BULLETIN
CALIFORNIA SOCIETY OF PEDIATRIC DENTISTRY
5 President's Message
2021 | Volume 49 - Number 3
8 Annual Meeting News
EVOLVING WITH TECHNOLOGY
Dr. MyLinh Ngo - Managing Editor
For almost two years, we've all been faced with making many awkward adjustments toward the new normaltrying to live the best life we can during a pandemic. And throughout this period of time, it is undeniable how important technology has been in keeping our lives connected to our local and national communities as well as helping us stay in touch with our family and friends when we couldn't physically be together. In this issue, Dr. Dorostkar illustrates how CSPD has worked diligently to connect with its members and is continually evolving to stay relevant in this new era, while Dr. Niethamer warns about the dark side of technology and some of the downfalls of having all these tools at our fingertips. You will also read about Dr. Chan’s story on connecting – how a simple letter to someone he met 13 years ago prompted a once in a lifetime opportunity on a very grand stage.
With the dizzying speed of information and connectivity that has advanced our lives so greatly, it has become much more difficult to disconnect. Do you ever find yourself reaching for your phone to tap it awake even though there were no alerts or pings that needed your attention? Many of us experience ‘FOMO’ (Fear Of Missing Out) if we are not constantly keeping up with all the news and updates of the hour. With our always-on culture of status updates, instant messaging, checking emails, calendars, news feeds, productivity apps, and chat groups, we are bombarded with content 24/7. According to a Pew Research Center survey (https://www.pewresearch.org/ internet/2021/09/01/the-internet-and-the-pandemic/#fn-27407-1) of U.S. adults conducted this past April, even though 90% of adults said the internet was important and essential during the coronavirus outbreak, 40% said they felt fatigue from it.
Let’s challenge ourselves to take steps to find time to disconnect, be aware of our usage, and give our minds and eyes some much needed rest. Here are some ideas to start with!
1. Pledge to set a screen-free or tech-free day every week to focus on self-care, mental wellness, and strengthening relationships on a deeper level than just photos and 160 character captions.
2. Try doing a “low-tech” activity each day such as reading a book with pages that you can flip, story-telling with your family, journaling, playing board games, taking a walk without earbuds in!
3. How about turning off notifications on your mobile device during lunch or when you get home from school/work, while exercising, or driving!
4. See if you can limit your social media activities to a computer, rather than on your phone.
5. Create tech-free zones in your home – for example, no phone/iPad/laptop at the dining table or in the bedroom. Or keep the phone out of reach when you are asleep.
Technology is here to stay and, much like SARSCOV-2, is something we are constantly learning to evolve with. We celebrate the great connections CSPD has made with our members through high-tech endeavors such as timely webinars, pop-up events, e-blast member notifications, social media, and increased Online Continuing education options.
We wish you a wonderful holiday connecting with your loved ones on all levels and thank you for being a member!
In keeping with my theme of relevance this year, I believe it is important that CSPD value investment in technology to keep CSPD at the forefront of modern association management. There was an expectation in the past that association members would come to the organization to access its benefits. In today’s world, it is important that organizations reach out instead to their members with information and membership benefits. The dynamic between member and association has completely changed. And with the technological advances available now, we can reach out to our members wherever they may be.
"According to recent AAPD demographic data, 42% of our membership is age 39 years and younger."
The work accomplished on our CSPD committees now operates at lightning quick speed compared to the old days of calling each other on the phone. We can plan webinars and Pop Up Events quickly and efficiently because of email, Google spreadsheets, and Zoom technology.
According to recent AAPD demographic data, 42% of our membership is age 39 years and younger. So, close to half of our pediatric dental members grew up with the internet and working in a digital world. If CSPD does not supply information in a progressive way to these members, we risk that they will turn to other sources who do. When asked recently what print publications a millennial member of CSPD subscribed to, he struggled to think of even one. This is exactly the reason why we provide the Bulletin, for example, in both a digital and print version.
CSPD has begun to pivot in a variety of ways to meet the new expectations of our members. Thanks to a $25,000 contribution from the CSPD Foundation, we were able to build out a new platform for our Online Continuing Education. This has allowed us to provide a robust line-up of CE courses to our members as well as secure an additional means for CSPD to gain non-revenue dollars by advertising our CE globally.
Our ongoing membership eblasts announce upcoming events and opportunities for CSPD members but also distribute valuable information instantly. We recently provided information of how upcoming SB501 legislation would affect members’ sedation permits as of January 1, 2022. We plan to use our eblasts to continue to disseminate information about developing legislation and its impacts on your daily patient care.
Looking for an Associate? Now you don’t have to wait until the next Annual Meeting or send out 52 random letters via snail mail postage like I did when I was a resident. Simply check out the Opportunities page on our CSPD website for your next great connection.
We’ve all witnessed the explosion of CE webinars during the pandemic and they are not going away. Building out a year-round curriculum of CE should not detract from our in-person Annual Meeting but instead can supplement and enhance our members’ CE experience.
We continue to increase our social media presence in reaching out to our members. However you may personally feel about social media, it would be short-sighted not to understand the value and relevance it has in today’s world. CSPD will continue to invest in navigating the best way to harness the power of social media for our organization.
Even the way we interact with our sponsors and vendors is changing in a very deliberate way. CSPD will be introducing our first ever electronic Media Kit intended to advertise all the different opportunities available for vendors to reach out to our members to provide goods and services. Another small example of taking advantage of technology was announcing which exhibitors would be attending the next Annual Meeting
and their show specials before the meeting. Offices were able to carefully think through their shopping list before attending the meeting to assess quantities they would need and obtain those supplies at a discounted rate. Win-win.
These are just some examples of the vast potential that technology can bring to CSPD operations and outreach. I foresee many more ways for CSPD to use technology to reimagine how we provide value for our members. And I would make the case that the needed financial investment in those resources is worthwhile. It is that important. In our continuing race for relevance, it is critical that we invest in the most effective delivery tools for CSPD and purposely abandon those that no longer work. The race is on.
