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Become a patient or schedule a tour today Call 702-986-0191 or visit SeniorFocusedLasVegas.com Monday - Friday, 8am - 5pm

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NOVEMBER 2021

From the editor

he American Dental Association refers to the mouth as the “window into the health of the body.” It’s a point that’s hard to argue when we consider all that we can learn from this one specific area. The mouth can show signs of nutritional deficiencies, general infections and even systemic diseases such as diabetes. It is also filled with countless bacteria, some of which can lead to tooth decay and gum disease—further contributing to other health problems including cardiovascular disease. There is extensive research on the association between oral health and whole-body wellness. The message is pretty clear: maintaining a healthy mouth is important for maintaining a healthy body. In this special issue of Health Care Quarterly, we went straight to the source and asked several local oral health and dentistry experts to weigh in on the oral-health/bodyhealth connection. LIBERTY Dental offers a roadmap to the body’s overall health as it relates to oral health and the Nevada Dental Foundation reinforces the message that dental care is health care—and the important role dentists play on your larger health care team. Given the pandemic, Roseman University College of Dental Medicine explains recent studies showing a potential link between oral health and COVID-19 complications. We also have a feature on children’s oral health with contributions from UnitedHealthcare on dental health guidelines for families with children and UNLV School of Dental Medicine on the vital role of healthy baby teeth and the resulting implications of untreated cavities on adult teeth. Additionally, local pediatric dentists discuss age 1 dental visits and how parents may be able to correct behavioral problems with dentistry. Community health and access to care continue to be leading priorities in Southern Nevada. We are

fortunate to have innovative and caring physicians, such as Dr. Luis Medina-Garcia with UMC who is leading the charge in the establishment of the Southern Nevada Infectious Disease Society—so that our community will be better prepared when faced with highly infectious diseases like influenza, HIV/AIDS, pneumonia, and of course, COVID-19. With an increased demand for emergency medical services and employees, Community Ambulance is expanding its educational offerings as well as its training center to help grow EMS and pre-hospital care education in the Valley. And, speaking of growth, CenterWell Senior Primary Care now offers eight centers aimed at caring for our seniors with a patient-focused, team-based initiatives—leading to improved patient outcomes and clinician wellbeing. On the heels of Breast Cancer Awareness month, Comprehensive Cancer Centers shares its newest program to incentivize women in Southern Nevada to get their annual mammogram. Preventive measures make it possible to check for the disease before any signs or symptoms and mammography is the best tool available to do this. And there is so much more in this issue of Health Care Quarterly. As we close out 2021, lets continue to recognize our dedicated health care professionals and the work they do to keep our community safe and healthy, so that we can ring in the New Year with gratitude for our blessings and hope for what’s yet to come.

Jennifer Inaba Special Publications Manager & Editor jennifer.inaba@gmgvegas.com

NOVEMBER 2021

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Medical News TABLE OF CONTENTS

COVER STORY

How your oral health provides a roadmap to your overall health

24 FEATURE

The origin and risks of mouth lesions

26 FEATURE

Pediatric dentistry helps keep kids smiling

30 34 36

Growing demand for EMS care and training in the Valley Mammogram incentive for Southern Nevadan women

Establishing the Southern Nevada Infectious Disease Society

LAS VEGAS-BASED MEDICAL PROVIDER ENSURES NATIONWIDE COVID-19 TESTING ProAm Sports Medicine, formerly Athlete Advantage Medical, a Las Vegas-based medical provider with nationwide capabilities, is providing COVID-19 testing services for sports and entertainment events, workplace, education, tradeshows and conventions across the country. The company is CLIA certified and contracted with high complexity labs and medical resources nationwide to provide both onsite and pre-travel at home COVID-19 testing solutions to clients. This includes testing for a variety of industries, events and companies such as the UFC, Miss Universe, Golden Entertainment and Hewlett-Packard.

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NOVEMBER 2021

INTERMOUNTAIN HEALTHCARE OFFERS LIVER TRANSPLANT SERVICE

NOVEMBER 2021

Intermountain Healthcare is partnering with community providers to bring liver care closer to home for Nevada residents at its hepatology and liver transplant clinic at 2650 N. Tenaya Way, Suite 360. In addition to treating liver failure, Intermountain specializes in treating all diseases of the liver and bile ducts. Areas of expertise include liver tumors with a focus on hepatocellular carcinoma and bile duct problems including bile duct tumors. A Fibroscan® machine is part of the clinic and provides a rapid and non-invasive diagnostic test for evaluating for scaring of the liver and cirrhosis, and enables many to avoid liver biopsies. Intermountain’s goal is to restore quality of life to patients with advanced liver disease. For more information, call 801-507-3380 or email liverintake@imail.org.

MOUNTAINVIEW HOSPITAL LAUNCHES MINIMALLY INVASIVE ROBOTIC-ASSISTED LUNG BIOPSY PROCEDURE MountainView Hospital launched a new procedure to aid in the detection of lung cancer with the use of the ION robotic-assisted bronchoscopy platform. This minimally invasive procedure extends the reach of the bronchoscope deep into all 18 segments of the lungs—often difficult in traditional bronchoscopy—in order to sample and detect lung cancer sooner. Robotic-assisted bronchoscopy uses an ultra-thin catheter and integrated vision probe that provides the physician with direct vision to reach all parts of the lung. The catheter can move 180 degrees in all directions and the biopsy needle is flexible. Additionally, shape-sensing technology provides precise location and shape information throughout the whole biopsy process.

INNOVATIVE INBRACE INVISIBLE BRACES AVAILABLE AT MOUNTAIN VIEW ORTHODONTICS The field of adult orthodontics has continued to gain popularity recently. People are spending more time in front of computer screens looking at themselves wanting to improve their smiles quickly without anyone knowing. People also want convenience—the ability to present on a video conference call and snack without compromising on life. InBrace meets these needs because of the patented Smartwire, which is bonded to the back of the teeth and programmed with Gentleforce Technology. “This allows us to move teeth like autopilot without monthly tightening or tray changes,” said Dr. Nadim Guirguis, DMD, MSD, owner of Mountain View Orthodontics. “InBrace Smartwires are personalized for each of our patients. You can eat, drink, brush and floss normally. InBrace is freedom, finding your beautiful smile with less time, less hassle and no compromise.”

NEW STUDY EXAMINES COVID ANTIBODIES IN LAS VEGAS RESIDENTS Touro University Nevada is conducting a valley-wide COVID-19 study to examine the presence of antibodies against SARS-CoV-2 in Las Vegas residents. This study will help to determine the prevalence of infection from those who are unvaccinated and the efficacy rate of the vaccines administered in our community. Touro’s preliminary data shows that while 94.4% of people report having either a vaccine or an episode of illness, only 81.7% of people have detectable antibodies in their serum. Healthy volunteers 18 and older and weighing at least 110 lbs. can schedule an appointment through Touro to provide a blood sample to be used in the study. Participants will complete a questionnaire related to their demographics, health history, COVID-19, vaccines and testing. Participants will have the option to learn if their blood samples indicate the presence of antibodies against COVID-19. Those interested in participating should email TUNCOVID19Study@gmail.com. Dr. Amy Stone, assistant professor of microbiology and immunology with Touro University Nevada.

