation. This is crucial to developing trust and The position of a patient care coordinator gathering information. Once this is done, After the patient has completed the ap-requires a firm knowledge and background in the PCC will escort the patient to the exami- pointment, the PCC will review all the in-oral dental conditions and treatments, excel- nation treatment room. If the patient does formation recorded in the patient’s record.lent telephone and interpersonal communi- not have current radiographs, the PCC will The PCC lists any interesting facts aboutcation skills, and a thorough understanding ask the dentist to come meet the patient and the patient in a designated section of the re-of the state’s dental practice act. The PCC prescribe the necessary radiographs. The cord, which is accessible to any team mem-candidate should have worked with the den- PCC will take the radiographs (if allowed by ber meeting the patient for the first time. Atist at least two years, or have previous experi- the state dental practice act) and then pro- mention of these facts confirms the value ofence as a patient care coordinator. Preferably, ceed to chart visual existing conditions. In that patient to the dental practice. The PCCthe candidate will have completed an ADA addition, the PCC discusses any conditions can also prepare a separate review of find-–accredited program and attained certifica- noted during the initial exam and any poten- ings (see Example Review of Findings Form ontion and/or registration in dental assisting, or tial treatments the dentist may suggest. If the page 41) that can be useful at a future con-be a licensed dental hygienist.* PCC notices obvious decay or wear prob- sultation appointment as needed. lems, the PCC notes these issues as discus- *The above guidelines are suggested so that sion items prior to the dentist’s exam. The For patients with larger treatment plans,the PCC will have adequate knowledge and ex- PCC may also prepare educational sheets the PCC and dentist should go over theperience to immediately work with the practice pertaining to conditions noted during the treatment plans together, developing otherwith minimal training and supervision. There exam, specifically for the patient to read be- optional plans in case a patient does notare presently no state or national requirements fore the dentist arrives. want or cannot afford an optimal plan. It isto fulfill in order to function as a PCC. important for the PCC to understand every The PCC will then briefly share any clin- aspect of the treatment plan and the den-PERSONAL ical and relevant personal information gath- tist’s reasons for recommending each treat-CHARACTERISTICS ered with the dentist including what has ment so that the PCC can confidently and been observed about the patient’s condition. correctly answer patients’ questions during The PCC is both an advocate for the The PCC relates the information relayed to the follow–up consultation.patient and a liaison for the practice. Devel- the patient and the patient’s reaction. Theoping a trusting and an empathetic relation- dentist and PCC then proceed with the The PCC will track the patient throughship with patients is essential in building a rest of the oral examination together. The completion of treatment and will also trackpositive relationship. Good listening skills dentist will perform periodontal probing maintenance and preventive care as well.are important and will help the PCC un- and the PCC will record the findings. The If the patient has any questions during thederstand the patient’s past history with den- dentist examines the patient and discusses course of treatment, or at any time, the PCCtistry and develop good questions so that recommendations with the patient. will be available to answer them. The PCCthe PCC and patient can go forward with a can also offer to accompany the patient toco–discovery of what the patient wants and Due to the prior discussion with the consultations with specialists, as referred byneeds from the practice. PCC, the patient has an understanding of the practice, if the coordination of treatment the dentist’s recommendations and ratio- is complicated and if the specialist agrees to The PCC ushers the patient into the prac- nale for treatment. As the dentist speaks to allow the PCC to participate.tice and has the first opportunity to knowl- ➤ 152009 July/August The Dental AssistantJ/A 09.indd 17 7/13/09 1:54:07 PM

ASSET TO THE DENTIST the consultation with a new patient who has provide information about the patient’s per-AND TO THE TEAM a preliminary knowledge of the dental con- sonality type. According to Dr. Bill Lockard, ditions and can then discuss necessary and there are generally three reasons that people A dedicated PCC position allows the recommended treatment options. The PCC call for an appointment:dentist to garner more information about will gather all the information from eachthe patient without losing productive oper- part of the examination and then generate • They have been referred by a friendative time. While the PCC spends time get- a treatment plan and review of findings, or specialist.ting to know the patient by asking and an- which will be used when the patient returnsswering questions, the dentist can perform for the next consultation. The PCC should • They have a painful emergency ortasks specific to the dentist’s expertise. spend as much time as necessary going over other urgent need. the results of the examination and the den- This information gathering by the PCC tist’s recommendations with the patient. • They want a second opinion.can begin with the initial phone call. The ini- A new patient packet should be pre-tial phone call should serve three purposes: The PCC will act as a patient advocate pared and sent to the patient before the and liaison. Any questions the patient may first appointment. It should contain the • To greet the patient and make a posi- have regarding treatment can be answered office brochure, a welcome letter that tive first impression; states the date and time of the patient’s ap- • To begin gathering information to The way the patient perceives this first contact can assemble a personality profile on the color the view of the practice and influence a patient’s prospective patient; and decisions and interactions thereafter. • To set up an appointment for a com- by the PCC, or the PCC can obtain an- pointment, financial policy, directions to prehensive exam. swers quickly from the dentist or other the office, medical/dental history form, a team members. The PCC can record the questionnaire and anything else deemed Since the PCC is the first contact a pa- patient’s preferences and be sure that any appropriate. The patient should be askedtient has with a specific dental practice, the team member involved in that patient’s to complete the forms at home and bringPCC must be a professional practice ad- treatment is aware of these preferences. them to the first appointment.vocate and make the patient feel confidentthat the choice made to come to the practice THE FIRST CONTACT THE PRECLINICAL INTERVIEWfor treatment was a good one. The way the As stated, the first telephone call is the pa- The patient should be made to feel im-patient perceives this first contact can colorthe view of the practice and influence a pa- tient’s first impression of the office. Whether portant immediately upon entering the of-tient’s decisions and interactions thereafter. the call is taken by the PCC or the business fice. The person at the reception desk shouldBarry Polansky, DMD, in his book The Art assistant, a pleasant, positive and encourag- rise and greet the patient by name and intro-of the Examination, suggests developing a ing demeanor is essential. Qualities such duce himself or herself. Address the patient“Personal Patient Profile” for each patient. as empathy, warmth, and nonjudgmental formally unless they give you permission toThis information allows the staff and doctor attitude, will make the patient feel comfort- use their first name. It is important to maketo learn about the patient before treatment able and at ease. The goal of the questions the patient feel accepted; the greeter shouldand creates a comfortable entry into the re- asked should be to acquire the information engage in some warm, genuine conversationlationship for the patient. necessary for the practice. If the patient was with the patient to relieve anxiety and create referred to the practice by another patient, a an atmosphere of friendliness and trust. A briefing by the PCC eliminates re- call to the referral source might be helpful.petitive questioning of the patient by other The PCC, having already reviewed anyteam members. Instead, the team members More information about the patient available information about the patient be-can concentrate on making the patient feel might be acquired if the referral was made fore a first meeting, then meets the patient.comfortable and welcome. Getting patients by a friend or family member. In addition, The PCC should go to the reception area,into the practice in a timely manner gives inquiries should be made concerning pre- extend a hand in welcome, make eye con-the comprehensive examination impor- vious radiographs and records that can be tact, and invite the patient to come alongtance and reassures patients their needs will requested prior to the patient’s appoint- to the private office. The greeting should bebe met in a reasonable time frame. ment. Carefully thought–out questions can warm and friendly and should give the ➤ Also, the PCC functions as an educa-tor on behalf of the dentist and the team.Patients who have been properly educatedregarding dental issues increase their DentalIQ and can make better informed choicesregarding dental care. The dentist can begin16 The Dental Assistant July/August 2009 2771_2J/A 09.indd 18 7/13/09 1:54:08 PM

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patient the feeling that the PCC has been This will lead to the patient’s primary choice is not to use the questions, be sure toanxious to meet them. This moment often complaint. gather information about the appearance ofopens the door to a good relationship be- the patient’s smile and oral health.tween the practice and the patient. 4. Do you believe that you will eventu- ally wear artificial dentures? Here are points to consider during the Once the PCC and patient are settled in This question will reveal the patient’s initial interview:the office, the PCC can explain his or her role beliefs about dentistry that should bein the practice and let the patient know how discussed. • Clarify the patient’s desires and po-the comprehensive examination will be con- tential needs, and encourage him orducted. Begin the discussion by asking about 5. How would you feel if you were to her to articulate concerns regardingthe patient’s origins, family, hobbies and pas- lose a tooth? oral health.times. Share some information about your- This will tell about the patient’s dental IQ.self as well, especially if there are interests or • Determine how much the patientareas that you have in common. The impor- 6. How would you describe the condi- understands about his/her presenttant thing is to make the new patient feel ac- tion of your mouth at the present time? condition and how it affects the pa-cepted, first as a person, then as a patient. This will tell you about the patient’s tient’s overall health and happiness. expectations. The examination of a person’s mouth is • Gauge the amount of responsibil-a very personal and intimate procedure. The 7. How do you feel about your past ity the patient is ready to accept forpreclinical interview gives the patient and dentistry? his/her oral health, now and in thethe dental professional a chance to develop Ask about fears. Explore this question as future.the beginning of a relationship and become it will reveal much.comfortable with each other. If performed • Remember to meet the patientscorrectly, it can offer insight to the patient’s 8. How important is it for you to retain where they are right now withouthistory with dentistry, any fears and desires, your teeth all of your life? making them feel guilty about theirand the patient’s personality. This also al- If the patient says, “Not very,” think present condition.lows the PCC to explain the philosophy of twice about presenting comprehensivethe practice and to determine whether or dentistry too quickly. • Congratulate the patient on mak-not patients ares ready to accept responsi- ing the decision to seek care and bebility for their oral health. 9. Would you like to change the ap- excited for the patient regarding the pearance of your mouth? improvements that will be accom- As suggested, begin by learning a little If the patient says no, avoid being force- plished with the help of the dentistabout your patient. This can be accom- ful about dentistry. and team.plished by asking open–ended questionsand using active listening techniques. 10. If you could start over, what would • Convey the practice’s philosophy toOpen–ended questions require more than you do differently regarding your mouth? the patient.a YES or NO answer and provide moreinsight into the patient. Active listening 11. If you had a magic wand, how would • Let the patient know not only whatconveys attentiveness and reflects that the you repair your own mouth? the practice can do for the patient’slistener is ensuring understanding of the This reveals expectations. oral health, but also clarify what willinformation. It helps to generate a list of be expected of the patient as a part-questions that can be asked of the patient. 12. Would you like to set goals regarding ner in maintaining oral health. your mouth? The following are some suggestions that Listen closely for financial concerns. • Observe the patient’s feelings andDr. Polansky gives in his book, The Art of the reactions. Don’t judge the patientExamination. 13. Would there be anything that would — rather, encourage the patient to stand in the way of treatment? express any doubts and concerns, 1. Are you new to the area? the patient’s true feelings about oral This is a good conversation starter. There are five major objections to dental health and any reactions to the infor- 2. Are you married? Do you have treatment: fear, money, time, a sense of ur- mation provided about the practice children? gency, and trust. and its philosophy. This will allow the PCC to share person- al information with the patient. The above questions are designed to This is a critical time in determining 3. Why did you choose to come to our get the conversation started. They are not whether this is the right practice for this office at this time? meant to be a rigid pattern to be followed patient. If the goals of the patient and the with each patient. The PCC must decide expectations of the practice differ, this which questions to ask based on each pa- might be a good time to gently suggest an tient’s personality and temperament. If the18 The Dental Assistant July/August 2009J/A 09.indd 20 7/13/09 1:54:08 PM