OPPORTUNITIES ON CSPD WEBSITE
Are you a recent or soon-to-be grad looking for an associateship? Have you been thinking about hiring an associate, but don’t know where to look? Have you been having more dreams about birdie-ing that ninth hole rather than doing another pulp and crown?
The Opportunities Page (www.cspd.org/networking) is available to all members who are looking for a position, looking for an associate, looking to sell their practice, or just plain looking.
It is FREE for CSPD members to post a listing. The Opportunities page is one of the most frequently visited pages on CSPD.org. Check it out. You might just find your next new opportunity.
MEETING OF THE DENTAL BOARD OF CALIFORNIA
Dr. Paul Reggiardo - Executive Director
The Dental Board of California met by virtual platform August 19-20, 2021. The following report summarizes actions and issues coming before the Board pertinent to pediatric oral health and practice delivery.
ANESTHESIA AND SEDATION PERMITS
Legislation (SB 501 Glazer) signed by the Governor in 2018 and scheduled to become effective January 1, 2022, requires significant change to permitting of General Anesthesia, Conscious Sedation, and Oral Conscious Sedation for Minors in the dental setting. These changes include the introduction of a pediatric endorsement, additional patient monitoring requirements when administering general anesthesia or sedation to a minor dental patient, and the creation a new Pediatric Minimal Sedation (PMS) permit (which replaces the current pediatric Oral Conscious Sedation permit). The PMS permit will be required to administer or order the administration of minimal sedation to a patient under 13 years of age. The Dental Board is required to adopt regulation to implement these changes.
1. The current General Anesthesia Permit will be replaced by a Deep Sedation/General Anesthesia Permit with changes in initial application and renewal requirements, development of standards for PALS equivalency training in pediatric dental anesthesia related emergencies, and new monitoring standards for patients under the age of seven years.
2. The current Conscious Sedation Permit will be replaced by a Moderate Sedation Permit with similar changes to application, renewal, PALS equivalency training courses, and monitoring of patients below seven years of age.
3. Then current Oral Conscious Sedation Permit for Minors will no longer be issued. It will be replaced by a Pediatric Minimal Sedation Permit with specific monitoring requirements for patients under 13 years of age.
4. The current Oral Conscious Sedation Permit for Adults will remain unchanged and there will be revision to the Medical General Anesthesia Permit required of the physician providing deep sedation or general anesthesia in the dental office.
Comment: Although intended for enactment at the beginning of next year, this new permitting system will not become effective until the Dental Board is able to adopt regulations necessary for implementation and this is unlikely by January 1. Until these regulations are announced, dentists should continue to adhere to the current permitting system.
Members should continue to renew their current certificates and permits, which remain valid until the changes have been put in place by the Dental Board, AND it is time for the next biannual renewal cycle. For the present, continue to follow the rules and regulations currently in place that apply to your permit.
INFECTION CONTROL EDUCATIONAL REQUIREMENTS FOR UNLICENSED DENTAL ASSISTANTS
Current law requires unlicensed dental assistants in California to complete a Boardapproved course in infection control no later than 120 days after employment. In April of this year, the Dental Board’s Dental Assistant Council recommended statute be amended to require the eight-hour course in infection control be successful completed prior to performing any basic supportive dental procedures involving potential exposure to blood, saliva, or other potentially infectious materials. The intent of the proposal would be to increase patient protections in a postCOVID-19 world. The Board agreed and voted to seek legislation that would place such change in the Dental Practice Act.
Comment: The proposal was supported by a broad coalition of dental assisting organizations and vocational training interests. The California Dental Association opposed on the basis that no demonstrated risk to the public exists in the current arrangement, either pre or post COVID. The purpose of infection control education for unlicensed dental assistants is to provide the context for understanding the office procedures and protocols under which they work. The proposed amendment would negatively impact dental workforce recruitment, staffing, and access to care with no demonstrable enhancement of public safety.
Questions or comments should be directed to Paul Reggiardo, CSPD Executive Director at preggiardo@cspd.org
ANNUAL MEETING NEWS
REGISTRATION IS LIVE!
Dr. Oariona Lowe - Annual Meeting Chair & Dr. Don Schmitt - Annual Meeting Co-Chair
We would like to share the exciting and wonderful news that the CSPD Annual Meeting on-line registration “is now live”. Don’t hesitate to sign up early to receive the discounted registration rate and a chance to win a complimentary “couples massage”. Reserve your rooms at the fabulous OMNI Resort and Spa in Montelucia, in the heart of Paradise Valley, Scottsdale, Arizona before the rooms are Sold-Out!
Come and enjoy the lovely desert sunrise and sunsets with your family and friends. Unwind and relax at the Oasis or Kasbah Pools and enjoy a Sangria drink with delicious Spanish tapas poolside. Revel in the hotel’s ambience and embark on an unforgettable experience. Enjoy a nice meal at the Prado, and experience the cuisine of Southern Spain. Sign up for an award winning spa treatment and massage at the Joya Spa!
Take home dental tips and knowledge that you can use in your private practice. Earn up to 20 CE units. In addition to the morning lecture topics and speakers, you will be enlightened by our CSPed Talks in the afternoon. These special talks will feature various topics:
• Unique Behavior Management techniques will be presented by Eyal Simchi.
• Learn how to relax and take care of yourself. Purnima Hernandez will share strategies and tidbits on Health and Wellness Care. Put some time aside to improve your personal health.
• Receive advice on how to protect your office and personal information from Cyberattacks and Ransomware. Listen to the experts first hand on how to protect your privacy and your patients’ confidential information.
Awake early and go for a morning walk or run, but be sure not to miss the lectures planned for the morning academic sessions.
• Dr. Donald Chi will speak on Parental Refusal of Fluoride.
• Dr. Joel Berg will present on Medical management of Caries and Alternatives to Traditional Restorative Techniques.
• Dr. Wanda Claro will refresh our knowledge on Phase I Orthodontic treatment options.
• Dr. Juan Yepes will teach us about radiation safety in Pediatric Radiology and CBCT.
The Covid-19 pandemic has affected and changed the way we work, live and socialize.