NOVEMBER 2021

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Virtual visits improve hospice and palliative care experience BY LISA ROSENBERG, MD

H Dr. Lisa Rosenberg is the medical director of Hospice and Palliative Medicine at Southwest Medical Hospice.

ospice care comes into the lives of our patients, and their families, when they are most vulnerable. Our responsibility is a great one, as we help guide patients and their loved ones through incredibly difficult decisions, and do everything we can to make our patients comfortable. As part of that responsibility, we continually look for innovations that can improve our service, and bring comfort into what can otherwise be a very uncomfortable time. One of those innovations is telemedicine, which has extended the hospice continuum of care. Southwest Medical first introduced telemedicine, or virtual visits, to Nevada in 2014, and the practice has since expanded throughout the health care community, growing even more rapidly since the beginning of the COVID-19 pandemic. Our patients rely on a strong network of support, and virtual visits have allowed our team— when appropriate—to provide patient assessments and support without additional risk. When a team member is with a patient, we can also use virtual platforms to include family members who are not able to be present. Additionally, being able to respond rapid-

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ly to a patient’s needs and concerns is vital throughout hospice care. Virtual visits help us more quickly address those needs, allowing us to connect with patients and caregivers instantly. We have also seen that our palliative care patients have generally been eager to embrace virtual visits, with patients and caregivers using it as an opportunity to learn and grow in their understanding of their health state as well as the importance of advocating for care consistent with their values. Virtual visits have allowed our palliative care program to expand beyond the borders of Southern Nevada, now assisting patients in Reno and Pahrump with serious and complex conditions to live as fully as possible. In-person care will always be central to our hospice care mission, and virtual visits are an invaluable addition to the services we provide, including consultations, chronic and acute condition management, and medication management. Regardless of our care-delivery method, whether in person or by virtual visit, we always strive to assist loved ones’ understanding of disease states as they progress, and to optimize the patient’s comfort and quality of life. That, in the end, is the ultimate goal of hospice care.

OUR PATIENTS RELY ON A STRONG NETWORK OF SUPPORT, AND VIRTUAL VISITS HAVE ALLOWED OUR TEAM—WHEN APPROPRIATE—TO PROVIDE PATIENT ASSESSMENTS AND SUPPORT WITHOUT ADDITIONAL RISK.

NOVEMBER 2021

Vision screenings a key component to children’s eye health BY NAOMIE WARNER, DO

O Dr. Naomie Warner is a pediatric ophthalmologist with Nevada Eye Physicians.

ctober was Blindness Awareness Month. This designation brings a heightened focus on the blind and visually impaired community and the realities of living without sight. It also serves as a great time to remind parents of the importance of vision screenings for children. Children should have an exam within the first year of life and again before they start school. Some of the most common issues I see in my clinic are vision problems related to the alignment of the eyes: conditions like strabismus and amblyopia (often referred to as lazy eye) which can be treated if caught early enough (between the ages of 1 and 9). If left untreated, these conditions can worsen and cause blurred and/or double vision, and can ultimately lead to loss of vision in the weaker eye as the brain begins to rely on the images sent from the stronger eye. So what should a parent look for? Many times there are no signs detectable by the family, which is why a vision screening is so important. Some signs that your child’s vision might not be 100% include: n The eyes are not aligned when fixated on an item like a toy or face n The eyes are not aligned when following a moving target and/or they do not follow the target smoothly n Excessive eye rubbing n Squinting n Developmental or behavior issues If parents notice any of these signs, they should schedule a vision screening as soon as possible. Even if both parents have 20/20 vision, there is no guarantee that their child will follow in their footsteps. I often encourage parents to “trust your gut.” If you think something is wrong, err on the side of caution and get it checked out. Parents are their child’s best advocate.

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Most vision can be fixed through glasses. More severe conditions may require surgery, and even then a percentage of vision conditions may leave a child with little or no vision. In cases of significant loss of vision, I refer families to specialists at Nevada Blind Children’s Foundation, who can help the child learn to navigate and adapt to their new world, independently, with little or no sight. So much of what we know is learned incidentally through our vision. A baby watches his family eating and is encouraged to use a cup or spoon. A toddler watches her family walking and is eager to take her first steps. But what happens when that baby or toddler cannot see those activities and is not motivated by his or her visual inputs? That’s when Nevada Blind Children’s Foundation can help. Similar to critical medical early intervention to help children reach their full potential, the Nevada Blind Children’s Foundation helps children learn to use their functional vision and/or learn to use adaptive technology and resources to access their education and navigate their world independently. The nonprofit organization provides specialized teachers and resources for children, starting at infancy, who are blind or visually impaired and their families. Its Learning Center offers a full-day, inclusive preschool and after-school programs for students in kindergarten through age 22, supporting families through each important transition and milestone in a child’s life and helping them to transition into adulthood. Founded in 2006, NBCF’s comprehensive services encompass advocacy, family support, education, adaptive recreation and health services, and life skills and employment training. For vision screening information, contact Nevada Eye Physicians at 702-896-6043. To learn more about Nevada Blind Children’s Foundation, visit nvblindchildren.org.

Flu vaccine critical to combat this year’s ‘twindemic’ concerns BY JUD FISHER, DO

rior to this pandemic, a lot of us really didn’t think about flu seriously, other than those of us in the medical field. As health care professionals, we know the importance of influenza vaccine for prevention of severe disease. Influenza— the type that we’re trying to prevent with flu vaccine—is a very serious illness. It is not the common cold. For anyone who’s ever really had it, it can be debilitating and life-threatening. Based on statistics from the Centers for Disease Control and Prevention, we know that 61,000 Americans died in 2017-2018 from influenza and 810,000 people were hospitalized. The World Health Organization categorizes the flu into four types: A, B, C and D. While flu A and B circulate seasonally, only type A viruses have been known to cause pandemics. In fact, as noted in Emerging Infectious Diseases, influenza A descends from the Spanish flu of 1918-1919, which infected a third of the world’s population and caused 50 million deaths, leading some to dub it the “mother” of all pandemics. Due to the risk of severity, I highly encourage everyone to get the flu vaccine. All new 2021-22 flu vaccines are quadrivalent (or designed to protect against four different viruses). The CDC recommends everyone 6 months and older obtain the flu shot approved for their age group to gain immunity ahead of the holiday season, as it takes about two weeks for us to develop an immune response that’s significant. There is also a high-dose flu vaccine available for specific patient populations. This high-dose vaccine has four times as much of the antigen—the protein that’s in the flu vaccine—to generate our immune response. It is indicated for those at high risk, particularly 65

years and over, and those with comorbid conditions, such as chronic obstructive pulmonary disease, diabetes, heart disease or obesity— for instance, those taking immune modulator medicines for their disease state. Regardless, the key is to get a flu vaccine, whether it’s regular dose or high dose. As social gatherings resume, there are mounting concerns about an uptick in flu cases. This, along with the rise of COVID-19’s delta and other variants, has stoked fears of a “twindemic”—two widespread contagions affecting the population at once. Fortunately, flu shots and COVID-19 vaccines or boosters can be given together. I recommend that patients receive the flu vaccine in one arm and the COVID vaccine in the other to differentiate any adverse reactions at the administration site. The good news is that our immune system can multitask incredibly well. It will respond and develop an immune response for the flu as well as SARS-CoV-2, the virus responsible for COVID-19. Anyone diagnosed with COVID-19, however, should wait at least two weeks before obtaining the flu vaccine, as the WHO recommends, to protect health care workers from exposure to the virus. Las Vegas and Nevada currently rank No. 1 for incidence of flu among metropolitan areas and states in the United States, according to the Walgreens Flu Index, which tracks weekly prescriptions of flu antiviral medication. By remaining vigilant to traditional health concerns, such as the flu, amid the ongoing pandemic, and keeping up to date with vaccinations, we can ensure adequate health care for all. The flu vaccine is safe. It’s been administered for decades. There are prevention characteristics to it that are excellent, and with it we can help save ourselves, our family, our neighbors and our loved ones.