alternative. Otherwise, proceed with the low the patient to see that the interviewer is • Let patients know that the dentistinterview. Next, the patient’s health his- trustworthy and caring. may be repeating many of the sametory requires reviewing. Be sure to probe questions because this is such an im-into the patient’s answers. Check the listed Finally, ask the patient if there are any portant part of the examination.medications and ask for what condition(s) questions, explain what will happen nextthe patient is being treated. This is impor- in the examination and proceed to seat the • Ask patients if they’ve noticed anytant because some medications can treat patient in a treatment room. At this time the changes or if they have any sores ormultiple conditions. For example, a pa- dentist may come into the treatment room ulcers that haven’t healed withintient with heart disease may not mention to meet the patient and order any necessary 10–14 days.this condition if the patient assumes the radiographs. The PCC will proceed with themedication has cured the disease. radiographs (if allowed by the state dental • Ask if they’ve noticed any numbness practice act) so the dentist can review them or hoarseness or have the feeling of Probing a little further may also help a pa- while the PCC continues with the initial having a lump in their throats.tienttoremembermedicationsthatheorsheis part of the examination.allergic to or other information that the patient • Begin by feeling for any unusualmay have neglected to provide initially. Ask THE CLINICAL EXAM lumps, bumps or swelling in the facethe patient about smoking or smoking in the The clinical examination begins with the and neck area. Make a note of anypast. If the patient smokes, ask about smoking nontender, nonmovable swellingcessation. If the patient is interested in quitting extraoral exam. You will want to be sure to tell and any asymmetry.smoking, explain how the dental practice can the patient what you are doing, why you arehelp. Also ask the patient about mouth sores or doing it and what you are discovering during • Place your fingers on patients’any changes in oral health. each part of the examination. That is a part of TMJs; have them open and close; educating the patient and allowing them to be feel and listen for any abnormal Each potential patient needs to be at- a part of the discovery process. It is important sounds or grating.tended to and cared for in a nonjudgmental to watch and gauge the patient’s reactions.and caring manner. This attention will make Many times this will be the first time they are • Ask patients if they have experi-the patient feel accepted and valued. When receiving this much information. enced symptoms such as pain,consulting with a new patient, be certain sounds, headaches, earaches, orto highlight anything positive about the • Encourage patients to ask questions locking of the jaw.patient’s condition or attitudes. The domi- at any time.nant feeling should be positive not negative. • Look at and feel the parotid glandsAlways discuss problems with a focus on for any swelling.improvement. Congratulate the patient for ➤taking this step toward improved oral healthand offer support. Photo courtesy of iStockphoto.com The patient’s desire for restorative care The examination of a person’s mouth is a very personal and intimate procedure. Theneeds to be balanced with the realities of preclinical interview gives the patient and the dental professional a chance to developthe dental disease. Establishing a good re- the beginning of a relationship and become comfortable with each other.lationship with a patient consists of listen-ing to the patient, providing hope for thefuture, and treating the patient in a respect-ful and thoughtful manner. When conducting an interview, be care-ful to follow HIPAA regulations to protectthe patient’s privacy at all times. Conductthe interview in a quiet area of the practice,preferably in an office with the door closed.During this interview, the patient is mostlikely to be open about any fears and pastdental experiences. If the patient becomesemotional, be supportive without judgingand give the patient time to regain his/hercomposure. Handling this correctly will al- 192009 July/August The Dental AssistantJ/A 09.indd 21 7/13/09 1:54:09 PM

• Palpate the thyroid gland and visual- • If patients are wearing removable • Make a note of excessive wear and W ly examine the area for enlargement. appliances ask them to remove the ask the patient about grinding or p appliances and check mouths for clenching of teeth.• Palpate the lymph nodes and notice redness and irritation. Check the ap- R any swelling, induration, tenderness pliance for wear, cracks, rough spots, • Check the margins of crowns and m and enlargement and ask patients cleanliness and fit. restorations for decay or leakage. w what they’ve noticed. d When examining the position of the • Test teeth for mobility and record w• Make notes during the examination teeth, ask if the patient has ever had ortho- any that are found. s or have another assistant record your dontics. If the teeth are out of alignment, D findings. with excessive overjet, overbite, crossbite, Every discovery is an opportunity to ed- p open bite, etc. Ask the patient whether ucate the patient and gain the patient’s trust. th• Notice any scars; ask about them and orthodontics would be considered at this Sit the patient up and provide the patient S measure and record the size and lo- time. If the patient says “No,” try to deter- with information sheets to read pertaining a cation of any moles. mine why not. Many people don’t realize to these possible issues before the dentist y that orthodontists treat patients for more comes into the consultation examination. d• Note whether there is any noticeable than cosmetic purposes. This is an oppor- The PCC privately briefs the dentist about malodor of the patient’s breath. tunity to educate the patient about func- what was discovered, what was discussed “ tion as well as form. The PCC should be with the patient, and the patient’s reactions• Use a piece of gauze to wrap around educated in these areas by reading or by and attitude toward receiving treatment. PR the tongue to gently pull it out and ex- consulting with the referring orthodontist amine for any sores, white patches of and staff to gain a comprehensive under- When the dentist comes into the treat- leukoplakia or any other abnormali- standing of the procedures and appliances ment room, introduce the dentist to the pa- ties. Leukoplakia are white patches on being used. Measure any overjet or over- tient and record the dentist's diagnosis and the mucous membrane that are usu- bite with a probe, and record the sever- treatment recommendations. At the com- ally found in adults age 40–70. They ity of overbite or open bite. If PCC knows pletion of the examination the PCC will go are found in males twice as often as fe- how to perform a load test, do that as well over the treatment plan options with the males and are often a result of tobacco and record any slides or deviations. patient. If the patient has an extensive treat- use. Five to 25 percent are premalig- ment plan, an appointment for a follow–up nant lesions. Explain that oral cancer Next, the PCC will chart any present consultation in the near future would be sug- is often found on the tongue and that conditions: gested. This would allow the PCC to discuss the dental team will regularly check the treatment plan with the dentist, prepare this area carefully. • Note any missing teeth. a review of findings and put together an in- • Go tooth by tooth and record all formation packet for the patient.• Take a mirror and check the areas alongside and under the tongue. It crowns, bridgework, restorations, re- The PCC will escort the patient to the is important to remember that the movable appliances and missing teeth. front desk and assist the business assistant PCC may not diagnose or prescribe • Look at the radiographs and record in setting up a follow–up consultation or treatment. The PCC may make the any endodontic treatment. Ask the the next appointment or series of appoint- patient aware of what the examiner patient when the work was done. Ex- ments for the patient. The PCC will express notices, the possible implications of amine the mouth one more time and pleasure in meeting the new patient and what is being seen, a possible treat- make handwritten notes of obvious anticipate the patient's return appointment. ment the dentist may recommend decay, fractures and failing restora- Also, the PCC can assure the patient that if and the pros and cons of each treat- tions for the dentist to confirm. there are any further questions, the PCC is ment. Thus, when the dentist exam- • Notice areas of food impaction and available to answer them. ines patients, they are already educat- plaque retention. ed about the possible scenarios and • Ask the patient about brushing and *Please note the link to Tufts University’s treatment options. flossing habits. If the patient indi- PDF, \"Oral Diagnosis, The Physical Exam,\" cates problem areas that are hard under Suggested Reading. It has a visual that• Examine the lips and mucous mem- to brush or floss, review the correct is helpful in preparing the PCC for performing branes and note any abnormalities technique with the patient and sug- an oral examination. in color or texture; note any scars, gest alternatives to floss, such as a lesions, effects of tobacco use and Proxabrush® or other aids. LEGAL SCOPE OF PRACTICE frenal abnormalities. AND RESPONSIBILITIES• Examine the palate and sublingual The PCC must be aware of, and act in area and make notes of any tori or accordance with, the legal scope of ➤ abnormalities.20 The Dental Assistant July/August 2009J/A 09.indd 22 7/13/09 1:54:10 PM