Listen to Dr. Michael Swetye on Pediatric Mental health as he identifies ways to address challenging behaviors that may arise in the dental practice due to underlying, hidden behavior issues.
Finally, Substance Use in Adolescents can be difficult to detect and may affect the delivery of safe dentistry. Learn from Dr. Randy Lout how to identify and manage substance use and withdrawal syndrome behaviors in patients.
A PALS recertification and full course along with BLS will be offered on Thursday afternoon. Sign up early as these courses tend to fill up. Space is limited.
Resident Poster presentations are planned on-site in the exhibit hall alongside the vendors.
Join us in Scottsdale for excitement, fun, and adventure!
GETTING TO KNOW DR. WAI-YIN CHAN
Interviewed by Dr. MyLinh Ngo
1. Please share a little about yourself. Background, training, hometown, upbringing, etc... anything you'd like to give details about is great :)
I am a first generation American, born to immigrants from Hong Kong. My hometown is Brentwood, TN, but I spent some of my childhood on the Jersey side of the Lincoln Tunnel (NYC). I attended the University of California, San Diego where I earned my undergraduate degree in Biochemistry and Cell Biology and then a Master’s degree in Biology. I then attended the Harvard School of Dental Medicine for dental school and the University of Washington, Yakima for pediatric dental residency. I obtained a Master’s degree in public health recently from the University of California, Berkeley, which I highly recommend for anyone considering expanding their understanding of health systems and how to effect change within our environment.
2. Any mentors or influences in your life who guided you towards where you are today?
Dr. Peggy Timothe (Texas A&M College of Dentistry) was an inspiration to me early on for her perseverance and tenacity in pursuit of dental public health as well as her commitment to dental education. I was also fortunate to have inspiring residency faculty including Dr. Todd Milledge, Dr. Jessica Webb and Dr. Joseph Wilson (NYU-Langone, Yakima)-- it was/ is an honor to have their guidance. I’ve also been very fortunate to have wonderful colleagues, namely Dr. Jacy Stauffer, Dr. Fadra Whyte and Dr. David Okuji. They embody professionalism, are fantastic clinicians and collaborators and have also encouraged me to pursue paths that I otherwise may not have had the confidence to do on my own. I’ve been very fortunate to have these people in my life.
3. What does your typical week look like? Is it a mix of private practice, teaching, volunteering? What aspects does your ideal week involve?
A typical week for me includes attending clinic care (including the OR), seeing patients when residents are in lecture and administrative responsibilities pertaining to the program’s needs such as resident research and program scheduling. I also teach a problem-based learning course to our 1st year residents on evidence-based dentistry which includes preparing written and oral exams, which keep everyone’s testing skills sharp!
My professional passions outside of the program include San Diego County involvement which I began as a MPH student and includes promoting HPV Vaccination Immunization Awareness and medicaldental integration in our community. Lastly, I manage the pediatric dental study guide- pediatricdentalstudyguide.weebly.com. It is a free, quick summary resource to guide clinicians in the care of patients with special health care needs (90 topics are presently represented). Our editors are entirely volunteer-driven. They are a great bunch and I celebrate their work whole-heartedly!
4. Any unique stories you can recall about residents or patient care during your time at the NYU langone residency program?
There have been so many unique patients with unique special health care needs over the years. This was a good teachable moment that I share with you now. One patient with a hematological disorder had premolars removed for orthodontic needs by another clinician. Unfortunately, the patient continued to bleed from her extraction sites and the healing was extremely poor and she went in and out of the ED over the course of a year. I think every attending at our site is aware of the case because we all saw her at some point during this year. It was a case I wish whole-heartedly had never been treated with orthodontic extractions. I emphasize the importance of “medicine over dentistry” with residents. It’s a little black and white, but basically, it’s my shorthand way of saying that what we do is important, but above all else, the patient’s overall health must take precedence.
My favorite case was an 8 or 9 year old who presented with a large opacity on panoramic xray in the area of her nares. When we asked the patient about it, she very casually shared that she had placed a screw up her nose back when the family lived in Italy. Mom shared that they had moved from Italy something like 2 or 3 years earlier and couldn’t believe that it had been there for that long. ENT removed a screw within the next day.
5. How do you keep in touch with the organization and department? Do you meet with the entire hospital in San Diego, how does communication work with the main branch in NYU? Is the curriculum set locally or nationwide?
We have a unique partnership with three organizations, San Ysidro Health (SYH, host site), a local partner who provides clinical rotations (Rady Children’s Hospital of San Diego- RCHSD) and the residency program (NYU-Langone). We keep in touch in many ways with each of these entities and I have way too many email accounts!
SYH is a FQHC and we meet monthly with the dental clinicians in the organization.
We also interface with the SYH pharmacy department for oral sedation needs and the various support staff within the organization. Our attending team is on medical staff at RCHSD as part of the Dental Department and as such, we interface with the physicians as often as we like. I also interact with pediatricians to coordinate rotations for the program. This is perhaps the most enjoyable part of what I do since this is the “un-siloing” of dentistry that I hope to foster in our community. With NYU-Langone, our local Associate Director is the conduit through which goals and resident performance is evaluated and programmatic details are shared. We also rely on NYU’s centralized network learning platform (NYU New Innovations) to stay connected.
6. How many colleagues do you work with on a daily basis? Are they a mix of medical and dental specialists or other disciplines? Trying to get a feel of how dynamic the environment is at a hospital based program.
We typically pair 2 or 3 attendings per day at our main clinical site on RCHSD campus to oversee resident clinical care. This includes our fantastic pediatric dental attending faculty but also orthodontic and endodontic faculty. We also communicate frequently through the hospital EHR with our medical counterparts who share mutual patients to collaborate on cases and determine patients’ needs. This is most often the Hematology/Oncology department case managers but also the various specialists in ENT, Orthopedics, Cardiology, etc just to name a few. We also have a dedicated Anesthesiologist with whom we can touch base with in advance of OR cases that we anticipate requiring special attention for preoperative or postoperative admissions, coordinated “piggy back” cases or those who may need elevated levels of care.