NOVEMBER 2021

Dr. Jud Fisher is the medical director at Intermountain Healthcare.

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Ways to maximize children’s speech development BY ATOUSA GHANEIAN, MD, FAAP

Dr. Atousa Ghaneian is a board-certified pediatrician at Healthy Kids Care at Sunrise. She is also a fellow of the American Academy of Pediatrics.

s a pediatrician and mom, I realize how important it is to give our children the tools to maximize their speech development. From the moment a baby comes into this world, they can comprehend and produce language. The early stage of language may be a cry to let us know they are hungry, wet or just tired. When parents respond to a baby’s cries and sounds, they begin to notice the relationship between vocalization and getting their needs met. This encourages communication. Infants’ brains continue to develop as does their ability to comprehend and produce language. Language is learned by taking in information and processing the meaning behind sights and sounds. Babies begin to mimic the sounds of other people as early as four months. The more babies are exposed to language, the more opportunities they have to develop communication. Talk to your baby frequently. Make eye contact. Use clear adult sentences. Facial expressions and hand gestures as well as pointing to objects with a description is a great brain building tool. Incorporate conversation throughout your day with your baby. Describe what you are doing while keeping eye contact. There are many opportunities to converse with your baby, such as bath time, while changing their diaper, feeding time or while doing daily chores and activities. Reading daily to young children, starting in infancy, can help with language acquisition, communication skills, social skills and literacy skills. This is because reading to children in the earliest months stimulates the part of the brain that allows them to understand the

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meaning of language. It also allows children to grow their vocabulary skills with exposure to new words, and develops listening skills. I recommend choosing books with bright, colorful pictures to stimulate interest. Describe pictures, act out animal sounds and emphasize rhyming words. Make it interactive and exciting. As the child gets older, incorporate other activities such as asking them questions like “what do you think will happen next?” Create opportunities to encourage children to practice communication to assist in their development: n Acknowledge when they are babbling or making sounds. n Put items slightly out of reach and wait for them to ask for the item in some way. n When your baby is forming a word, elaborate on the word. Example: “dada.” Respond with, “yes, dada loves you very much.” n Repeat their words to demonstrate you are listening and understand. Example: “milk.” Respond with, “would you like some milk?” n Engagement empowers children to try new words and to communicate in new ways. Try to respond quickly to all attempts of communication. n Talk to your baby about a family picture. Create a story. Describe what is happening. Point and say the names of family members. n Help your child understand concepts such as up and down, right and left, first and last. Talk to your pediatrician at each visit to make sure your baby or child is meeting their speech and communication developmental milestones. This way, if there are any concerns, they can be addressed early on and a plan of care can be developed.

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R O A D M A P

THE ORAL HEALTH ISSUE

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THE ORAL HEALTH ISSUE

BY PETER FUENTES, DMD

few months ago, my son blew out his candles on his 6th birthday cake. As soon as he finished his second slice of cake, it was approaching bedtime. “Brush, shower, book, bed!” I called out as he went upstairs. It is the final four words I call out every night as he goes upstairs and gets ready for bed. Having a mother and father who are both dentists, it is something we try to instill in our children. Brushing teeth should be as routine as taking a shower or putting on pajamas—something we do every day without thought. Unfortunately, many people struggle with poor dental hygiene. In fact, due to poor oral health, 90% of all systemic, noncommunicable chronic Dr. Peter Fuentes diseases start in our mouths. In is the chief dental officer for LIBERTY many ways, our mouths serve as Dental Plan. a window to our overall health and provide us with indicators of health issues we may have in the future. But what does that mean for us and what can we do about it? By understanding what oral health is and how it links to our body, we can understand the types of illnesses we may develop and, most importantly, the steps we can take to prevent them before they start. Oral health can be one of the easiest things for us to maintain, and dental diseases are some of the most common chronic diseases, however they are largely preventable. Regular brushing, flossing and dental check-ups ensure issues like cavities are avoided or, if they arise, are quickly treated. Continued on page 18

Larry Hon, DMD, treats a patient at Cosmic Kid Dental in Henderson. (Courtesy)

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DENTAL CARE I S H E A LT H C A R E that either originally manifest or whose earliest signs can be detected in the mouth. Visiting the dentist is a familThat includes everything from iar routine for most of us. Twice pneumonia to cardiovascular a year, you visit your dentist, disease—and even pregnancy sneak into the lobby bathroom and birth complications. while waiting for Other wholeyour appointment body health issues to brush your with a direct link teeth one more to oral care include time and pop a diabetes, heart quick breath mint, disease, and even then open wide the severity of and say “ahhh” COVID-19 sympthrough a quick, toms. hopefully painRecent studies less, process of proposed a link bescraping, brushing, tween overall poor flossing and fluohygiene and the seride. Then, promDr. Ed De Andrade verity of symptoms ising not to eat or is the president of in those diagnosed drink anything for the Nevada Dental with COVID-19. 90 minutes, you Association. Patients with poor return to work, oral hygiene may home or school have a higher bacterial load and put the dentist out of your of the virus than the general mind for another six months. population. Periodontal infecAs important as oral health tion may secrete into the lungs has always been perceived during a bout of COVID-19, to be, I welcome and fiercely worsening symptoms. encourage a change in how we Like our colleagues in other view the importance of dental medical fields, the top priorcare as part and parcel of our ity of dentists is keeping our overall health and welfare. patients healthy and happy, Put simply, dental care is and providing the very best health care. medical care when, despite Beyond the difference best preventive efforts, medical between stained teeth or conditions arise. pearly whites, bad breath or Beginning with four years of minty freshness, and wincing post-graduate medical training, at too-hot coffee or enjoying followed by another three to a cold glass of iced tea, oral four years of specialty trainhealth professionals are in fact ing before entering residency, indispensable gatekeepers ours is a lifelong pursuit of to whole-body health and knowledge and dedication to wellness. protecting and serving our While most of us tend to patients. visit our primary care physician As orthodontists or periowhen we’re sick or our children dontists, pediatricians or nuneed clearance to play a school tritionists, or countless others sport, each year more than half in between, we all serve under of U.S. children visit the dentist, the common, important banner and nearly half of U.S. adults do of health care professionals— the same. This means that dendedicated to the health and tists are in many cases the first well-being of our patients. line of defense for health issues

BY ED DE ANDRADE, DDS

SIGNS OF GOOD ORAL HEALTH 1. Gums that don’t bleed when brushing or flossing 2. Teeth that are not sensitive to cold or sweet foods 3. Pleasant breath after brushing