LIsoYoursinPracticegManageAlmenttiSoftud etware?We’ve been leading thepractice management revolution for 16 years.Revolutionary thinking in practice that can wreak havoc with your data! Andmanagement software began in 1992 we believe in providing your staff withwhen we introduced DENTRIX to the effective, certified training in your officedental professional. Now, 16 years later, with an experienced professional who canwe continue the revolution to help you answer your questions. As a result, yoursuccessfully grow your practice with staff can implement time- and money-DENTRIX G4, providing treatment planning, saving features immediately while takingpatient education, and electronic solutions advantage of quick and easy access tothat are unparalleled. True to the Henry our technical support team. Bottom line:Schein reputation for quality, we provide DENTRIX provides a rapid return ona comprehensive data conversion saving your investment to make your practiceyou from hours of frustrating and expensive take flight and reach new heights.data entry—we don’t offer budget solutions“10 Secrets from 10 DENTRIX Doctors:  Call 1.800.DENTRIX How to Win in this Economy” to get your FREE white paper today!PRACTICE SOLUTIONS ©2009 All rights reserved. DENTRIX, Henry Schein and the ‘S’ logo are registered trademarks of Henry Schein, Inc. Not responsible for typographical errors. A-DTXADAA-0209J/A 09.indd 23 7/13/09 1:54:10 PM

practice in the respective state and as al- tained, the PCC can complete the review of pictures and any applicable demonstrationlowed by the PCC’s licensure and/or edu- of findings. As previously mentioned, the items such as bridges, dentures and implantcation. A dental assistant may not perform first part of the review of findings will list components, and items obtained during theperiodontal probing (in most states), but what was observed and the causes and ef- patient’s initial exam may also be helpful.the assistant can inform the patient what fects of present conditions. Occlusal issuesto expect prior to the dentist or hygienist’s will also be mentioned here. The second If finances are a concern, try to find outperiodontal examination. (A hygienist may part of the review of findings will entail the what would make it possible for the patientperform the probing but may not make an recommended treatment in the suggested to proceed with treatment. Some possibil-absolute diagnosis for the patient.) sequence. This will begin with the dentist’s ities include phasing treatment and using first choice of treatment options. a financing company that serves dental By informing the patient about pocket patients. Be sure to make notes about thedepths and what the absence or presence of It is also important to have any educa- patient’s thoughts and decisions. Whenbleeding means, the assistant is taking a first tional or informational material at hand the patient decides on a course of treat-step in educating the patient about this part of that will help the patient understand his/ ment, have the patient sign the acceptedthe examination. Explain that pocket depths her condition and the need for treatment. treatment plan and provide a copy to themeasuring over 3mm are a beginning sign of This information may include radiographs, patient and keep a copy for the practice.periodontal disease. Educate the patient con- diagnostic casts, intraoral photography, Collate any written information and edu-cerning what treatments the dentist may rec- periodontal charting and information cational sheets for the patient and presentommend and what benefits the patient may sheets with photos. this to them in a folder. Offer to answerget from following those recommendations. any questions or concerns at any time. SetThe PCC or hygienist can tell the patient that Finally, a sequenced treatment plan with up an appointment to begin treatment orthere are conditions in the patient’s mouth fees will be needed. If there is more than one even a series of appointments.that may indicate decay or other detriments possible choice of treatment have a separateto dental health. However, the dentist is the treatment plan for each option. Be sure to Remember that patients are often sur-only person who can address the patient with include duplicates to keep on file. It is pref- prised by the expense of the treatmentan absolute diagnosis. erable to conduct the consultation in a pri- suggested and the patient’s first response is vate office so that the patient can feel free usually driven by emotion. Keep remind-THE FINAL CONSULTATION to ask questions in a private manner. Many ing the patient of the benefits derived from The first step in preparing for the final patients will enter the consultation and im- the treatment plan. At the same time, the mediately ask about fees. It is best to discuss PCC must respect the patient’s decisionconsultation appointment, if needed, re- the treatment options available before dis- and be careful not to try to persuade thequires the PCC to accurately enter all the cussing the fees. patient to accept a plan that is unafford-gathered information into the patient’s re- able or that the patient may resent in thecord. The patient record (chart) is a legal Have the folder of information in front future. Even if the patient decides not todocument so it is critical to be careful, ob- of you and begin by reviewing the positive accept treatment at this time because ofjective and accurate. Once the information aspects of their oral health and then begin the fees, it is important to remember thathas been entered, it is advisable to prepare to discuss areas of concern. Try not to over- “no” today doesn’t mean “no” forever, so itthe findings section of the review of find- whelm the patient or to make him/her feel is in everyone’s best interest to maintain aings. The review of findings is a document guilty or ashamed. If you were careful to good relationship with the patient. Offer tothat organizes all the information gathered let the patient know what you were seeing discuss treatment plans with the patient infrom the patient and from the examination during the comprehensive examination, the the future, if he/she desires.of the patient. It also details the treatment patient will not be shocked to hear that theythat is being proposed by the dentist. have some conditions that need attention. Once the patient has left, be sure to record notes about any decisions and concerns in the Once the PCC has completed the find- Go over the problems that exist, the rea- patient’s record. Record any financial arrange-ings section, the PCC should meet with sons they exist, the benefits of treatment and ments in the guarantor notes section of thethe dentist to go over possible treatments the implications of doing nothing. You can ledger. Discuss the results of the consultationoptions. The PCC must understand the talk about, without mentioning names, other with the dentist and any team members whotreatment options that are being suggested patients who have had similar treatment and will be involved with the patient’s treatment.including advantages and disadvantages of the benefits they have derived from the treat-each. Be sure to place in preferred order the ment. Allow the patient to ask questions and FINANCIAL ARRANGEMENTSrecommendations and review the treatment express concerns. Do not make the patientoptions with the dentist. feel pressured into treatment and do not be The discussion of fees will arise during impatient. Use visuals to help the patient un- the consultation appointment. By saving the Once this information has been ob- derstand what you are talking about. The use discussion about fees until the end of the con-22 The Dental Assistant July/August 2009J/A 09.indd 24 7/13/09 1:54:10 PM

sultation, the patient will hear all the possible TRACKING TREATMENT The PCC will review the progress of pa-treatment options. Then, the PCC can review FROM BEGINNING TO END tient treatment to check that the sequence isthe fees with the patient. There are times that correct, and also regularly run an unscheduledpatients will become annoyed or upset to A primary responsibility of the PCC is to treatment plan report to ensure that all patienthear how much the treatment will cost. At be available for the patient. By tracking the needs are being met. Often, a patient will waitthis time, the role of the PCC is to provide patient’s treatment, the PCC indicates to the for the office to call in order to make an ap-the patient with information and help the pa- patient that the treatment is important and pointment to commence treatment. If thesetient decide which treatment will work best necessary. Also, the PCC ensures that the misunderstandings occur, and are not correct-for the patient and the patient’s budget. treatment is completed in a timely manner ed, the patient may feel that the practice is not and that it is coordinated with any specialists interested in providing care. By remaining calm, the PCC may help that may be involved. Once the patient’s trustthe patient find ways to afford the desired is earned, it must be respected. The patient Again, the PCC must make contact withtreatment. Options may include: in–office needs to know that the PCC is available to any specialists who will be working with thepayment plans, independent lending com- answer any questions or concerns. patient, and offer to share information andpanies, obtaining a credit card that will be results. The specialist must be made awarededicated to dental treatment fees, and The PCC should be prepared to coor- of the steps that need to be coordinated be-phasing treatment. If the patient has insur- dinate treatment with any specialists who tween the two offices, in order to fulfill theance the PCC can offer to submit a request are brought into the patient’s case, and must treatment process. For instance, if a patientfor a pre–determination of fees and suggest also be aware of any conflicts or miscom- is referred to an oral surgeon for implants,an informed estimate of what the insurance munications between different treatment an agreement must be made on who willcompany will pay based on insurance plan plans. The PCC should not only ensure that perform any extractions, whether a surgicalmaximums. Be prepared in advance to be the patient understands the treatment and guide will be needed from the PCC officeable to suggest ways to phase the patient’s the time it will take, but also any discomfort before surgery, how long the treatment willtreatment over the course of a few years. One that the patient may experience, the medica- be expected to last, and even which implantadvantage to phasing treatment over two or tions that will help, and provide awareness sizes and style were used by the oral surgeon.three years is that it maximizes the patient’s of the fees that are involved. The patientinsurance coverage if the patient has insur- must know that the PCC will be available to If the patient is to receive treatment thatance. Make the patient aware of the practice’s answer any questions that arise. requires pain medication, antibiotics, or oth-fee increase policy. If fees are only guaranteedfor a certain length of time, be sure that the Continued on page 40patient understands that the fees on the treat-ment plan may increase if the treatment is not Photo courtesy of iStockphoto.comcompleted within a certain time frame. The PCC is a career ladder position for an educated dental assistant with complete Once the patient has made a decision, credentials and good organizational skills. That person must enjoy the challenges of thehelp the patient get started. If the patient position, which center on working with many different people on a regular basis.will use a dental lending company, providethe necessary information and allow thepatient to call from the office. This processis often very easy and can be accomplishedby the responsible party with a singlephone call. If the patient will be using anin–office payment agreement, draw up theagreement and print out a truth in lendingstatement. The PCC can copy the agree-ment into the patient’s guarantor notes orelse prepare everything in duplicate andstore a copy in a financial agreement file.Print out a financial agreement form thatoutlines the fees and payments and ask thepatient to sign it as well as a copy of thetreatment plan. This protects the practiceand prevents any future confusion. 232009 July/August The Dental AssistantJ/A 09.indd 25 7/13/09 1:54:11 PM

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Colgat U.S. Army MSG Arnold L. Voigt Challenges & Opportunities Providing dental care under harsh conditions in remote corners of the world he motto of “Challenges & Op- Army Dental assistants SPC Natasha Kendrick (left) and SPC Porshia Brown portunities” proved to be more (right) relax in their gymnasium \"room\" after a day of treating patients in the Alas- than just a phrase this pastMarch as a selected group of Army den- kan town of Bethel, Alaska.tal assistants and dentists assigned tothe DENTAC in Alaska participated inOperation Arctic Care (OAC) 2009,which was based in Bethel, Alaska. OACis a multiservice medical and dentalmission to remote villages in Alaskawhere members of these communitiesare provided with much–needed andappreciated dental care. OAC is a complex two–week–longmedical humanitarian mission that re-quires a year of significant planning,preparation, and training. To under-stand the logistics and the scale of thismission, one must understand that sol-diers and doctors who participate inOAC are not operating out of their fixeddental clinics but are instead working inaustere conditions inside tents that ➤26 The Dental Assistant July/August 2009J/A 09.indd 28 7/13/09 1:54:13 PM

ColgateDentalAssistant109.qxp:ColgateDA 12/16/08 11:45 PM Page 1 Introducing Colgate Total® Advanced Clean The full spectrum of Colgate Total® benefits now with superior stain removal* The ADA Council on Scientific Affairs’ Acceptance of 7/13/09 1:54:14 PM Colgate Total® Advanced Clean plus Whitening toothpaste is based on its finding that the product is effective in helping to prevent and reduce tooth decay, gingivitis and plaque above the gum line, bad breath and to whiten teeth by removing surface stains, when used as directed. Visit colgateprofessional.com *vs ordinary fluoride toothpaste. 1. Panagakos FS, et al. J Clin Dent. 2005;16(suppl):S1-S19. 2. Data on file. Colgate-Palmolive. New York, NY. © 2009 Colgate-Palmolive Company CTACr21208J/A 09.indd 29