7. Any fun activities that you look forward to each month? Any traditions the program celebrates each year?
NYU-Langone does a lot of engagement across the many sitesrecently there was the Halloween throwdown which is a costume contest. This year, the San Diego site did a week-long Halloween celebration with themed days and a door-decorating contest organized by our chief residents Dr. Naheed Ahmad and Dr. Marytza Rios. In the past, attendings have hosted a “Resident Appreciation Event” that has unfortunately been on hold but I’m optimistic it can make it’s way back into our schedule. We celebrate graduation locally and we look forward to what this will look like after the 2020 and 2021 ‘modified’ graduation events.
8. What hidden hobbies do you have? Favorite snack food?
I love cooking and shamelessly enjoy chocolate and celebrity “news”, although I’m getting to the point where I’m no longer sure who celebrities are since I’m not able to keep up with “influencers”. I’ve taken up lap swimming in my fitness routine and highly recommend it for its low impact as well as strengthening deltoids, lats and traps which our profession tends to struggle with.
9. How has CSPD helped you as a member these past few years?
I’ve genuinely enjoyed the interactions with CSPD since I was a dental resident. It’s a strong group which can provide niche CE opportunities and helps bridge the gap between regional issues and centralize information and resources. I also appreciate the CSPD’s focus on fostering future leaders in organized dentistry. I’ve been privileged to personally know a number of former Warren-Brandli and Santos-Cortes Interns. Also, the CSPD Foundation generously granted each residency program in California with a $25,000 contribution. This is a fantastic resource which our residents will be able to utilize to support their needs.
UCSF SCHOOL OF DENTISTRY
Pardis Lipkin, 3rd Year Resident
The residents at the UCSF school of Dentistry have had an eventful and busy year so far. We welcomed the second class to our two-year post-graduate program at our sister site loacted at La Clinica De La Raza/Children's Hospital Oakland. One of our residents (Mimansa Cholera) is a recent recipient of the CSPD Foundation research grant for her research on "Saliva insulin as biomarker of risk factors for metabolic dysregulation and caries that can be limited by drinking water intervention in elementary school age children." Her research aims to enable school-based oral health screening programs in San Francisco to add saliva insulin monitoring to their annual screening protocol.
Saliva insulin shows promise as a non-invasive biomarker of high carbohydrate intake and/or insulin resistance and risk of metabolic dysregulation and caries.
Some of the acitivites we have enjoyed so far this year include attending a NuSmile workshop in Napa, volunteering at a kids festival in Cupertino, and completing our annual Dental office Emergency training with Dr. Bill Stiers (an ER physician) in October.
This is the first year we have a couple of our first-year residents (Omid Mirfendereski and Marivic 'Mar' De Leon) opting to pursue their MPH at San Jose State University (in place of the traditional MS at UCSF).
A few of us volunteered at the Kids Fun Festival in August in Cupertino alongside our faculty member, Dr. Ye-Ming Wu, to provide Oral hygiene instruction for kids.
A large group of residents attended the NuSmile Progressive Esthetics Workshop in Napa in August to advance our understanding and hands-on skills to provide zirconia crowns for our patients. A social organized by Dr. Evan Chang followed, as well!
We were Power Rangers for Halloween!
Practicing advanced airway during our annual dental office emergency course with Dr. Stiers.
MEMBER SPOTLIGHT
CONGRATULATIONS TO DR. LINDA YOUNG!
We would like to congratulate Dr. Linda Young on her graduation from the NYU Langone Program in San Diego! Dr. Linda Young was born and raised in Lima, Peru. She worked through dental school as an English and Portuguese teacher and as a swimming instructor. Right after graduating top of her dental class, Linda enrolled into a Master Program and became a faculty member and eventually chair of the Public Health Department in the School of Dentistry. After her PhD in Public Health, she became President of the National Program of Oral Health Education for the Dental Board of Peru. This experience stirred a new passion within her, pediatric dentistry.
She completed the residency program at the Rio de Janeiro State University, Brazil, and attained her pediatric dental license. Linda moved to the US in 2015 and went to UCLA for her dental degree and received her pediatric dental certificate from NYU Langone. She currently works in private practice in her hometown – San Diego.
A LIGHT AT THE END OF THE PANDEMIC TUNNEL COALITIONS
ARE OUR FUTURE AND STRENGTH
Dr. Jonathon Lee - 11th AAPD Western District Trustee
AAPD is the Umbrella of Organized Pediatric Dentistry under which the Western District and the State of California reside. In this period of inclusion, good leaders weigh breadth of opinion. Diversity of opinion is important because hearing different points of view prevents the reinforcement confirmation bias.
As the largest state and district, California and the Western District respectively have a long history of providing points of view to the leadership of AAPD that have advanced Pediatric Dentistry and supported its members.
Initiatives from the West have led to the establishment of Simplified Unified Tripartite Dues Collection, AAPD Policy on School Absences for Dental Appointments, and Clarification of the Role of the Midlevel Provider in Pediatric Dentistry, to name a few.
The same is true where AAPD has helped the State and District. For example, AAPD helped CSPD when developing The California Society of Pediatric Dentistry Position Statement and Legislative Policy Regarding Minimal, Moderate, and Deep/General Anesthesia used during Dental Treatment of Children when addressing Legislative Sedation issues in California such as SB501 in 2018.
The Affiliate General Dentist Member of AAPD has been an engaging topic through the years. According to District Numbers from WSPD Executive Assistant, Dr. Christine Roalofs, there are 61 General Dentist members of AAPD in California.
As far as the rest of the State and Province Chapters of our District, the General Dentist Affiliate Members are as follows: Alberta- 1, Alaska- 1, Arizona- 9, Idaho- 1, Hawaii- 1, Montana- 1, Nevada- 4, Oregon- 7, Utah- 3, and Washington State- 12.
Recently, as noted below in Action Item 19 of the published minutes of the AAPD BOT September 25, 2021 meeting, The AAPD BOT moved to charge the AAPD Affiliate Advisory Committee to investigate developing an affiliate track for affiliate members to earn acknowledgement.
The AAPD Leadership is interested in your thoughts regarding the GP Affiliate AAPD Membership Category and proposed earned acknowledgement. Please share your thoughts to the leadership of CSPD who will relay to the District, which will relay it to AAPD.