NOVEMBER 2021

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THE ORAL HEALTH ISSUE

Continued from page 16

Signs of good oral health demonstrate that proper brushing and flossing techniques are being used, while serving as good indicators that the rest of our body is healthy. In fact, the mouth serves as a roadmap, not only to our body’s overall health but also shows us how bacteria impact other areas of our body. In addition, good oral health leads to increased self-confidence through a nice smile. Bacteria that build up on our teeth, because of a lack of proper brushing or flossing, cause gums to become prone to infection. Poor oral hygiene, coupled with skipped visits to the dentist, results in heavy build up on the teeth called calculus. This heavy, plaque-like substance will inflame the gums, causing bleeding. As the gums stay inflamed, bacterial infections can occur. Our bodies then release chemicals to fight off the infection that eat away at the bones in the jaw, causing periodontal disease. This process also paves the way for other diseases to set in, both in the mouth and in the body. Unfortunately, without clear signs, these diseases are not always easily detectable. Thankfully, the mouth gives several indicators of its overall health and potential issues with the rest of the body. There are many systemic issues that manifest in the mouth. Unexplained bad breath is often a sign of acid reflux or ulcers. Grinding of the teeth at night is commonly a side effect of stress. Even swollen gums can be the first symptom of pregnancy. Dentists can often diagnose these systemic, bodily issues at your checkup appointments. However, oral findings

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at your dental appointments may be indicators of more serious diseases such as anemia, lupus and Crohn’s disease. Certain markers are signs such as localized mucogingivitis, honeycomb plaques or oral ulceration. The most common diseases associated with periodontal disease are cardiovascular disease, stroke, diabetes and adverse pregnancy outcomes. The connection between poor oral health and cardiovascular disease is widely discussed. Due to the inflammation caused when the body detects the presence of bacteria, it is easier for blood vessels to carry those bacteria through the body and to the heart. These bacteria can affect the heart valves and increase the risk for developing heart disease. There are strong correlations between tooth loss and coronary artery disease. Most importantly, the inflammation caused by periodontal disease can increase the risk of stroke, particularly in individuals who have had poor oral health for prolonged periods of time. Similarly, poor oral health can also be dangerous for pregnant women and their unborn children, particularly as bacteria and inflammation increase the risk of bacteria circulating through the bloodstream to the fetus. In addition, pregnant women are at an increased risk for cavities, and those bacteria can be passed on to unborn children, increasing their risk for cavities and extensive dental care at a young age. Unlike some other diseases, diabetes is not linked in causation to poor oral health but greatly affected by it. Individuals with diabetes are at an increased risk of dry mouth, gingivitis, slowed healing and thrush, among other issues. Untreated diabetes often leads to early tooth loss. Gingivitis and thrush, two infections that increase the presence of bacteria, are 20 times

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more likely in individuals with diabetes. Diabetes also increases the risk of other diseases such as cardiovascular disease, stressing the importance of routinely visiting a dentist and practicing proper oral hygiene techniques. While there are various diseases that are worsened or created due to poor oral health, there are several ways to ensure that these issues don’t arise. A well-balanced diet that includes dairy, protein, leafy greens and fresh fruit provides the appropriate chemicals, probiotics and nourishment that teeth need to develop properly. However, it cannot be understated that one of the most important parts of a well-balanced diet is water. By staying hydrated, the body can distribute healthy nutrients, get rid of waste, and keep teeth healthy by washing away food particles and keeping saliva levels high. These practices ensure proper enamel development and decrease the risk of dental erosion and periodontal disease. Keep in mind, a proper diet can only go so far without other oral hygiene tips and yearly dental visits. To safeguard your oral health, be sure to brush twice a day, taking about two minutes to do a thorough job. Proper tooth brushing also includes cleaning the tongue, which holds extra bacteria that can latch on to the teeth after the teeth are cleaned. It is also important to use a fluoride toothpaste and soft-bristled toothbrush to help reduce plaque and other forms of gum disease. Flossing is an equally important part of oral hygiene which helps remove bacteria and food particles from in between the teeth and other hard-to-reach places, decreasing the risk of gum disease. Finally, it is imperative to schedule regular dental cleanings and exams which include X-rays. By regularly visiting the dentist, existing problems can be appropriately treated, and other health risks and issues can be detected before worsening and affecting other parts of the body.

Bacteria that build up on our teeth because of a lack of proper brushing or flossing cause gums to become prone to infection. ... Heavy, plaque-like substance will inflame the gums, causing bleeding. As the gums stay inflamed, bacterial infections can occur. ...

Our bodies then release chemicals to fight off the infection that eat away at the bones in the jaw, causing periodontal disease. This process also paves the way for other diseases to set in, both in the mouth and in the body. NOVEMBER 2021

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O R A L H E A LT H A N D I T S RELATIONSH IP WITH NUTRITION BY OWEN SANDERS, DMD

Learn more at sunrisechildrensdentistrylv.com.

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Cariology is the art and science of dental decay. As dental professionals, we study the vast degree in which dental decay can occur within the human mouth. So when I am asked by my patients, “how do I avoid cavities?” an entire cascade of facts floods through my mind. One of my favorite points to cover is nutrition. If it’s good for the body, it’s probably good for your teeth. Each day we are presented with food choices. When we think of good food choices, we often think of fruits and vegetables. Whole fruits and vegetables contribute to not only a healthy body, but also healthy teeth. The natural scrubbing action of the peel and crunchy parts of the vegetable help to remove areas of bacterial Dr. Owen Sanders is a board-certified pe- build-up. This chewing action also helps to stimulate diatric dentist with saliva that aids in washing Sunrise Children’s acids from the teeth that Dentistry, specialcan contribute to tooth izing in dentistry of decay. children of all ages Another great food as well as those with medical and intellec- choice is to drink plenty of water. Water helps to tual complexities. keep the mouth hydrated. A dehydrated or dry mouth can decrease the effectiveness of the mouth’s natural defense against tooth decay. Good snack choices are important to maintaining a healthy body and teeth. We want to limit the number of foods that are dense in simple sugars and starches. Snacks such as hard or gummy candies increase our mouth’s exposure to acids that can quickly erode enamel. Another major contributing factor to tooth decay is sugary drinks. However, hard or gummy candies and sodas are not the only culprits. Savory snacks such as chips or crackers can also contribute to the overall acidity of the mouth and tooth decay. The reality is that most of us throughout our lives will enjoy a sugary snack from time to time. The frequency in which we indulge ourselves can in fact determine our risk of cavities. More frequent eating increases our risk of decay. This creates a constant acidic environment in our mouths, especially if the food choice is a sugary snack. If snacking is a habit, choose whole fruits, vegetables or whole grains as snacks. Your body will thank you—as will your teeth.

THE ORAL HEALTH ISSUE

SLEEP BREATHING DISORDERS AND SLEEP DENTISTS BY TANYA AL-TALIB, DDS, MSO, D. ABDSM Do you or someone you know snore? It could be a symptom of sleep disordered breathing, which can cause daytime drowsiness and fatigue, and a sleep dentist may be able to help. Many of us can identify the most common form of sleep disordered breathing— obstructive sleep apnea. Sleep apnea refers to repeated episodes of either incomplete (called hypopnea) or complete (apnea) closure of the airway while Dr. Tanya Al-Talib is sleeping. The an associate profesclosure can sor in residence at cause a dethe UNLV School of crease in the Dental Medicine. blood’s normal oxygen level that, in turn, may promote a list of medical conditions such as high blood pressure, stroke, atrial fibrillation and heart failure. The common signs of sleep apnea include snoring, particularly loud snoring, experiencing daytime sleepiness, morning headaches, episodes of breathing cessation and gasping for air during sleep. Many people with this disorder tend to feel unrefreshed after waking, despite the number of hours at rest. There are also several physiological, anatomic and lifestyle factors that increase the risk for developing obstructive sleep breathing issues such as age, gender (males have two to three times higher risk),