During Operation Arctic care the main method of transportation, for both personnel and equipment, was the UH-60 Blackhawk helicop-ter. This means of transportation allowed for quick and efficient movement around the area of operation.are over 500 miles from their clinics. 2009 from carrying out its mission. The Master Sergeant Arnold L. Voigt Every village served during this op- operation serviced 11 outlying villages was born on 15 September 1965 in Bar- and provided 2871 dental procedures ron, Wis. In 1986 he enlisted in the U.S.eration is isolated and completely in- to 1059 Alaskans. Despite the harsh and Army. He is currently working towards hisaccessible by automobile. Therefore, rudimentary conditions, a wide variety Bachelors of Science Degree in Businessall equipment and personnel have to of dental treatment was provided to pa- Administration from Liberty University ofbe flown in by helicopter. Due to the tients in need, including restorations, Virginia.heavy reliance on aircraft for soldier and endodontics, extractions, prophylaxisequipment movement, weather condi- and denture or appliance repair. MSG Voigt has served as the Seniortions factor heavily into the feasibility of Soldiers who serve as dental assis- Dental NCO of the DENTAC Alaska foroperations, a reality that was made clear tants within the Army Dental Com- the past year. He is a graduate of the Basicduring OAC 2009. mand have great opportunities to help Infantry School, Fort Benning, Ga. He is others while honing their dental assist- also the Honor Graduate of the Dental Spe- Immediately prior to the start of op- ing skills in a variety of conditions and cialist course at Fort Sam Houston, Texas,erations, a massive weather front moved environments. Regardless of where the and attended the Primary Leadership De-out of the Gulf of Alaska to blanket the call of duty sends them, the soldiers of velopment Course, the Advanced Airbornewestern Alaskan coast with heavy snow the Dental Command feel privileged School, Battle Staff NCO Course, the Den-and high winds. This weather system to serve their nation and the desire to tal Management Development Course, thestranded all but a few soldiers in An- honor the confidence of the people of Basic and Advanced Non–Commissionedchorage for nearly a week. The same the United States. Dental soldiers are Officer Courses at Fort Sam Houston, Tex-system later stranded soldiers in Bethel always ready to deploy wherever need- as, the USASMA, Fort Bliss, Texas, andfor two days, making it impossible for ed and provide outstanding dental care numerous other Army schools and courses.traffic to move into or out of the exer- under even the most inhospitable of He is married to the former Patricia Joanncise area or the villages that needed conditions. Bauer of Durand, Wis., and they both cur-critical support. ❖ rently reside in North Pole, Alaska. However, the uncooperative weath-er conditions did not prevent OAC28 The Dental Assistant July/August 2009J/A 09.indd 30 7/13/09 1:54:16 PM

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Fusio_Vision Impairment continued from page 10 be careful not to shine the dental light in pa- may feel some of the instruments. Tap theyourself and first find out if help is required. tients’ eyes; dark safety glasses may be best. If mirror and explorer together so they willIf your offer is accepted, ask how you can youremovethepatient’sownglassesaskwhere recognize this sound as these instrumentsbest help. Allow the patient to take your he or she would like you to put them. Explain may touch each other in the mouth.arm just above the elbow. Children should every procedure in detail slowly and in termshold your waist or your hand. As you guide that can be understood. Describe the texture, Discuss rinsing options before it is nec-the patient to the operatory, be very specific temperature, softness or hardness of materials essary to rinse. There are several ways towhen you point out obstacles in the path of and instruments before you use them. do this. Place the cup in the patient’s handtravel. For example, if there are steps, de- and have him or her rinse and emit the wa-scribe how many there are and if they go up Since the patient’s other senses may be ter into a second cup. Always take the cupor down; also describe which way the door more acute warn him or her about smells away when they are finished. If using theopens before you let the patient follow you and tastes, including any medications and saliva bowl, run the water as a sound cuethrough the doorway. Using clock direc- prophy paste. Tell the patient before using and guide patients’ hands to the bowl ortions in your description may be helpful, the air and/or water. Let them feel and hear give the suction to patients and let themsuch as the door is at two o’clock. the suction tip and let them know that the clear their mouth themselves. Another op- hand piece will vibrate. A moving rubber tion is to simply rinse the patient’s mouth You may guide the person’s hand to a prophy cup can first be applied to a finger- using the water spray and suction (see Boxstair railing or the back of a chair to help nail so they can get a sense of what it will feel 4 on page 32 for an overview of dental man-lead them to stairs or a seat. If the patient like on the teeth. With assistance, the patient agement). For dismissal of the patient ➤has a service animal or guide dog, walk onthe side opposite the dog. Do not touch or Physical Access to the Office3, 8, 10, Internet Resourcespet the dog, or offer to feed the dog, as thedog is working and needs to concentrate. ✓✓ Keep passages clear of clutter.The dog may stay in the operatory with the ✓✓ No loose rugs.person but out of the way. While working ✓✓ Hang plants.be aware of tail and paws at all times. ✓✓ Ensure a clear passage to the chair in the operatory before the To seat the patient, first place his or her patient arrives—move operator and assistant chair, hoses forhand on the back of the chair and make hand piece, suction and air, foot pedals, bracket tray, and anysure they have physical contact with the x-ray equipment.chair for orientation. Position yourself near ✓✓ All areas should be well–lit.the chair as the patient sits down and be ✓✓ Furniture should have no sharp edges.ready to help if necessary. Once the patient ✓✓ Door frames and handles and edges of steps should be wellis seated, give a verbal description of where defined in contrasting colors to prevent accidents. Contrastthe chair is located in relation to the rest colors are also important to differentiate walls from floors.of the room. If the patient uses a cane, ask ✓✓ Handrails on staircases with steps that are not too steep.where he or she would like to keep it. Box ✓✓ Tactile or Braille maps posted in the halls and elevators.3 (page 31) describes guiding and seating ✓✓ The effects of glare may make it difficult to see due to:the patient.3, Internet ResourcesDental Management • High intensity lighting; • Sun shining directly through windows; and It may be easy to recognize patients with • Highly polished floors.visual impairments because they have diffi-culty reading, wear glasses, use a white cane ✓✓ Use large print signs.or are accompanied by a guide dog. It is im- ✓✓ Contrast colors for words against background.portant to find out how much impairment apatient has, if he or she needs your help and Box 2how he or she prefers to communicate. Theenvironment should be relaxed. Let patientsknow before you change the position of thechair so they do not feel like they are falling. Some patients may be sensitive to light so30 The Dental Assistant July/August 2009J/A 09.indd 32 7/13/09 1:54:18 PM

Fusio_ADAA_0609a:Layout 2 6/8/09 1:50 PM Page 1 A Fusion of Composite & Adhesive Technology! Fusio Liquid Dentin, the natural progression of composite resin technology! Introducing Fusio™ Liquid Dentin, the flowable composite that tenaciously bonds to both dentin (25.5 MPa*) and enamel (22.7 MPa*) without acid etching or a bonding agent. By fusing together adhesive and composite technology into a single product, we’ve created one of the most versatile materials in dentistry. Whether you use it as a dentin replacement, self-adhesive base liner, or a pit and fissure sealant, it doesn’t get any easier than this. Simply syringe into the preparation, agitate and light-cure. Call now to find out just how Fusio Liquid Dentin can improve the way you practice dentistry. The self-adhesive properties of Fusio Liquid Dentin make it an indispensable material in any dental operatory!800.551.0283 | 203.265.7397 | www.pentron.comArtiste® | Simile® | Flow-It®ALC™ | Alert® | Fini™ | Fusio™ Restoratives Impression Adhesives Crown & Bridge* Internal data. Copyright © 2009 Pentron Clinical Technologies, LLC. All rights reserved.J/A 09.indd 33 7/13/09 1:54:19 PM

Guiding and Seating the Patient3, Internet Resources ✓✓ Allow extra time. ✓✓ Have the operatory ready. ✓✓ Identify yourself and others who may be with you. ✓✓ Ask if the patient needs help. ✓✓ When the patient takes your arm: • Guide by walking as straight as possible, a half–step in front of the patient. • Do not grab or pull the patient by the arm; you may throw the patient off balance. • Do not hold onto or move a patient’s cane; it is part of the patient’s personal space. • Let the patient you are guiding set the pace. • Avoid sudden, unexpected movements. • Point out obstacles. • Be specific. ✓✓ Guide dog or service animal • Walk on the side opposite the dog. • Do not touch or pet the dog, or offer food. • The dog may stay in the operatory with the patient but out of the way. ✓✓ Patient Seating • Put the patient’s hand on the back of the chair. • Position yourself near the chair as the patient sits down; help if necessary. • Give a verbal description of where the chair is located in relation to the rest of the room. • If the patient uses a cane, ask where he or she would like to keep it.Box 3remember to let the patient know when detail so for partially sighted patients, posi- record your oral hygiene instructions on au-changing chair position, reverse the guide- tion the chair for best visibility, have them dio tape or you can supply the informationlines for seating and be ready to provide as- wear their glasses and use good lighting. Ask in large print or Braille.3, 6sistance out of the operatory if necessary.3, them to scrape a little plaque from the tooth, have them feel it and smell it, and then feel Conclusion5, 6, 8–10 with their tongue how dirty the teeth are. If The 20 million Americans with visual the patient has extremely limited or no vi-Oral Hygiene Instruction sion at all, explain toothbrush position and impairment translate to one out of 20 pa- The patient’s attitude may cause a lack of motion by placing the patient’s hand over tients whom you will see in your office your hand as you move the brush in his or having some degree of vision disability.2motivation with home care. There may be her mouth. Give a detailed verbal descrip- Therefore, it is vital that the dental teammore plaque and calculus present because tion while moving the brush. Make sure to be knowledgeable and confident in treat-there may be little or no visual feedback watch patients perform procedures them- ing these patients. Being prepared will helpwhen the teeth look dirty. Remember that selves and have them feel with their tongue save valuable treatment time as well as makethe patient may not be able to learn by imi- how clean the teeth are after brushing. the appointment more comfortable and ef-tation so be inventive with your instruction. fective and a good experience for everyone. Use similar methods for flossing instruc- The next article will help your office care for As with anyone else, first have the pa- tion and point out that when the tooth sur- patients with hearing impairments.tient demonstrate their current technique face is clean they should hear a squeak asand then make any modifications to existing the floss moves on the tooth. Patients can ❖practice. They may not be able to see fine32 The Dental Assistant July/August 2009J/A 09.indd 34 7/13/09 1:54:20 PM