It is a pleasure to serve as your Western District Trustee.
Actions taken by the AAPD Board at the September 25, 2021 meeting:
No. 19: To charge the Affiliate Advisory Committee to investigate developing an affiliate track for affiliate members to earn acknowledgement. Action Carried.
• To accomplish the mission of advancing optimal oral health for all children, we need to help the general practitioners who treat children.
• Teaching GPs helps them recognize what they're not able to take care of and when it's time to refer to pediatric dentists.
• We need to attract more GP members so we can educate more GPs; to attract, we need to give them something.
• The more GPs who are AAPD members, the more control we have over what they learn and how they treat children.
• Need to be sensitive to potential effect on pediatric dentists.
• Report to the Board in January. No. 21: The AAPD strongly urges our members and their staff to be vaccinated against COVID-19. Action Carried.
AAPD 2021-2022 Budget:
Summary of adjustments to the 2021-2022 budget approved by the Board of Trustees:
• Expenses, Original: $11,471,181.70
• Revenue, Original: $ 10,238,503.74
• Net loss: - $1.332,677.96
Adjustments Detail:
• Revised AAPD Annual Session Expenses: $2,877,009.49
• Revised AAPD Annual Session Revenue: $2,373,987.00
• Net loss for AAPD 2022: - 503,022.49
• $250 - IADR/AAPD Research Award (Motion 12)
• Expenses, Revised: $11,045,356.50
• Revenue, Revised: $9,657,731.94
• Net loss: - $1,387,624,56
To read the full account of AAPD Board Motions, visit the AAPD District Trustee Report at cspd.org.
BILLS OF INTEREST
AB 454 (Rodriguez) Health Care Provider Emergency Payments.
Summary: Would require a health care service plan or health insurer to provide specified payments and support to a health care provider in a Federally-designated Health Professional Shortage Area or California Department of Public Health-designated medical or dental underserved area during a declared state of emergency exceeding three-months of impact.
CSPD POSITION: SUPPORT
STATUS: STALLED IN LEGISLATIVE PROCESS
Comment: This a companion to SB 242 (Newman) in response to the COVID-19 pandemic. It is based on the premise that such policy is necessary during a public health crisis or other declared state of emergency to keep intact provider networks and ensure uninterrupted access to care.
AB 526 (Wood) COVID-19 Testing and Vaccine Administration
Summary: Would amend the Dental Practice Act to permit dentists to prescribe and administer COVID-19 and annual influenza vaccines to patients three years of age and older and allow dentists to conduct COVID-19 rapid testing for the screening of patients and staff when such tests become available and appropriate for in-office use.
CSPD POSITION: SUPPORT
STATUS: PASSED BY LEGISLATURE AND SIGNED INTO LAW
Comment: Under the Governor’s public health emergency declaration, a Department of Consumer Affairs waiver currently allows dentists with specified training to administer COVID-19 vaccines. The bill would count vaccine training provided through the federal Centers for Disease Control and Prevention toward fulfillment of the dentist’s continuing education licensure renewal requirement. CSPD sent a letter of support to the Governor’s office.
AB 733 (Chiu) Registered Dental Hygienists in Alternative Practice: Settings
Summary: The bill is intended to increase access to dental care for children and pregnant women enrolled in California Medicaid (Medi-Cal) by allowing medical practices to engage Registered Dental Hygienists in Alternative Practice (RDHAPs) onsite to provide oral health education, preventive services, and care coordination through referral to a dental home as entry to the dental delivery system.
CSPD POSITION: SUPPORT IF AMENDED
STATUS: INACTIVE UNTIL 2022 LEGISLATIVE SESSION
Comment: Support is dependent upon amending the bill by the addition of a sunset provision taking effect after no more than five years. An independent outcomes assessment would also have to be added, measuring, among other benchmarks, program effectiveness in determining conversion rates (i.e. percentage of patients seen by the RDHAP in the medical setting that subsequently establish a dental home) compared to the general pediatric Medi-Cal population.
AB 1163 (Nazarian) Sugar-Sweetened Beverage Local Tax Preemption
Summary: Would repeal current law successfully brought by the beverage industry in 2018 that preempts local governments from imposing taxes on sugary drinks until 2030. This bill returns power to local governments to impose sugary drink excise taxes.
CSPD POSITION: SUPPORT STATUS: STALLED IN LEGISLATIVE PROCESS
Comment: This bill follows failed legislative efforts in 2014, 2015, 2018 and 2020 to impose safety warnings on sugar-sweetened sealed beverage containers and dispensing machines.
SB 242 (Newman) Public Health Emergency Provider Cost Reimbursement
Summary: Would require a health plan or a health insurer to reimburse its contracting health care providers for business expenses (such as for PPE and related costs) necessary to render treatment to patients, to protect health care workers, and to prevent the spread of diseases causing public health emergencies.
CSPD POSITION: SUPPORT
STATUS: PASSED BY LEGISLATURE AND SIGNED INTO LAW
Comment: Included under the bill as introduced was the Department of Health Care Services to provide such payment to Med-Cal dental providers. Amended as passed to remove MediCal from the bill’s provisions. CSPD sent a letter of support to the Governor’s Office.
SB 652 (Bates) Sedation Permitting and Regulation
Summary: Extends to all patients regardless of age the current requirements effective January 1, 2022, under SB 501 (2018) for dental patients under 13 years of age. These are, specifically, that an operating dentist and at least two additional personnel be present throughout a procedure involving deep sedation/general anesthesia and that the dentist and one additional personnel maintain current certification in Advanced Cardiac Life Support (ACLS) (instead of PALS) for adolescent and adult patients.
CSPD POSITION: OPPOSE UNLESS AMENDED
STATUS: INACTIVE UNTIL THE 2022 LEGISLATIVE SESSION
Comment: The bill effectively creates one standard for the delivery of deep sedation/general anesthesia in the dental office regardless of the age of the patient. CSPD would oppose the bill unless amended to specify that for patients 13 – 18 years of age, one person in the room must be ACLS trained and certified while one other person in the room must hold certification in ACLS or PALS, rather than requiring that two persons present must both be ACLS certified.