family history, smoking, excessive weight and small airways. In addition, complications of sleep apnea may include diabetes, high blood pressure, complications during surgery or with medications, unhappy bed partner and increased daytime sleepiness that may contribute to motor vehicle accidents. Remember, these signs and risk factors are indicators only, but if you’re concerned, talk to your primary care physician. Sleep breathing disorders such as apnea should be diagnosed by a certified sleep physician, who will likely require an overnight observation study called polysomnography. You can also discuss signs and risk factors with a qualified sleep dentist or a diplomate of the American Academy of Dental Sleep Medicine. Many of us see our dentist more often than our physician each year. If your dentist is a qualified sleep dentist or a diplomate of AADSM, you may be able to be screened for sleep disordered breathing in the dental office and receive a referral

to a sleep physician for diagnosis. In some cases, patients with sleep breathing disorders may benefit from an oral appliance that looks like a retainer, which a qualified sleep dentist or a diplomate of AADSM can design, adjust and provide long term follow-up. As with many medical conditions, early diagnosis promotes higher treatment efficacy. If you’re concerned about your snoring, talk with your doctor or qualified sleep dentist.

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THE POSSIBLE LINK BETWEEN O R A L H E A LT H A N D COVID -19 COMPLICATION S BY JASON ROTH

Jason Roth is the vice president of communications for Roseman University of Health Sciences.

Dr. Karthikeyan Subramani is an associate professor and researcher at Roseman University College of Dental Medicine.

Maintaining good oral health is more than just about the health of your mouth, teeth and gums. Over the years, studies have demonstrated a strong link between oral health and overall health and wellness. “Our mouths are teeming with mostly harmless bacteria,” said Karthikeyan Subramani, BDS, MSc, MS, an associate professor and researcher at Roseman University College of Dental Medicine in Henderson. “Normally the body’s natural defenses and good oral health care—daily brushing and flossing, and regular dental visits—keep the bacteria under control. Without maintaining proper oral hygiene, bacteria in the mouth can cause tooth decay and gum disease. With the mouth being the entry point to digestive and respiratory tracts, some of these harmful bacteria can enter the body and cause disease.” Poor oral hygiene has been shown in some studies to contribute to endocarditis, which is an infection of the lining of the heart, cardiovascular disease and pneumonia. Now, a new study published in the Journal of Clinical Periodontology by researchers at McGill University in Montreal, Canada, has found a possible link between oral hygiene and higher rates of complications and more fatal outcomes for individuals diagnosed with COVID-19. The McGill researchers discovered that COVID-19 patients with gum disease were 3.5 times more likely to be admitted to the intensive care unit, 4.5 times more likely to need a ventilator and 8.8 times more likely to die when compared to those without gum disease. According to Subramani, “the study found that blood levels of biomarkers which indicate inflammation in the body were significant-

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ly higher in COVID-19 patients with gum disease, which may explain the higher rates of complications for those patients.” In addition to preventive measures, such as masks, frequent hand washing and social distancing, Subramani encourages attention to oral hygiene as another way to help protect oneself from COVID-19. “People of all ages should be brushing their teeth at least twice a day with a fluoride toothpaste, flossing daily and replacing toothbrushes every three months,” he said. “It’s also important to schedule regular dental cleanings and checkups to identify and address any issues.” Unfortunately, the COVID-19 pandemic caused many Americans to delay their dental care. An article published in the Journal of the American Medical Association Health Forum in December 2020 reported that one in five adults in the United States—roughly 20%—reported experiencing delayed care during the COVID-19 pandemic. In fact, 31-42% reported postponing health care for non-COVID-19 issues. This included dental care. “Since the start of the COVID-19 pandemic, I’ve seen a lot of major dental issues,” said Subramani. “With the shutdown, fears about going to the dentist, and people losing their jobs, many people had no choice but to ignore their dental health, unless they were experiencing significant pain. With the potential link between oral hygiene and severity of COVID-19, it’s more important than ever to see your dentist regularly.”

A PROJECT BY MIKE MILNE CDT AND JB WHITE DDS

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THE ORIGIN AND RISKS BY JO-LAWRENCE MARTINEZ BIGCAS, MD

s a specialist in head and neck cancer, I am frequently asked to evaluate a variety of lesions in the mouth. Such lesions are common. We all have developed—at one point in our lives—some irregularity on the pink, mucosal lining of the oral cavity. Often, these lesions are benign and resolve on their own. Other lesions may be present for months to years and never evolve into anything more than a nuisance. However, some may persist for uncomfortably long periods of time, accompanied by the development of more worrisome characteristics such as pain, bleeding or a wound that never heals.

Dr. Jo-Lawrence Martinez Bigcas is a head and neck surgical oncologist, microvascular surgeon and otolaryngologist with the Kirk Kerkorian School of Medicine at UNLV.

inflammation, such as repeated trauma from a nearby tooth or dental prosthetic, or autoimmune diseases such as lichen planus, which are raised, purple plaques on the mucosal surfaces of the mouth. Those with personal or family history of head and neck cancer are also at higher risk.

Know the history of the lesion

Get the lesion examined

The evaluation starts with the patient’s story of the lesion. Its velocity, evolution and associated symptoms are key elements in the history. It is important to know how long the lesion has been present. The doubling time of a head and neck cancer is around 6-8 weeks. The longer the lesion has been around, the less likely it is to be malignant. If the lesion is evolving, in what way has it changed and how quickly is it doing so? Associated symptoms I find worrisome include progressively worsening pain, relentless ear pain, bleeding of the lesion on contact (such as toothbrushing or eating), enlarging neck lymph nodes, difficulty eating or swallowing, and significant unexplained weight loss. History of tobacco or alcohol abuse are known risk factors for developing pre-cancerous lesions and cancers of the mouth. We often think of smoking when we talk about tobacco, but smokeless tobacco, also known as chew or dip, presents a greater risk for developing cancer of the mouth than smoking. Less frequently, oral cavity cancers in people with no risk factors can arise in the setting of chronic mucosal

A thorough exam by an experienced health care professional creates a clinical impression and guides management of the lesion. When examining the oral cavity, I interrogate all the surfaces of the mouth, looking for all mucosal irregularities. I describe them based on their location, size and worrisome attributes. Lesions in the midline tend to be less worrisome, such as midline rhomboid glossitis, which is a smooth raised area in the middle of the tongue, or torus palatinus, which is a bony overgrowth of the hard palate. Smooth, symmetric lesions on the cheek surfaces are generally benign and could be due to grinding of nearby teeth. Tobacco chewers can leave a trail of the various areas they have placed their tobacco, changing the location once they realize the underlying patch of mucosa is evolving. Mucosal lesions are evaluated for color, asymmetry and their borders. White lesions (“leukoplakia”) are commonly benign but have the potential to progress toward cancer. Red lesions (“erythroplakia”), particularly those ulcerated or with irregular borders, are more worrisome for

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White lesions (leukoplakia) on the mucosal surfaces in a patient with a history of lichen planus. This patient is at higher risk for developing a cancer.

Raised reddish plaque on the gums that bleeds on contact. Biopsy showed cancer.

Non-healing, ulcerative lesion of the gums present for several months. Biopsy was consistent with cancer.