Dental Management3,5,6,8,9 Internet Resources ✓✓ Provide a relaxed environment. 1. American with Disabilities Act Fact Sheet Series. Fact Sheet 2-Providing Effective Com- ✓✓ Warn the patient before any change in chair position. munication, Fact Sheet 3 Communicating with People with Disabilities. Available at : http:// ✓✓ If the patient is sensitive to light, use dark glasses. www.adata.org/ 2. U.S. Department of Labor. Office of Dis- • If you remove the patient’s own glasses, find out where ability Employment Policy. Communication the patient prefers to have the glasses placed. with and About People with Disabilities. Avail- able at: http://www.dol.gov/odep/pubs/fact/ • Avoid shining the light in the patient’s eyes. comucate.htm. 3. American Foundation for the Blind. AFB. ✓✓ Explain every procedure slowly using descriptive words. Tact and Courtesy. Available at: http://www. afb.org/Section.asp?sectionid=36&topicid=16 ✓✓ Describe any smells and/or tastes. 3&documentid=2263 4. United Spinal Association. Disability Eti- ✓✓ Avoid surprise applications of suction, air, water, moving rubber quette, Tips on interacting with people with dis- prophy cup and the vibration of motor–driven instruments. abilities. Available at: http://www.unitedspinal. org/pdf/DisabilityEtiquette.pdf ✓✓ With assistance, the patient may feel some of the instruments. 5. World institute on Disability. WID. Treating Adults with Physical Disabilities: ✓✓ D iscuss rinsing options before it becomes necessary. Access and Communication. Available at: http://www.wid.org/ ✓✓ R everse seating procedures for patient dismissal; guide the 6. Mace, R.L., Removing Barriers to health patient if necessary . Care. A Guide for Health Professionals. Pro- duced by The Center for Universal DesignBox 4 and The North Carolina Office on Disability and Health. Available at: http://www.fpg.unc.References 2nd ed. St. Louis, Mo.: Saunders; 2003: 800-4. edu/~ncodh/rbar/. 7. Shinh, Y.H., Chang, C.H., Teaching Oral1. U.S. Department of Justice. Americans Hygiene Skills to elementary students with visual Janet Jaccarino, CDA, RDH, MA, iswith Disabilities Act. Available at: http://www. impairments. Journal of Visual Impairment and an Assistant Professor in the Departmentada.gov/t3hilght.htm. Accessed: May 2009. Blindness. 2005; 99 (1). Available at American of Allied Dental Education in the School of2. American Foundation for the Blind. Facts Federation for the Blind http://www.afb.org/ Health Related Professions at the UniversityAnd Figures About Blind & Visually Impaired jvib/jvibabstractNew.asp?articleid=JVIB990104. of Medicine and Dentistry of New Jersey. SheIndividuals In US. Available at American Fed- Accessed: May, 2009. has been teaching dental hygiene and den-eration for the Blind : http://www.afb.org/Sec- 8. Mahoney, E.K., Kumar, N., Porter, S.R., Ef- tal assisting students since 2000 and can betion.asp?SectionID=15&DocumentID=4398# fect of visual impairment upon oral health care: a reached at [email protected]. Accessed: May, 2009. review. Br Dent J. 2008; 204: 63-673. DECOD Program (Dental Education in 9. Dougal, A., Fiske, J. Access to special careCare of the Disabled). Module IX. Dental Man- dentistry, part 2. Communication. Br Dent J.agement of patients with CNS and neurologic 2008; 205: 11-21.impairment (a series of 12 booklets). 2nd ed. Se- 10. DeAngelis, S., Visual impairment in theattle: DECOD, School of Dentistry, University older adult: breaking down the barriers to com-of Washington; 1998. munication. Access: 2002; December: 36-39.4. National Eye Institute, NIH. Eye Health 11. Chavez, E.M., Ship, J.A., Sensory and Mo-Information, A–Z Diseases and Disorders. tor Deficits in the Elderly: impact on oral health.Available at: http://www.nei.nih.gov/health/. J Public Health Dent. 2000; 60 (4): 297-303.Accessed May, 2009.5. Wilkins, E.M. The patient with a sensory Reference for Photographsdisability. In: Clinical Practice of the Dental Hy- in Table 1gienist. 10th ed. Philadelphia, Pa.: LippincottWilliams & Wilkins; 2009: 870-898 \"Most Common Causes of Age Related Vision6. Wentworth, L.E., Rowe, D., Persons with Loss.\" National Eye Institute, National InstitutesNeurologic and Sensory Disabilities. In: Darby of Health. Available at: http://www.nei.nih.and Walsh. Dental Hygiene Theory and Practice. gov/health/. Accessed: May, 2009. 332009 July/August The Dental AssistantJ/A 09.indd 35 7/13/09 1:54:20 PM

ADAA Annual Session Update Session Schedule*WEDNESDAY, SEPTEMBER 30 Reference Committees: 11am – 12:30pm 11am – 12:30pm U.S. Army Track 8am – 5pm Bylaws 11am – 12:30pm Thursday, Sept. 30 – Saturday, Oct. 3. Budget Resolutions An estimated 50 to 60 soldiers and leaders from the United States Dental Command will attend the Annu- U.S. Air Force Session 1pm – 3pm al Session in Hawaii this year. Besides a historical tourof the USS Arizona and Pearl Harbor, classes will be conducted The Air Force Dental Service will hold a two–houron following topics: Duties of NCOICs vs. Practice Managers; Role ofthe Dental Assistant on the Battle Field in Iraq/Afghanistan; Dental As- special session on Friday, Oct. 2, from 1–3 p.m.sistants and Technology Update (Going Paperless); Recruitment and Re-tention—Army Today; Career Management—Maximize Human Capital; The Air Force Federal District Trustee and AirMentorship—What Is a Mentor?; DANB Certification and Lab Techni-cians Certification (Maintaining Current Certifications); Proper Counseling Force Dental Career Field Manager, Chief MasterTechniques—PE—Soldiers. The Lead Army Theme for 2009 is “Yearof the NCO.” This session is for US Army dental soldiers only. Sergeant Thomas Davis, will provide an overview of the Air Force Dental Service and give updates on key dental assisting initiatives. Attendance is mandatory for all AF dental assistants in attendance at the annual meeting. Non–AF dental assistants interested in learning more about the Air Force Dental Service are welcome to attend the session as well.THURSDAY, OCTOBER 1 Caucus 1:30pm – 3pmPre–Conference Board of Trustees Meeting 8am – 11am Balloting 3pm – 5pmNew Delegate Orientation 9am – 10am Delegates elect officers and trustees according to ADAA’s balloting procedures as stated in the Bylaws. Credential cards and badges areIf you are a new delegate, this orientation will explain what you can required to ballot.expect in the House of Delegates, what goes on in a caucus, whatyou are voting on, the importance of being a delegate and more; SATURDAY, OCTOBER 3there will be time to answer your questions. While we strongly rec- Army Workout 7am – 8amommend this for those who have not previously attended an ADAA Join SGM Drumm for a military workout. Wage war on your bodyAnnual Session, this orientation is open to all delegates and all are while burning calories along with the U.S. Army’s finest! OPENinvited to attend. TO ALL!Caucus 11:30am – 12:30pm Fellowship/Mastership Convocation 9:30amCaucuses disseminate information and issues of the Association. Second House of Delegates 10am – 1pmParticipation in a Caucus is mandated by your Trustee or State. Open to delegates and ADAA members only. Caucus meetings are for delegates and alternates only.First House of Delegates 2pm – 4pm ADAA PRESIDENT’S GALA 6pm – 10pm CODE: E004The legislative and policy–making body of the Association is the $35.00 (Ticketed Event)House of Delegates. The House of Delegates shall transact all busi- You are cordially invited to join us at the official installation Galaness of the Association as stated in the Bylaws, and shall elect the for our ADAA newly elected and returning officers and trustees.general officers. Open to ADAA members and invited guests only. Receive your commemorative gift in honor of our 85th Anniver- sary. To purchase your gala ticket, go to ADA’s website under spe-FRIDAY, OCTOBER 2 cial events. TICKET PURCHASE NOT AVAILABLE ONSITE. Event sponsored in part by a grant fromVision Presentation 8am – 10:30amThis presentation is focused on the future of ADAA. We will discussthe new membership initiative and the benefits it can bring to the As- SUNDAY, OCTOBER 4 Post–Session Board of Trustees Meeting sociation. Open to ADAA members only. 8am – 10am*Delegate Services: Hours will vary, DRESS CODE (please note: no jeans/shorts/T–shirts or flip flops. )check onsite for schedule.*Schedule subject to change. House of Delegates — Business AttireVisit www.dentalassistant.org for Men: suit, slacks, collared shirt or knit shirt with collar, sports jacket optional.updates. Women: collared blouse, slacks, skirts, dresses or suits ADAA President’s Gala — “Elegant Resort Formal” Men: suit or slacks, sports jacket and a button down shirt. Women: cocktail dress, gown or dressy pant suit.J/A 09.indd 36 7/13/09 1:54:22 PM