CSPD follows a number of bills under consideration by the state legislature which potentially impact pediatric oral health. Members having questions or wishing to comment on these or any other legislative matters are invited to contact CSPD’s Public Policy Advocate, Dr. Natalie Mansour, at natalie.usc. trojan@gmail.com
WILL AAPD PROPOSE QUASI-PEDIATRIC CREDENTIALING FOR GENERAL DENTISTS?
Dr. Dennis Nutter - WSPD President
First, a sad story. On December 3rd, 2014, three year-old Finley Boyle was taken by her parents to Island Dentistry for Children to have 10 cavities restored under sedation. During the procedure, Finley went into bronchospasm. Her doctor was unable to successfully manage it. Finley was transported to local hospital where she died three months later.
There are two wrinkles to the Finley Boyle tragedy that make it particularly relevant to review. First, Finley’s dentist was not a pediatric dentist but the broad outlines of her website made her appear like one. Second, on that website, as proof of her pediatric credentials, Finley’s doctor identified herself as an “Affiliate of the American Academy of Pediatric Dentistry”. The concern here is that Finley’s parents may have selected Island Dentistry for Children because they were misled into thinking that they were taking their child to a pediatric specialist, one who had attended a multi-year pediatric specialty program. If you have been in pediatric dentistry long enough, you will have had the experience of listening to parents identify their child’s previous general dentist as a pediatric specialist. We know it happens. This is why the 400+ American Academy of Pediatric Dentistry (AAPD) Affiliate General Practice members (GP’s) are currently prohibited from identifying themselves as an AAPD Affiliate member on their websites, correspondence and advertising literature. The Finley Boyle case is emblematic of how difficult it is to police this rule. This problem will only increase as private equity converts pediatric dental practice ownership to a corporate ownership model that blurs distinctions by hiring a mix of general dentists and pediatric dentists to treat children.
Finley’s case is especially relevant today because the AAPD board is again considering allowing “Affiliate members to earn acknowledgement” that can then be displayed on their websites, correspondence or advertising. Membership in a specialty organization may not, strictly speaking, represent a “credential”, but the public will view it as one. Western District Trustee, Jonathon Lee, reports in this issue that “acknowledgement” is being considered for four reasons (not his order): 1. Attract more dues paying GP members who treat children. 2. Advance the oral health of children by helping educate GP’s. 3. Help GP’s understand when to refer. 4. Control what they learn.
The form of AAPD Affiliate “acknowledgement” has not yet been determined. I asked our Board of Trustees (comprised of leadership from 10 western states and two Canadian Provinces) if they would agree to allow the Affiliates to identify themselves as a “General Dentist member of AAPD”. The board overwhelmingly rejected the idea. Dr. Morsi witnessed the vote and no doubt is aware of the broad opposition there is to the idea. No other specialty can be found that allows non-specialist members to publicly identify themselves as members of the specialty organization.
The courses given by AAPD and its State chapters are presently open for all Affiliate GP’s to attend. Attracting more Affiliates to attend these courses and tailoring them to their specific needs may be a proactive way to address the knowledge deficit in GP’s treating children. Enticing them with a carrot, a quasi-pediatric credential, may be the most expedient way to do this. It will also help alleviate the fiscal imperative caused by a 1.3 million dollar AAPD budget shortfall last year. It may not be an existential threat at this time, but it is unsustainable.
The Affiliate general dentist chairing the committee that is charged with developing a mechanism for “acknowledgement” will report their recommendation to the AAPD Board of Directors in January. One of the charges of this committee is to be sensitive to the concerns of pediatric dentist members of AAPD. The report of this committee may be received by the AAPD board in January where a motion could be made to draft language for a Bylaws change. WSPD (and CSPD) leadership will be keenly watching these developments. Stay tuned. In the meantime, if you wish to send me your thoughts, my email is dennispaulnutterdds@yahoo.com.
TOUCHING LIVES
Dr. Steve Chan, Past President
This story – is about touching lives.
When I was a senior in high school, I got matched in a Career Day event. In this event, a high school kid –shadows a person at work for an entire day. A student gets to see what a person does in a job – in the real world.
My Dad knew someone who was an investigator for the Los Angeles County Coroner. My Career Day match was with the L.A. Coroner himself! The Coroner was, Dr. Thomas Noguchi, a media celebrity.
The media dubbed Dr. Noguchi – the “Coroner to the Stars.” His claim to fame was for the autopsies of movie stars: Marilyn Monroe, William Holden, Natalie Wood, and the assassinated Robert Kennedy. But we’re getting ahead of the story.
I shadowed him for the whole day. Imagine what I saw as a high school kid.
Dr. Noguchi was very distinguished. He was impeccably dressed in a well-tailored suit. He was driven in a limo everywhere. A Deputy Sheriff’s officer was his bodyguard - escorting him everywhere. People came up to greet him with a lot of deference and respect. He was an important guy!
He didn’t take me to the morgue or see autopsies. But he took me through the different science labs. He took the time to explain the science behind investigating crimes. This was way before the popular CSI TV series. I didn’t understand a lot of the technical jargon – but I was fascinated. He was Sherlock Holmes – but with a white lab coat. And, everywhere we went he introduced me as his protégé
Dr. Noguchi was transformative. Before his tenure, the Office of County Coroner – was a political appointment. Typically the appointee was high up in County Law Enforcement or from the District Attorney’s office. The job qualifications before Dr. Noguchi – didn’t even mention a science or medical background.
He was the first physician, let alone the first Asian American - to occupy this seat. Through his performance and demonstrated expertise, the Office evolved to a merit and science-based system. His department grew a national reputation – for being the leading edge forensic science lab that we know today.
He scored the highest possible score in the Civil Service test. He was President of an international association for forensic sciences. He authored many of the standards in his industry. Universities from three countries graced him with honorary degrees.
His model of what today’s Coroner’s Office looks like –became the model for the popular TV series, “Quincy” starring Jack Klugman – the precursor to the CSI series. He was the series consultant. Who knew better – how to solve the case?! Fast forward.