A red lesion (erythroplakia) of the palate.

malignant potential. Flat, smooth, symmetric lesions favor a benign course, while firm ones with uneven contours and erratic borders should be given their due respect for potential cancer. Examiners should always run their finger over the mucosal surfaces to feel for any additional qualities—including firmness, contact bleeding, underlying mass and tenderness. Additionally, a head and neck neurologic exam (to see if any nerves are dysfunctional due to tumor invasion) and examination of the neck (to see if cancer is spreading through lymph nodes) should be performed to evaluate for signs that favor cancer. Most oral cavity lesions are harmless, usually the manifestation of nearby trauma (e.g. teeth grinding) or infection (e.g. canker sores, herpes, etc.). While bothersome, they are usually short-lived. When a lesion has been present for more than two months, one should seek the advice of a dental or medical professional. Most will start with their dentist or their primary care provider. Patients may subsequently be referred to an otolaryngologist (ear, nose and throat specialist), oral surgeon or an oncologist. They may be able to identify irritants that created the lesion, such as rubbing from nearby teeth. More importantly, a seasoned professional can decide if an oral lesion can be safely observed or warrants an immediate biopsy. In experienced hands, the clinical history combined with a good physical exam can lead to an accurate and prompt diagnosis, avoiding unnecessary stress over a benign process, or worse, potential delays in cancer treatment.

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HOW TO HELP KEEP KIDS SMILING BY COLLEEN VAN HAM

OVID-19 has disrupted multiple aspects of daily life, including how people access dental care. As a result, fewer people may be accessing routine dental care that may help prevent oral pain and untreated disease. Maintaining proper dental care is especially important for children, given that by age 5 nearly 50% have at least one cavity.

O R A L H E A LT H T I P S T O C O N S I D E R Good oral health habits should start early. Recommended dental health guidelines from the American Dental Association for babies and children include: 1. During infancy, clean the baby’s gums with water and a child-sized toothbrush.

Colleen Van Ham is the chief executive officer for UnitedHealthcare Dental.

2. At age 2, parents can start brushing a baby’s teeth with a soft-bristled toothbrush and a smear-sized dab of fluoride toothpaste, teaching the toddler to spit out the toothpaste. 3. Begin flossing when back teeth emerge. 4. Never put a baby to bed with a bottle of milk, formula or fruit juice, as these liquids can lead to infection.

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AVOID POTENTIAL OPIOID ISSUES

TAP INTO TELE-DENTISTRY

KEEP UP ON CLEANINGS A N D T R E AT M E N T S

For millions of young people, wisdom-teeth removal is part of the rite of passage into adulthood. But for some, the procedure represents a first exposure to opioids, which may lead to addiction. If prescribed an opioid following a dental procedure or another medical event, ask your health care professional if there are alternatives, including over-the-counter pain relievers. In many cases, these medications can be equally effective in pain management, without the risk of addiction.

Virtual care has become an important option for accessing health care amid COVID-19, including for dentistry. Some dentists and dental plans are making available telephone and video consultations, which offer people a starting point for advice and guidance to help select (if needed) an appropriate setting for in-person care. Not all dental services are eligible for tele-dentistry.

For children and adults, the ADA recommends that during the COVID-19 pandemic, people continue routine oral health care, including dental checkups, cleanings and preventive care. To further help with prevention, parents should consider fluoride supplements for children, which may strengthen tooth enamel and help protect it from decay. Sealants are another option, as these plastic coatings are placed on back teeth to help protect them from decay. They are sometimes covered as a preventive service by dental plans, so ask the dentist about sealants when your child’s molars first come in.

By considering these tips, you may help maintain or improve your own dental well-being, while also enabling young people to develop good oral health habits.

UP YOUR CHILD’S H Y G I E N E AT H O M E Maintaining proper oral health at home is important year-round. Recommended dental health guidelines from the ADA for adults and children include: n Brush your teeth (and tongue) for up to two minutes, after meals and before bedtime. n Rinse for 30 seconds with a mouthwash, which may help kill bacteria and clean parts of the mouth brushing might miss. n Floss daily and consider using a water flosser.

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HOW A DENTIST’S CARE CAN CORRECT CHILDHOOD SLEEP AND BEHAVIOR PROBLEMS BY DEE DEE MEEVASIN, DMD

ven in normal times, parents—and their child’s health care providers— may put little focus on dental health, as long as tooth decay is under control. If there are crooked teeth or crowding concerns, the long-held thinking is to deal with it in their teen years. Here’s why this decision may compromise the physical and mental well-being of a child for life, and how it can all be avoided with the proper early dental intervention. guide the growth of the jaw and arches. With proper jaw development, airways naturally open and sleep issues quickly reWe see these issues all the time, children solve. And the welcomed downstream side with crowded or crooked teeth, an undereffect is adult teeth that grow in straight, or over-bite, teeth grinding, snoring, bed too. In most cases, orthodontics wetting and mouth breathing. and retainers are entirely avoidThese shouldn’t be passed off as ed. You can start myofunctional normal. There’s a good chance therapy as early as 2 years old— the child suffers from sleep disthe earlier the better. ordered breathing or obstructive The device rests in the roof sleep apnea. of the child’s mouth and is In many cases, these sympproperly fitted by a dental protoms are the product of poor fessional. The child wears it for jaw development and narrow two hours each day and during dental arches. As the jaw and sleep hours. At check-ups, the arches develop incorrectly, dental team can adjust the it compromises the tongue’s size and shape of the device, if placement in the mouth and disneeded, as the child grows. rupts airflow and can also lead Dr. Dee Dee MeevaOur dental practice has to crowded or crooked teeth. sin is the founder worked with this system for five It can even hinder proper facial of Dee For Dentist, years, and I have even used it growth. Family and Cosmetic with my own children. In some If not addressed early, far too Dental Care. Learn cases, we see results as early as many parents face a long, frusmore by visiting one month with children who trating road, which may include deefordentist.com, come in with dark circles under a misdiagnosis of ADHD, behavcalling 702-586their eyes, then come back fully ior and speech problems, and 7800 or follow rested as parents remark on poor academic performance. @deefordentist on positive changes. Even in cases But there is a way to proactively social media. where a child truly does have treat the underlying cause of ADHD, better sleep has imthese concerns with a unique proved the ability to navigate life. preventive dental care system. It’s time to change our perspective on straight teeth and when and how to correct them. Today, with more adult sleep apnea now diagnosed, my hope is that parents Myofunctional therapy has been around and medical professionals also realize the since the 1980s, and it changes thousands power of addressing these issues early of children’s lives every year. The therain children to help them achieve their full py involves the fitting of a small dental potential as adults. appliance into the child’s mouth to naturally

A SILENT EPIDEMIC

A PROVEN SOLUTION

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UNDERSTANDING THE VITAL R O L E O F H E A LT H Y B A B Y T E E T H BY VICTORIA SULLIVAN, DDS As a pediatric dentist, I have faced many incredulous parents confronted with costly and stressful treatment plans for their children, and as many of my colleagues will attest, their rebukes frequently include the same two sentences: “But they’re just baby teeth. They’re going to fall out anyway.” We all need our baby teeth for several critical growth and development issues including speaking, chewing and smiling. Yes, our baby teeth will fall out, but, as with many things in life, timing is everything. These early teeth hold space in our jaws for the permanent adult teeth growing under our gums. Removing a baby tooth too early can upset the delicate balance between the interlocking upper and lower teeth, causing the growing adult tooth to be pushed so far out of alignment that it becomes trapped within the jaw, unable to erupt. Additionally, if cavities in baby teeth are not treated immediately, the decay can cause pre-eruptive caries, which spread the infection to the developing teeth and damage them before they enter the mouth. In this situation, a root canal would be needed to try and save the adult tooth. However, in many cases, the new tooth is destroyed. Tooth decay has been cited as the most common chronic illness among school-age children in our country. And if those two issues were not serious enough, there is the impact of dental pain—the No. 1 reason children miss school nationwide. Dental pain is so distracting that children cannot sleep, eat or concentrate, all of which affects their overall wellbeing. Children’s baby teeth require daily care, good nutrition and regular dental checkups. The consequences of disregardDr. Victoria Sulliing them because van is an associ“they’re going to fall ate professor and out anyway” can adboard-certified versely affect a child’s pediatric dentist at health, development the UNLV School of and future. Dental Medicine.