“I kuka makemake e hei mai, hele no me ka malo’elo’e.” (Hawaiian proverb)“If the wish to come arises,walkfirmly.Ifyouwish to come do not be hesitant,foryou arewelcome.” ADAA OFFICIAL ADA Opening General Session An Evening Under the Stars HEADQUARTERS HOTEL and Distinguished Speaker Series Friday, Oct. 2 Wednesday, Sept. 30 7:30 – 9:30pm Waikiki Beach Marriott Resortand Spa ADAAF Silent Auction to run concurrently with ADAA Governance and other meetings at the Waikiki Beach Marriott Resort and Spa Hotel. Bidding hours 2552 Kalakaua Ave will start Thursday, Oct. 1, prior to the First House of Delegates. Honolulu, HI 96815 The Silent Auction closes before the Second House of Delegates—Saturday, WORLD MARKETPLACE Oct. 3, approximately 10am. Don’t forget to come back and check to see what great EXHIBITION items you’ve won—approximately 1pm.Itempickupimmediatelyafter2ndhouse. Hawaii Convention Center Silent Auction Hours 1801 Kalakaua Ave Honolulu, HI Thursday,Oct.1 8:30am – 4:30pm HOURS Friday, Oct. 2 10am – 5:00pmThursday, Oct. 1, Friday, Oct. 2 , Saturday, Oct. 3 7:30am—3:30pm Saturday,Oct.3 9am – 10amREGISTRATION ness days if requesting the acknowledgment and confirmation be sent viaGo to www.ada.org before September 3rd. Registration fees increase af- U.S. Mail.ter September 3. Register by September 3 to avoid fee increase. All sales are Confirmations will be sent via e–mail (if an e–mail address is provided)final for registration and tickets purchased after September 3. or by fax (if a fax number is provided) within 72 hours of receipt of yourIf you register online after September 3, 2009, or if your registration form registration request. If you do not provide an e-mail address or fax number,is received by fax or by mail after this date, it will be processed at the in- your confirmation will be sent by regular mail.creased registration and course fees, and a confirmation will be issued. Youwill be required to pick up your badge, tickets and other materials on–site at BADGE AND REGISTRATION MATERIALSthe On–site Registration Area located in the Welcome Foyer of the Hawaii If you register by the Thursday, September 3, 2009, deadline, yourConvention Center. Please bring your confirmation letter to allow expedi- badge and registration materials will be mailed to the address providedtious completion of your registration. (materials cannot be mailed to P.O. boxes). Each registrant will receive anYour registration materials will arrive in advance via the U.S. Postal Ser- envelope containing his/her badge and tickets.vice. Be sure to complete your registration online by Thursday, September If you register after Thursday, September 3, 2009, your registration will be3, 2009. If you register by fax or mail, please allow enough time to be sure processed at the increased registration fee. You will receive a confirmation,that your registration form is received at Experient by Thursday, September but you must pick up your badge and other materials at the on–site registra-3, 2009. Registration materials — badges, tickets, etc. — will begin mailing tion area (please bring your confirmation and photo I.D.).in mid–August in the order in which registrations were received. Registrants from outside the U.S. must pick up their badges and tickets atTo correct information on your badge — prior to September 3, 2009, you may the International Registration counters located in the on–site registrationcorrect your badge information online by accessing your registration re- area. Please present your registration confirmation and photo I.D.cord. You may also go to the on-site Registration Area at the Hawaii Con-vention Center. CANCELLATIONS, REFUNDS AND CHANGES Registration cancellations must be received in writing to ExperientSHUTTLE SERVICE by 5:00pm Central Time on Thursday, September 3, 2009.Shuttle bus service will be provided between the Hawaii Convention Cen- Cancellations received by this date will receive a full refund less a $10ter and all ADA Official Hotels that are not in walking distance of the processing fee per cancellation. No refunds or exchanges will be madeConvention Center. The schedule for the shuttle service will be available at for cancellations received by Experient after September 3, 2009, for anythe front desk of each Official Hotel serviced by the shuttle and at the Ha- reason. Please allow 60 days for refund processing. After the Annual Ses-waii information booths located at the Hawaii Convention Center. Shuttle sion, requests for special consideration of registration refunds must beservice is not available to any nonofficial hotel. submitted to the ADA no later than December 1, 2009. Refunds will notDays of shuttle bus operation are Wednesday, September 30 — Tuesday, be issued after December 1, 2009.October 6. Please e–mail, fax or mail your cancellation request to:To view a list of ADA Official Hotels visit http://www.dentalassistant.org. Experient/ADA Annual Session,CONFIRMATIONS 568 Atrium Dr., Vernon Hills, IL 60061A confirmation of registration and housing will be sent via contact in- Fax: 800-521-6017 and 847-996-5401formation provided, immediately after processing. Please allow 5–7 busi- E-mail: [email protected]/A 09.indd 37 7/13/09 1:54:23 PM

Legislative Update compiled by Rosana Rodriguez, CDA, CDPMA, FADAALegislative Assistance Program tested procedures be retained after 2009, with changes to the materialFunding for 2008 used for the direct provisional restoration (currently referred to as a temporary sedative dressing). It is anticipated that COMDA and theCDAA Legislative Update for Receipt of 2008 LAP Funds Board will make a decision later this year.February 3, 2009Submitted by Kristy S. Borquez, CDA, RDAEF, FADAA COMDA and the Board may need RDAs to provide input for theGovernment Relations Chair various written tests that must be developed, including the Orthodon- tic Assistant and Dental Sedation Assistant. If you might be interested, The CDAA is part of the Dental Assisting Alliance in California e–mail me at [email protected] and I will contact you when morealong with the California Association of Dental Assisting Teachers information is available.(CADAT). We have one consultant who is extremely diligent in keep-ing current on everything regarding “Dental Assisting” in California. As a reminder, COMDA will cease to exist on July 1 of this year, andShe bills us monthly and CDAA splits her bill with CADAT. CDAA its functions integrated into the Dental Board. At the same time, a newhas paid as little as $300 a month and as much as $2000. That is how our Dental Hygiene Committee will be created.2008 LAP fund assistance of $2,000 was spent. The Dental Assisting Alliance will be making recommendations Legislation in California has changed over the last few years. We were to the Dental Board concerning the most appropriate way for dentalsupposed to have three RDA specialty categories for dental assistants and assisting issues to be appropriately addressed, and will also be askingthat was changed. Now the RDA will stay in play and two permit catego- that the Board develop some mechanism by which to ensure the den-ries will be added. The RDAEF will have more duties added to this li- tal assisting community that fees paid by dental assistants are spentcensed category and the program will be lengthened. Unlicensed dental solely on dental assisting activities.assistants will be required to take mandatory courses in Infection Controland California Dental Practice Act. The guidelines for RDA programs The Dental Board of California’s website is: www.dbc.ca.gov.need to be restructured to accommodate the new duties.Legislative Update Michigan Legislative Update for Receipt of 2008 LAP Funds April 27, 2009 Now that AB2637 and SB853 have gone into effect, efforts are being Submitted by Lori Barnhart, CDA, RDAdevotedto identifying areas that need clarification and ensuring a smooth Legislative Chairmanimplementation and transition. It is unknown at this time whether therewill be any additional legislation in 2009 that On behalf of the Michigan Dental Assistants Association, I sincerelywill require monitoring or action. thank the LAP Fund Committee and ADAA Board of Trustees for ap- Several areas surrounding educational proving and providing the MDAA with $1500 in LAP Funds. ➤programs are being addressed, but it doesnot appear that there will need to be anysignificant changes that will need to bemade to the new laws governing RDA ap-plicants and licensees. One recent clarification of interest toRDAs is that existing RDAs do not have tobe certified in pit and fissure sealants, unlessthey wish to perform that duty. Only RDAswho first become licensed on and after Janu-ary 1, 2010, must provide proof of havingcompleted a board-approved course in thisduty in order to be licensed. However, RDAeducational program faculty must be certi-fied in this duty no later than July 1, 2009. With regard to the RDA practical exam,the Dental Assisting Alliance has advo-cated to COMDA that the two currently36 The Dental Assistant July/August 2009J/A 09.indd 38 7/13/09 1:54:24 PM

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We purchased the RDA list from the state delegated and utilized. There was no sense in formation if they were willing to provide writ-and prepared a mailing to all RDAs that was fighting for it if nobody was interested in per- ten or verbal testimony on our behalf. This is afour pages in length. We had asked the Board forming the function or the employer would very valuable list for us. We were also able to getof Dentistry to make changes to the adminis- not delegate it. feedback from the RDAs on how many of themtrative rules to allow RDAs to place and con- went back to school to acquire the necessarydense composite resins and there was some In addition, the Board was looking at add- education to perform the new RDA functionsopposition on the Board. In addition the ing in the Assignment Category into the rules added in 2003.RDA representatives on the Board of Den- that would for the first time allow an RDA totistry wanted to know how much support was work without the dentist being present. This In our original request for funds I hadout there from the RDAs and their employers is huge for us. Dentists and RDAs had the op- mentioned that the dental association wasin regards to adding the administration of lo- portunity to respond to our mailing and list interested in setting up another task force tocal anesthesia to the rules. We needed to find functions that they would like to see added to look at adding the dental assistant into theout if these two functions would readily be the rules in the future and those dentists who were supportive provided us with contact in- Continued on page 48Minnesota Legislative Update for Receipt of 2008 LAP FundsSubmitted by Natalie Kaweckyj, RDARF, CDA, CDPMA, COA, COMSA, MADAA, BALegislative ChairmanMDAA was awarded $3,000 The quest for dental assistant licensure began approximately in 1996 when the MDAA legislative committee was directed to investigate ahousekeeping change in the verbiage pertaining to Minnesota RDAs. Through the years MDAA worked with Senator James Vickerman on sev-eral bills to change the status of regulatory language from registration to licensure. It was viewed as a simple housekeeping change but the journeywas far from simple. Although the MDAA had the support of the Board of Dentistry, the Minnesota Dental Association (MDA) was not sup-portive of the quest and through the years the licensure bills made various advancements through different committees at the legislature. Twelve years later, in 2008, a proposal from the Minnesota Society of Oral Maxillofacial Surgeons to permit assistants to start IVs and to pushmedications came forward and there was a lot discussion in the Policy and Sedation Committees regarding training and regulatory status; as aresult, renewed discussions about RDA licensure occurred and the DA Task Force on Licensure reconvened meeting twice in December andonce in January 2009. The task force recommended that the Policy Committee take the lead on the DA Licensure Bill for the 2009 legislativesession. On January 30, 2009, the Policy Committee made a recommendation to the full Board to introduce the bill for DA Licensure in 2009Legislative Session. The Board voted to move forward with legislative language and the MDA went on record stating its support for licensure ofRDAs — a first in as long as the pursuit had been ongoing. On March 16, the bill was submitted under SF1911. On March 27, MDAA PresidentBrenda Spanovich and Legislative Chair Natalie Kaweckyj gave testimony to the Senate Health, Housing and Family Security Committee. Thecommittee referred the bill to the Senate finance committee. Through the next eight weeks, the bill underwent several number changes andwas heard on the floor May 15th and 16th. Last minute lobbying was done by President Spanovich and legislative committee member TeriYoungdahl to educate legislators unfamiliar with the bill. The bill passed that weekend and went on to be signed by the governor. The law goesinto effect August 1, 2009, and those applying for initial dental assistant licensure who were not previously registered will be required to passthe DANB CDA exam prior to licensure beginning January 1, 2010; previous RDAs are being grandfathered in. Why licensure? Licensure is the more appropriate designation for RDA regulation in Minnesota because licensure more accurately re-flects the level of duties and responsibilities of the RDA as expanded functions have increased exponentially over time. It was felt by many thatlicensure would help reduce attrition of dental assistants and encourage entry into the profession by giving a higher degree of ownership intheir work. It was also felt that licensure would provide better access to dental care, an issue affecting the nation. The goal of change in nomen-clature was essentially a “catch–up” for a change that could have been (and should have been) made a long time ago. Dental assistants in Minnesota were first regulated in 1977 and at that time were only allowed to perform a total of 11 expanded functions.Today, the RDAs are allowed to perform over 30 functions with the level of responsibility nearly tripling that of 1977. Many of these duties areunder general and indirect supervision. The scope of practice has changed significantly through the years with the most notable additions ofsealants in 1994, nitrous oxide administration, bond removal with rotary instruments and restorative functions in 2003. Minnesota traditionally has been viewed as a leader in progressive action in furthering the dental assisting scope of practice and profession.The dedication and time commitment of just a few members for the overall profession in the state is tremendous. Other states often look at Min-nesota when considering new duties or regulatory changes because of the accomplishments seen within the state. MDAA is thankful for the won-derful working relationships it has with many professional organizations such as the Board of Dentistry, MDA, Minnesota Educators of DentalAssistants, MNDHA, Minnesota Association of Orthodontists and Minnesota Association of Community Dentists to name a few. MDAA couldnot have been successful without the assistance of the ADAA LAP Funds awarded in 2004–2008 to help defray the costs associated with the legis-lation. Advice to other states struggling with legislation — be determined, be educated on issues, be visible and most of all — be persistent!38 The Dental Assistant July/August 2009J/A 09.indd 40 7/13/09 1:54:25 PM