Apparently, he had an ego.
In very high profile news, the higher ups in the county – were trying to fire him.
It got pretty nasty. They couldn’t fire him – on the basis of his Civil Service exams scores. His work was known for multiple major breakthroughs in his industry. His academic credentials became the gold standard for the job description. All over the country, coroner offices adopted his science-based model. He was sought after - as a consultant in national high profile crime scene cases. He was attacked very publicly – with stinging personal hits to his reputation.
I was in undergrad at UCLA at the time. I was following the daily news reports. The accusations sounded really demoralizing. The attacks were obtuse but personal.
I wrote Dr. Noguchi a letter.
I reminisced on my Career Day experiences from high school. Apparently I was his first Career Day “protégé”.
I told him that I couldn’t imagine what he was facing every day in the news.
But...I wanted to thank him.
The experience with him – stirred a passion to learn about the tools of forensics.
Above all - from the time he shared with me – I saw him as a role model.
You didn’t see Asian Americans in any high profile leadership roles at the time.
In my head, I still hear his lessons:
You have to study better than anyone else...
You have to work harder than anyone else...and You have to perform better than anyone else...just to get there. Fast forward. I went to Georgetown Dental School in Washington DC. I came back to California to complete a pediatric dental specialty program. I moved to Northern CA – to seek opportunities.
I got involved with a local county dental society. I was given the job - to orchestrate the monthly membership dinner meetings. Typically, there were about 70 attendees. We typically engaged a speaker for continuing education credit.
I wanted to do a meeting to feature a speaker –on the science of forensic dentistry. I wrote to Dr. Noguchi – to see if he had contacts for a speaker.
One morning, at 7:00 AM, as I was getting ready for work – I got a call.
It was Dr. Noguchi! I had not had any contact with him since that impression filled Career Day – almost 13 years later. I fumbled for words. We talked about what I was looking for. Then he said, “I’ll come up to do the lecture - for you!” I choked!
At the time, his book “Coroner to the Stars” was on the NY Times best sellers’ list. He was on national TV talk shows, in national news interviews, and in high demand as a speaker. At the time, the speaker’s fees were in the $5000 range – plus expenses for lodging and travel.
“Dr. Noguchi. We can’t afford you!”
He said, “I’m going to have my publishing company pay my expenses to come to your event.
I was at the lowest point of my life when I was being attacked...And then I received your letter. I’m coming because of your letter.”
That evening, we filled an entire ballroom. Judges, law enforcement, District Attorneys, dentists from all over the Bay area, physicians and hospital techs, TV and radio personalities came. The ballroom had a capacity of around 600.
It was just a letter. But he taught me a lesson of a lifetime – to tell this story.
Epilogue:
Almost 30 years after I was invited to speak at a national dental meeting in Montreal, Canada. My local host was the leading forensic dentist in all of Canada. I told him the story of Dr. Noguchi.
My host excitedly said, “There’s an international conference next month which was going to have Dr. Noguchi as a featured speaker!”
I wrote Dr. Noguchi – another letter...
A SCARY CYBERSECURITY PROGRAM
Dr. Steven Niethamer - Website Editor
Many of our members watched the latest CSPD PopUp Webinar on Cybersecurity presented by Gary Salman. I spent over an hour sitting on the edge of my chair while listening to descriptions about how these bad, internet actors can harm our good practices and cost larger practices many tens of thousands in losses. We may think that we have most of these problems covered until we learn how sophisticated some of these bad actors really are.
Having a perfect backup protects us some – but not really. We might be able to reinstall all our programs and data if our backups are perfect. But the ransomware warriors may then threaten to release your data – all patients’ personal information – to the “dark web” unless they are paid. If a practice owner still refuses to pay, the bad players can then go directly to the patients with requests for money to not release their personal information. All this makes the practice owners look awfully bad and increases the likelihood of HIPAA fines and lawsuits. The costs can be significant.
If these ransomware evil people get into our computers, they will likely succeed at some level in receiving a ransom. So, our only way of reducing risks is to make our computers more difficult to enter than those of another dental office. The bad people will then likely move on to easier targets.
Mr. Salman recommends that we adopt some best practices to enhance the security of our computer systems. They partly include:
• Creating for each part of our computer system extraordinarily strong, unique passwords generated by password management tools and using multi-factor authentication options.
• Being extremely careful if remote access tools are used. We should purchase and use the best business level versions of remote access technologies.
• Having regular training sessions for office staff or anyone with access to our network on how to identify various phishing techniques.
• Contracting with cybersecurity firms to evaluate your network system, identify risks and perform penetration attacks on your network.
• Deploy threat detection and mitigation technology software on all computers and servers.
• Use strong passwords EVERYWHERE. Create strong passwords by combining a minimum of 12 characters, numbers and special characters like @, $, #,!, &, etc.
• Utilize password management tools like LastPass or Dashlane to manage and create strong/uniquepasswords.
It seems best to pay some money upfront to cybersecurity firms to protect your computer networks from a ransomware attack and their considerable related costs and lost production time.
This Cybersecurity webinar is now available to view on CSPD’s OCE website at oce.cspd.org.
A few additional words about Social Media and the Internet
This is the season for what, to me, always seemed to be a scary song – Santa Claus is Coming to Town. I “googled” the words to this song on a MS Edge browser, clicked on a link and could conveniently read the lyrics. What was a little creepy, or possibly helpful depending on your view, were the advertisements that also appeared for 1/4 inch round floor molding, a HP laptop video, information about a Roku Streambar Pro and a small window containing someone looking like Donald Trump in the backseat of a limo with a young girl in his arms. All these ads could be explained by the search for wood flooring, repair of my laptop, purchase of a Roku streaming device and a subscription to the Washington Post news service, but it is creepy.
Google, Amazon and Facebook all keep track of key words. Alexa listens continuously. Email and text messages are likely screened for these words. What happens to FB “likes”? Somewhere this information is likely connected, which reminds me of some of that song again:
He sees you when you're sleeping He knows when you're awake He knows when you've been bad or good So be good for goodness sake
He's making a list And checking it twice He's going to find out Who's naughty and nice…
The internet technology is coming…to town. And…be careful out there!