SET TING AGE 1 DENTAL VISIT E XPE CTATIONS BY CODY C. HUGHES, DMD, MSD As a parent of five children, I know how exciting, joyful and stressful that first year of your baby’s life can be. There’s so much to learn about how to care for a child and what you need to give them the best chance at being healthy. In general, most parents understand the importance of taking a child to a health care specialist, such as a pediatrician; but when it comes to oral health, we often receive the question, “At what age should I start taking my child to the dentist?” The American Academy of Pediatrics and the American Academy of Pediatric Dentistry, along with other medical and dental associations, advocate for children to have a dental examination before their first birthday. Dr. Cody C. Hughes At this first visit, an is a pediatric dentist exam is completed at Sunrise Children’s to ensure proper Dentistry. He is also development and a diplomate with the look for dental American Board of decay. It might surPediatric Dentistry. prise some people to learn that it is possible to encounter dental decay in a child this young. Another important aspect of the first dental visit is to assess the child’s risk for experiencing dental decay. To make this assessment, the dental professional will discuss habits pertaining to hygiene and diet. Additionally, at the first visit, education and information to help parents prevent dental disease in their child will be provided. Research has shown that the earlier children have their first dental visit, the less likely they are to experience severe dental disease. Delaying a child’s first visit may lead to increased costs, the need for more extensive treatment and the child requiring sedation or general anesthesia. Don’t wait until the child is in pain or a problem becomes evident. Dental disease is preventable, and establishing a dental home early is a key factor.

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Driving and innovating EMS care BY GLEN SIMPSON

C Glen Simpson is the senior director of specialty care and innovation at Community Ambulance.

ommunity Ambulance has been Southern Nevada’s hometown ambulance company for over 10 years. With trailblazing technology, more than 400 employees and a growing fleet of over 50 ambulances, we provide the fastest and highest level of service to patients for 911 and non-911 medical services including advanced life support, critical care transport, as well as neo-natal, flight team and long-distance transports. Community Ambulance also serves as a premier provider of medical standby services for Las Vegas’ dynamic and world-renowned sports, special events and entertainment scene. As a company, we have always put our community first and are consistently looking for proactive and responsive solutions to meet its needs. A critical part of this commitment is providing education to help fuel a safer and healthier place to call home. Post-pandemic trends show support for the growing demand for emergency medical service employees surrounding a shortage of EMS workers nationwide. With our soon-to-open Community Ambulance Health Science Center expansion, we are working to grow EMS and pre-hospital care education in the Valley.

A Center of Excellence

The Health Science Center will have two classrooms built for in-person and virtual instruction as well as several breakout rooms for real-life simulation out in the field. The

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instructional spaces will give EMS instructors powerful tools to inspire and inform the next generation of EMS professionals, other pre-hospital care providers and those who may need to administer care in the community. It is our goal that any pre-hospital care providers trained at the Health Science Center will have the ability and resources to handle any emergency that may be encountered. A central feature of the center is a real-life ambulance box mounted inside one of the classroom walls to better assist students in making the transition from class into working on an actual ambulance. Cameras inside the ambulance will be broadcast in the classroom.

Students will also get hands-on experience with the equipment they will use when working as an EMS professional. When called to the scene, they often have seconds to react, and we want our students ready to hit the ground running. One of the breakout rooms, in true Las Vegas fashion, is designed as a hotel room. The multipurpose living room setting will prepare students, including local hotel and casino frontline security officers, for medical emergency calls. Another breakout room is set as a

hospital room. Equipped with trauma equipment and a simulation mannequin able to simulate a patient with cardiac monitoring capabilities, the room will “throw students into the fire” of emergency medical services testing their classroom curriculum. In addition, students will learn about transferring patients to or from facilities, such as nursing homes, and practice transferring patients to and from hospital beds. Simulation for special events, a specialty area Community Ambulance has most notably earned a reputation

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by servicing high-profile clients like MGM Resorts International, Allegiant Stadium, Las Vegas Raiders, EDC and the City of Henderson, will span all facets of the center to equip non-medical and medical roles across the company. Since our “boots on the ground” experience during the October 1 mass shooting at the Route 91 Harvest Festival in 2017, Community Ambulance is all too aware of the devastation emergency casualty situations may present. Continued on page 32

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Continued from page 31 For this reason, we are highly engaged with addressing the issue of potential violence before, during and after both scheduled and unscheduled events through classroom curriculum. During the pandemic, our commitment to ensuring safety extended to an extra push to practice meticulous infection-control measures for COVID-19.

EMS and general public courses

The Health Science Center will also offer more classes to the public with its added classroom space, including CPR and Stop The Bleed, Advanced Cardiac Life Support, Pediatric Advanced Life

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Support, Pre-Hospital Trauma Life Support and Tactical Emergency Casualty Care (TECC). Commission on Accreditation For Pre-Hospital Continuing Education-approved courses will continue to be offered with additional hours available. Community Ambulance is an authorized National Association of EMT training site in Southern Nevada, a fully accredited NV Postsecondary Education Institute and is the only NAEMT training center that offers local TECC education. TECC instructs students on the three phases of tactical care: Direct Threat Care, Indirect Threat Care and Evacuation Care. As part of the top ambulance providers in the U.S., we’ve earned the

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highest accreditation in the industry for EMS excellence continuously since 2012 by the Commission on Accreditation of Ambulance Services. Accreditation assures patients, local officials, health care partners and the community that the ambulance service has met the commission’s standard for quality patient care. The Community Ambulance Health Science Center will hold a special ribbon-cutting celebration with the Henderson Chamber of Commerce in February at its company headquarters. For more details or to sign-up for a class, visit communityambulance. com/education.

Our response began before the crisis did.

COVID-19 changed everything. But UMC was ready. Our team of infectious disease doctors had prepared for this moment their entire careers. We’d practiced pandemic drills over and over. Our stockpile of critical equipment was ample and robust. And we blazed new trails in large-scale testing, including every patient we admit, making us the safest hospital in the state. When Nevada needed us, we were there. Just as we’ve always been. Just as we always will.