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Patient Care Coordinator continued from GLOSSARY of TERMSpage 23 Advocateer medications, the PCC must ensure thatthe patient is given the proper prescriptions Dental IQprior to the appointment date, and of coursedetermine any allergies of the patient. The Indurationpatient should be called after treatment, notonly to determine the post–treatment condi- Linda Zdanowicz, CDA, CDPMA, is the practice administrator for Nigel R. Morgan, DDS, Henderson, NC.tion, but also to find out any future dates of She is the author of several articles that have been published in Dental Economics, Dental Office, The Ob-treatments that are scheduled with specialist server and Contemporary Dental Assisting magazines. She is a contributor to the online publication Dentaloffices. Essentially, the PCC must do every- Assisting Digest. Linda has been a lecturer at the Holiday Dental Conference and will present at the Floridathing possible to coordinate the patient ex- Dental Convention in 2009. Ms. Zdanowicz is a former Advisory Board Member at Asheville Buncombe Techni-perience and demonstrate a concern for the cal College Allied Health Program and writes the Exceptional Dental Practice Management web log that can bepatient’s welfare. The end results will benefit found at: http://dentalpracticemanagement.typepad.com. Linda can be reached at [email protected] the patient and the practice.SUMMARY Fulfillment of the role of Patient CareCoordinator not only provides great sat-isfaction for the employee, it also yields apositive impact on the patient, the dentist,and the dental practice. The PCC is a ca-reer ladder position for an educated dentalassistant with complete credentials andgood organizational skills. That personmust enjoy the challenges of the position,which center on working with many differ-ent people on a regular basis. The PCC is an educator and a facilitator,playing an integral part within the overallcare of the patient, including the synergybetween the practice and any specialistsbrought in for patient care. There is roomfor a PCC in any practice that wants to pro-vide excellent service to patients. ❖SUGGESTED READINGLockard, Jr., DDS, M. William, The ExceptionalDental Practice, 2007, Lockard Publications.Pankey, Lindsey D., A Philosophy of the Practice ofDentistry, 1987, Medical College Press.Polansky, DMD, Barry, The Art of the Examination,2002, Word of Mouth Enterprises.Oral Diagnosis: The Physical Exam, Tufts University,2007, http://ocw.tufts.edu/data/24/339120.pdf.Detecting Oral Cancer, National Institutes of Health,National Institute of Dental Research, Baylor Uni-versity, 1996 http://www.tambcd.edu/oralexam/nidroc00.htm.REFERENCESPolansky, DMD, Barry, The Art of the Examination,2002, www.drbarrypolansky.com.Lockard, Jr., DDS, M. William, The Exceptional DentalPractice, 2007, Lockard PublicationsWikipedia, http://en.wikipedia.org/wiki/Leukoplakia.40 The Dental Assistant July/August 2009J/A 09.indd 42 7/13/09 1:54:38 PM

(Example Review of Findings Form) An important requirement of good treatment planning is to do John R. Doe, DDS the minimum treatment needed to achieve optimal oral health. 1234 Main Street Among other things, optimal oral health provides for comfort- able function free of pain and infection as well as a natural Anytown, USA 01234 appearance. Telephone The following is a treatment plan for your recommended dental care. www.johndoedds.com DIAGNOSIS OF PRESENT CONDITIONSReview of Findings for [Patient’s Name] FOR [Patient’s Name] The most important services any dentist or physician can Chief complaintsoffer are a thorough examination, diagnosis of the existing • Your daughter has told you that your teeth do not lookconditions and development of a suitable treatment plan that attractiveserves the short- and long-range needs of the patient. Your un- • State of existing dentistryderstanding of the existing conditions in your mouth provides • You have numerous very large, old amalgam (silver)you with the knowledge to make informed choices that meet fillingsyour individual wants and needs. While it is important for you • You are missing 5 premolars and 1 molarto understand existing conditions, it is even more important • You have lost a filling from tooth #29 (lower rightto understand how these conditions occurred and what can be side)done to prevent the recurrence of dental disease to protect • You have incomplete fractures in your molarsyour teeth and supporting structures from more damage and • You have severe erosion on your premolars and frontloss in the future. Our goal is to help you achieve optimal oral teethhealth. In the past your dental treatment may have been car-ried out without a plan, without concrete goals and objectives Active dental decayof what you would like to have happen. For this reason, we • There is decay on teeth #’s 3, 6, 7 and 32take a great deal of time and effort in the beginning to help youcompletely understand your mouth and dental concerns, and Periodontal conditionthen help you make the decision that is right for you. More and • 1–3 mm measurements are considered a healthy peri-more research is linking oral health to complete body health. A odontal condition. Anything above 3 mm may be causehealthy mouth can literally add years to your life. High quality for concern. You have generalized 1-3 mm probing withcare should remain constant, with the amount of time needed localized 4–5 mm pockets with bleeding on probing.to complete this care suited to the needs of you as an individual.Once your master treatment plan has been agreed upon by our Occlusionpractice and yourself, it will be your responsibility to complete • There is incisal wear on your anterior teeth.the plan in a time period that works for you and meets yourobjectives for your optimal oral health. People lose their teeth Othereither through destruction of the teeth themselves or through • Teeth #’s 4, 12, 13, 20, 21 & 30 have not been re-deterioration of the supporting structures that hold the teeth placed.in place. Our concept of complete dentistry is to eliminate all • Teeth #’s 3 & 14 have drifted down out of their socketsfactors contributing to breakdown of both the teeth and their • Your lower molars have drifted forwardsupporting tissues. • Your plane of occlusion is unevenOther than accidents, the causes of accelerated break- TREATMENT RECOMMENDATIONSdown of teeth include: FOR [Patient’s Name] Phase I — Periodontal control and maintenance • Bacterial plaque — Bacteria produce acids and toxins that cause cavities and contribute to periodontal dis- • Scaling and root planing with our hygienist eases (pyorrhea). Phase II — Caries control • Bite–related stress — Unbalanced and destructive • An amalgam (silver) filling in #3 and composite (white) stresses contribute to cracked teeth, excessive wear of filling in #32. teeth, “TMJ” problems and loose teeth. Phase III — RestorationContributing factors that lower resistance to causes of • Adjust your bite and reshape #26dental disease include: • Crown teeth #’s 6, 7, 8, 9 & 10 and fixed bridges to replace your missing back teeth. • Hereditary predisposition • Crown teeth #’s 2, 3 & 5. • General health • Nutrition Phase IV — Maintenance and prevention • Emotional stress • Three–month periodontal maintenance schedule with our hygienist.A complete dental treatment plan should include: • A personalized approach to instructing home care This plan was presented on February 10, XXXX techniques for plaque control and maintenance of oral health. (Presenter) (Patient) • The reduction of stresses on the teeth to a point that they are not destructive. • Restoring natural teeth to optimal strength and natural contours. • Replacement of missing teeth as indicated.Appendix A (Test on page 42) 412009 July/August The Dental AssistantJ/A 09.indd 43 7/13/09 1:54:38 PM