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MEDICAL EMERGENCIES AND SEDATION SAFETY
Same Event, Two In-Person Locations!
February 4, 2022
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BOARD
OF DIRECTOR'S
MEETING - OCTOBER 16, 2021
BOARD MOTIONS
MOTION 2021.10.16.04(5): Move to approve the of action of the Executive Committee 9/20/21 that for upcoming in-person courses, membership events, and the 2022 Annual Meeting an obligatory COVID-19 “Liability Release and Waiver of Claims” statement recommended by the Executive Director be placed in the registration process. This is not intended to preclude additional advisories and precautions being put into place at the time of the event.
MOTION CARRIED
MOTION 2021.10.16.06 (SABBADINI): Move to accept the CSPD Finance Committee recommendation that $350,000 be invested in the 40% Equity Income and 60% Intermediate Length Fixed Income Portfolio with Wealth Management Group. MOTION CARRIED
MOTION 2021.10.16.07 (HSIEH): Move to approve the plans as included in the Patient Services Committee Report for a “Pop-Up Event” Dental Team Emergency and Sedation Preparedness Continuing Education Course February 4 and 5, 2022. MOTION CARRIED
MOTION: 2021.10.16.08 (SCHMITT): Move to approve the recommendation of the Strategic Planning Committee to secure Mr. Bill Pawlucy of Association Options as facilitator for the 2022 Strategic Planning Session. MOTION CARRIED
MOTION: 2021.10.16.10 (TANBONLIONG): Move that CSPD’s Government and Legislative Affairs Committee further explore Dr. Cortez’s proposal for statewide surgery centers for special needs patients and report back to the Board in January of 2022. MOTION CARRIED
MOTION: 2021.10.16.12 (SCHMITT): Move that a regularly maintained Leadership Development Manual be posted on the Website as a responsibility of the Leadership Development Committee. MOTION CARRIED
MOTION: 2021.10.16.14 (SCHMITT): Move geographical boundaries be established that candidates or positions for elective office [that] must practice or reside in (“be from”) either “Northern” or “Southern” California be defined in CSPD governance. MOTION CARRIED. STANDING VOTE COUNT: 5-3-1.
MOTION: 2021.10.16.17 (MO): Move that CSPD provide real time virtual attendance voting in addition to current onsite, mail, and digital (email) voting on (1) motions, (2) Constitution and Bylaws changes, and (3) elective offices coming before the membership at the Annual Business Meeting. MOTION FAILED. STANDING VOTE COUNT: 2-3-4
CALIFORNIA SOCIETY OF PEDIATRIC DENTISTRY
CSPD LEADERSHIP
Full list of committee members is located at www.cspd.org.
OFFICERS
President: Dr. Gila Dorostkar
President-Elect: Dr. Thomas Tanbonliong
Vice President: Dr. Donald Schmitt
Secretary: Dr. Mitch Poiset
Treasurer: Dr. Gary Sabbadini
Immed. Past President: Dr. Nancy Hsieh
DIRECTORS
North (22): Dr. Natalie Vander Kam
North (22): Dr. Chanel McCreedy
North (23): Dr. Amber Nierode
North (23): Dr. Helen Mo
South (22): Dr. John Guijon
South (22): Dr. Dora Lee
South (23): Dr. Leslie Butler
South (23): Dr. Catherine Pham
APPOINTED OFFICERS
Managing Editor: Dr. MyLinh Ngo
Associate Editor: Dr. Angela Lee
Associate Editor: Dr. Chanel McCreedy
Website Editor: Dr. Steve Niethamer
Public Policy Advocate:
Dr. Natalie Mansour
EXECUTIVE DIRECTOR
Dr. Paul Reggiardo
WARREN BRANDLI LEADERSHIP INTERNS
Dr. Letitia Edwards (USC)
Dr. Imran Ahmed (UCLA)
Dr. Ida Gorshteyn (UCSF)
SANTOS CORTEZ GRADUATE STUDENT LEGISLATIVE ADVOCACY INTERNS
Dr. JoyAh Brooks (NYU Langone San Diego)
Dr. JungSoo Kim (UCSF)
CONTACTS & LIAISONS
AAPD District V (WSPD) Trustee:
Dr. Jonathon Lee
AAPD Liaison: Catherine Pham
WSPD Liaison: Catherine Pham
AAP California Chapters Coordinator:
Dr. Kim Nichelini
AAP CA Chapter 1 Liaison:
Dr. Kim Nichelini
AAP CA Chapter 2 Liaison:
Dr. Catherine Pham
AAP CA Chapter 3 Liaison:
Dr. Nicole LaMantia
AAP CA Chapter 4 Liaison:
Dr. John Guijon
UPCOMING CONFERENCES
Annual Meeting Sponsor Relations Liaison: Dr. Leslie Butler
California Dental Society of Anesthesiology Liaison:
Dr. Dave Rothman
CSPD Foundation Liaison:
Dr. Nancy Hsieh
Consultant – Legislative Affairs:
Dr. Santos Cortez
Consultant – Dental Board California:
Dr. Paul Reggiardo
CSPD VOTING MEMBERS TO THE WSPD BOARD OF TRUSTEES
Dr. Gila Dorostkar
Dr. Thomas Tanbonliong
Dr. Donald Schmitt
Dr. Catherine Pham
STAFF
Association Management Services: Smith Moore & Associates
CSPD Account Manager: Yelena Martynovskaya
CSPD Account Coordinator: Abi Hague
CSPD’s newly launched Online Continuing Education (OCE) platform makes it easier to view our comprehensive library of pediatric dentistry lectures and webinars. Programs can be purchased and viewed at any time from the comfort of your home or office without all of the extra travel costs and time away from family!
• CSPD’s OCE can satisfy up to 50% of the total CE required for license renewal in CA
• All available sedation courses qualify for the renewal of California’s Oral Conscious Sedation for Minor Patients Permit
• Programs can be purchased in bundled packages or by themselves … all at affordable prices