Please note: There is an administrative fee of $8 to cover a portion of grading and publication costs. This fee MUST accompany the test when it is submitted for grading. Use answer sheet opposite. This course and exam are also available online, absolutely FREE for members, until September 12, 2009, at ADAA's Continuing Education website, www.adaa1.com. 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). approved for two continuing education creditS — adaa Members Only patient care coordinator: Are You Ready for the Challenge? Post–Test Choose the one best answer1. Working side by side with the dentist allows the PCC to understand 9. Leukoplakia can be a result of ___________.the dentist’s __________________ and __________________. A. tobacco use B. drinking cola A. moods and temperament B. plans and ideas C. dietary deficiency D. old age C. philosophies and modalities D. likes and dislikes 10. Overjet is a condition in which the _______________.2. The PCC position requires a firm understanding of ____________. A. maxillary teeth are biting end to end with the lower teeth B. mandibular teeth protrude past the upper teeth A. psychology B. dental conditions and treatments C. maxillaryteethoverlapthemandibularteeth horizontally C. math and science D. scheduling concepts D. teeth are in crossbite3. __________ is NOT one of the three main reasons patients call 11. The PCC should talk to patients about what they are seeing because:a dental practice. A. the dentist doesn’t want to B. the PCC knows as much as the dentist A. They were referred by another patient or specialist. C. an educated patient will be able to understand his/her conditions B. The office is close to work. when the dentist comes into the room C. They are in pain. D. patients don’t care about their teeth D. They want a second opinion.4. A __________________ should be prepared and sent to the 12. Only the dentist can ___________________.patient before his/her first appointment. A. clean the patient’s teeth B. perio probe A. statement B. release of information form C. diagnose conditions C. financial arrangement request form D. new patient packet D. conduct the preclinical consultation5. When the new patient arrives at the office the PCC should: 13. The Review of Findings document includes ________________. A. review the patient’s information A. the patient’s personal information B. straighten her/his office B. the health history C. answer phone messages so the PCC won’t be disturbed C. the financial arrangements D. invite the patient into a private office D. everything discovered during the exam, the patient’s chief complaint and the dentist’s recommendations6. Open–ended questions _________________. A. require more than a yes or no answer 14. Phasing treatment can help the patient___________________. B. are too personal A. maximize insurance benefits C. prevent the patient from giving information B. avoid treatment D. should never be used C. save money on taxes D. lose the patient’s fear of dentistry7. During the preclinical interview the PCC should focus on: A. the patient’s poor dental health 15. The PCC should track the patient’s treatment to _____________. B. anything positive about the patient’s condition or attitude C. the patient’s clothing A. make money for the practice D. the patient’s financial status B. show the patient that the treatment is important and necessary and8. Leukoplakia are ______________________. ensure that it is completed in a timely manner A. red spots resembling pimples on the palate C. keep the schedule full B. soft, gummy residue on the teeth D. report it to the IRS C. white patches on the mucous membranes D. caused by drinking too much milk (Test Answer Sheet & Certificate on following pages)J/A 09.indd 44 7/13/09 1:54:39 PM

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ADAA Test Answer Sheet For Office Use Only Date Received:___________________Patient Care Coordinator: Date Graded: ____________________ Pass Fail: _______________________ Are You Ready for the Challenge? Approved for TWO (2) continuing education credits.Only current ADAA members are eligible to take this course for continuing education credit. Tests submitted by nonmem-bers will not be graded or returned. TESTS NOT ACCOMPANIED BY $8 FEE, completed certificate AND #10SELF–ADDRESSED STAMPED ENVELOPE WILL NOT BE GRADED OR RETURNED. Deadline for tests to be submitted to the ADAA for grading is September 12, 2009.Name:Address:City, State, Zip:Daytime Telephone Number: (_­ ______)___________________ “DANB Approval” indicates that a continuing education course appears to meet certain specifications as*ADAA Membership Number: described in the DANB Recertification Guidelines. DANB does not, however, endorse or recommend any*Do not use CDA or RDA #. Membership # can be found above your name on the particular continuing education course and is notaddress line of the magazine cover. responsible for the quality of any course content.☐ Check or money order for $8 enclosed. ☐ Completed Certificate☐ #10 self–addressed stamped envelope enclosed. (Use pen or pencil to completely fill in the circle of your chosen answer.) 1. A B C D 6. A B C D 9. A B C D 2. A B C D 7. A B C D 10. A B C D 3. A B C D 8. A B C D 1 1. A B C D 4. A B C D 9. A B C D 1 2. A B C D 5. A B C D 10. A B C D 13. A B C D This course and exam are available online, absolutely FREE for members until September 12, 2009, at ADAA's CE website, www.adaa1.com 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). Return to American Dental Assistants Association, Continuing Education Department 35 East Wacker Drive, Suite 1730, Chicago, Illinois 60601-2211J/A 09.indd 46 7/13/09 1:54:39 PM

AMERICAN DENTAL ASSISTANTS ASSOCIATION CERTIFICATE OF COMPLETIONName ADAA#Course Title Patient Care Coordinator: Are You Ready for the Challenge?Course# July/August 2009 Course Hours 2 (Two)Signature Please sign in ink and keep for your records! FOR OFFICE USE ONLY! DO NOT DETACHAuthorized CA Provider #RP2169 ADAA Authorized Provider Date Graded:*Dental Practice Management courses are not approvedfor credit by the CA Board of Dental ExaminersDANB Accredited CourseAGD Approved National SponsorFAGD/MAGD Credit 04/10/1992-05/31/2011J/A 09.indd 47 7/13/09 1:54:40 PM

Association Bulletin Chicago, Ill. — The Bureau of Labor Statistics says we will AATC is Florida Community College in Jacksonville. There is noneed a lot of new hands in dental assisting and predicts a 29 percent other public school — high school, tech center, college or universitygrowth of the field through 2016. — in Florida with this designation. This makes Orlando Tech one of the top schools, if not the best, in Florida for digital video pro- The American Dental Assistants Association now offers “Your duction. The editor for the dental assisting video is a student who isFuture in Dental Assisting,” an 8–minute DVD outlining the chal- recognized by Apple as an Apple Certified Professional in video ed-lenges and rewards of dental assisting in a contemporary, colorful iting. The software used to edit the video, Final Cut Pro, is the samepresentation that could help a prospective assistant take a closer software used to edit many of the feature films and television showslook a field that is not ready to hang out the “No Help Wanted” sign. today. It is the top video editing software in the world. The presentation was made possible in part by support from theAmerican Dental Assistants Association Foundation. ❖ This eye–opening career video may be viewed on the ADAA Scenes from “Your Future in Dental Assisting.”website www.dentalassistant.org and a free copy ordered [email protected]. School counselors, educators and dental asso-ciations will receive preference while the supply lasts. The presentation was produced by the Digital Video ProductionDepartment at Orlando Tech. Orlando Tech is a public school inFlorida that also has the distinction of being an Apple AuthorizedTraining Center (AATC); recently, the school attained the status ofLevel Two AATC. The only other public school in Florida that is an vacuum-line cleaning made simple Preparing your treatment rooms for patients just got easier. Welcome to ICV, a vacuum-line cleaning innovation that integrates right into your cabinetry. Just connect the HVE and saliva ejector to ICV, press the Start button, and in 2 minutes (or less) the vacuum lines are purged with the cleaner of your choice. Simply put, ICV can help save precious time and effort—all while extending the life of your vacuum system. • simple 3-step operation • fast; 2 minutes/cycle • easy-to-fill tank • compatible with most cabinets* • safer and cleaner than other vacuum-line cleaning methods *requires minimum 7”Wx20”Dx21”H module to store refillable tank For details call 1.800.547.1883 today, or visit us online at www.a-dec.com aada.indd 1 10/25/07 10:41:42 AM 7/13/09 1:54:41 PM 46 The Dental Assistant July/August 2009J/A 09.indd 48

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insideLegislative Update continued from page 38 25th, which was to do a legislative change to the Public Health Codepublic health code. A second task force was formed with three assis- so that every place it currently says “dental assistant” should insteadtants, three dentists a chair and secretary. They had two meetings and read “Registered Dental Assistant,” since that is who it is referring to.came up with a resolution to present to MDA and MDAA. Basically, it Secondly, we insert the title “dental assistant” into the Public Healthwas the same resolution we had to begin with except instead of having Code and define the on–the–job trained–assistant. We are trying tothe on–the–job–trained assistants register their contact information create a career ladder system, so next is to add the CDA from DANBwith the state, the task force was proposing they have them register into the code as well.through our association. Once these two additions are made, the understanding with the li- MDAA’s board voted to approve the resolution, but the MDA censing director is that changes to the administrative rules will then beboard of trustees said no. After this was over, the MDA printed a very done to accommodate the categories with distinct lines of division andmisleading article about the task force in their Journal. We replied to it duties. In addition the DA will have to take 18 hours of CE over threeand indicated that although the MDA is not being supportive of our years and maintain current CPR. Neither of these would be monitoredefforts that we will continue to meet the board of dentistry’s resolution by the state. The release of some RDA functions to the CDA may be astating that we will initiate legislation to incorporate the DA in to the selling point to get the dentists on board.public health code with mandatory CE and CPR. We had about 35 people volunteer to work on this endeavor to In January I met with our lobbyist and we decided that we were help do research to answer the questions and some just to help donot ready to initiate legislation this year. We needed more time to the fundraising. The lobbyist charges $2,000 per month and at fourprepare and to continue to get the dentists on our side. I also met years will total $96,000. In addition, meetings will have to be set upwith the Bureau of Health Professions, Licensing Director and I took to discuss this with the CDAs, RDAs, DAs, dentists, hygienists anda list of 26 questions and she responded. She unofficially offered to educators. I am planning on another $4,000 to do this. And of course,help us prepare our legislation. She seems supportive. printing, postage and mileage etc.,… So, we are in high fund–raising mode. As I finished my presentation on Saturday, members in the I presented our plan to our MDAA House of Delegates on April house gathered up $2,450 to help in our fund–raising effort. ❖ List of Advertisers Classifieds ADAA 36 Classified ad rates: $20 minimum for 30 words or A–Dec 46 less, 25 cents for each additional word. Blind box num- Bosworth 39 ber: $3 additional. Display classified ad rates: $100 per Colgate 27 column inch. Maximum depth accepted: 4 inches. Line Crosstex 11 art must be supplied as high–res (minimum 300 dpi) Dentrix 21 .jpeg or .tif file. To place a classified or classified display GC America 47 ad, contact The Dental Assistant — Classifieds, (312) Henry Schein Dental 5 541–1550 x209 or [email protected]. Ads must be Hu–Friedy C4 paid in advance. Kerr 43 ADAA neither investigates nor assumes responsibility for TotalCare Div. of Kerr C2 ads published in this space. TotalCare Div. of Kerr C3 Patterson Dental Supply 24–25 Next Issue: It’s back — the ADAA Pentron 31 Annual Session: Hawaii issue, featuring Sonicare–Philips Oral Healthcare 37 a comprehensive guide to the confer- Proctor & Gamble 29 ence, including educational seminars, Septodont 7 special events, and local attractions. 3M Espe 3 3M Espe 17 7/13/09 1:54:43 PM48 The Dental Assistant July/August 2009J/A 09.indd 50