Highest Level of Care in Nevada

umcsn.com

Incentivizing women to schedule their mammograms

BY RUPESH PARIKH, MD

Dr. Rupesh Parikh is a medical oncologist and practice president at Comprehensive Cancer Centers. For more information about the Mammo Cup initiative, visit cccnevada.com/ kays-power-play.

little extra motivation never hurts—particularly when it comes to staying one step ahead of a potential breast cancer diagnosis. There are currently more than 3.8 million women living in the United States who have been diagnosed with breast cancer. It is the second-most common cancer in American women, only behind skin cancer. Moreover, 43,600 women will lose their lives to the disease this year, making it the second-most common cause of death for women in the United States. There is a one in eight chance that a woman in the U.S. will develop the disease in her lifetime. When one receives the life-altering news that she has breast cancer, it is understandable that it may prompt various emotions such as depression, anxiety and fear. But for many, there is still hope. According to the American Society of Clinical Oncology, if the disease is found before it spreads beyond the breast, the five-year survival rate of women is 99%. Unfortunately, for the many women who are not diagnosed before the disease spreads, the survival rate diminishes. While there are various risk factors associated with breast cancer, the two main factors are uncontrollable: being a woman and getting older. There are women with risk factors who never develop the disease and women without risk factors that are diagnosed. Since a diagnosis is often out of the individual’s hands, early detection and prevention of breast cancer becomes even more crucial.

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Preventive measures such as mammograms make it possible to check for the disease in women before they have any signs or symptoms. There are various breast cancer screening methods, but mammography is the best tool doctors have at their disposal. This is due partly to the fact that mammography can be used to screen otherwise healthy women for the disease, while other methods are more commonly used on women who are considered to be high-risk. The American Cancer Society estimates that 2,490 women in Nevada will be diagnosed with breast cancer this year and an estimated 400 will lose their lives to the disease. Additionally, 60% of women 45 years and older in Nevada have upto-date mammography. This ranks 47th in the nation, with the national average being 68%. To incentivize women in Southern Nevada to get their annual mammogram, Comprehensive Cancer Centers teamed up with Vegas Golden Knights defenseman Shea Theodore to create the Mammo Cup patch program. Since September 1, women across the Las Vegas Valley who completed their annual mammogram at a designated location were eligible to receive the specially designed limited-edition Mammo Cup patch. The patch is inspired by patches worn on team jerseys to celebrate milestones or accomplishments, and having an up-to-date mammogram is an accomplishment worth donning proudly on a favorite Golden Knights jersey or keepsake. The Mammo Cup patch is part of Kay’s Power Play, a fund launched in November 2020 for Susan G. Komen Nevada, that is named in Kay Darlington’s memory—Theodore’s late grandmother and a beloved breast cancer patient at Comprehensive. The fund serves as a critical lifeline, providing financial assistance for the uninsured, underinsured and patients under 40, whose mammograms are not covered by insurance. For those needing preventive resources, Kay’s Power Play is a means to receive care that may lead to a potentially life-altering diagnosis. Since November 2020, Kay’s Power Play fund has supported nearly 100 Southern Nevadans. And since the beginning of the Mammo Cup initiative, 12,000 patches have been distributed to various imaging partners throughout Southern Nevada to be handed out to women who receive their mammograms. Amid these figures, even if one life is saved thanks to these preventive resources or one woman’s mind is put at ease, the fund is an absolute success.

Clinical Research at Comprehensive has led to

100 New FDA Approved Cancer Treatments

Giving me more holidays with my family COMPREHENSIVE CANCER CENTERS has participated in the development of 100 new FDA approved cancer treatments. With 170 ongoing clinical research studies, right here in Southern Nevada, we are entering a new age in cancer treatment — where people are no longer entrenched in their battle against cancer, but instead living with cancer. These new cancer therapies are increasing the quality of life for our patients and their families, and most importantly, giving them the opportunity to live their lives to the fullest.

cccnevada.com • 702.952.3350

Why Southern Nevada needs an infectious disease society BY LUIS MEDINA-GARCIA, MD

Dr. Luis Medina-Garcia is an infectious disease specialist at University Medical Center.

s the COVID-19 pandemic tightened its grip on the world last year, it crystallized an idea I had long been pondering: the need for an infectious disease society in Southern Nevada. In times of crisis, information, collaboration and sharing of resources is everything. At no time in recent history has this been more apparent, especially in the early days of COVID-19, when the world was grappling with a highly infectious disease whose fallout would change almost everything in our daily life. As an infectious disease specialist at UMC, I was acutely aware that our region did not have an organization that brought together physicians, advanced practice providers, pharmacists and other health care professionals to share critical information and brainstorm solutions, advocate for research, interpret data and support others to pursue careers in infectious disease. Most states with large metropolitan areas have infectious disease societies that help prepare communities to fight public health challenges today and in the future. Through this turbulent time and with the help and support of many, especially Las Vegas City Councilman Brian Knudsen, who has generously provided meeting space, resources and encouragement, the Southern Nevada Infectious Disease Society was born. We are the first professional society for infectious dis-

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ease practitioners in the history of our state and we are still in our infancy. The nonprofit organization is meeting regularly and we are actively recruiting medical professionals to join us. A major goal of the Southern Nevada Infectious Disease Society is to promote the formation of the state’s first infectious diseases fellowship training program. By encouraging more medical professionals to become infectious disease specialists, we can help meet the dire need for these services both locally and nationwide. To that end, we plan to establish scholarships and provide financial support for the trainees through our nonprofit and philanthropy. Currently, there are only about 20 practicing infectious disease doctors in Clark County. Given our growing population and our huge influx of tourists, the need is far greater. It takes a community of experts to deal with the societal scourge of infectious diseases like influenza, tuberculosis, sexually transmitted diseases, HIV/AIDS, hepatitis, pneumonias and many common preventable infections for which vaccines are readily available, including measles, mumps and chickenpox, and of course, COVID-19. And that’s just scratching the surface of a long list of infectious diseases that have the potential to disrupt both personal lives and impact public health. Las Vegas leads the nation as the city with the highest number of syphilis cases, which sadly means we also see a commensurate number of syphilis cases in newborns. Because of our large global tourist population, we have a fair number of tuberculosis cases, and the Las Vegas area is endemic for an infection with a fungus called Coccidioides. These are just a few examples outside of COVID-19 that illustrate the need for more infectious disease doctors and specialists. Sadly, there are just not enough of us to meet the need. An important issue within the infectious disease universe is antibiotic resistance—bacterial diseases where the organisms mutate to become resistant to antibiotics. This is often a result of these drugs being commonly overprescribed. That’s why antibiotic stewardship programs inside our hospitals and nursing homes are critical to guide health care professionals in the appropriate use of antibiotics. By including pharmacy specialists in our society, we are better positioned to leverage

It takes a community of experts to deal with the societal scourge of infectious diseases like influenza, tuberculosis, sexually transmitted diseases, HIV/AIDS, hepatitis, pneumonias and many common preventable infections for which vaccines are readily available, including measles, mumps and chickenpox, and of course, COVID-19. And that’s just scratching the surface of a long list of infectious diseases that have the potential to disrupt both personal lives and impact public health.

improved physician-pharmacist relationships to choose the best medicine for patients, especially in difficult cases. Now is the time to strengthen our public health workforce, which includes those who specialize in treating infectious diseases. Pandemics haven’t occurred that often, but with globalization, they are going to become much more common. We are working hard toward growing our society to become affiliated with the Infectious Diseases Society of America, one of the world’s most prestigious ID societies, an important step that will give us even greater access to resources and information to protect Southern Nevada.

GROWING PUBLIC HEALTH RESOURCES AND MEDICINE IN THE VALLEY BY COUNCILMAN BRIAN KNUDSEN As a Las Vegas city councilman whose constituents include the Las Vegas Medical District, but most importantly, as the father of two children, I feel a huge sense of responsibility to support the establishment and growth of the Southern Nevada Infectious Disease Society. Such an organization is founded in science and fact—comprised of experts in their fields, whose collective knowledge combined create a powerful tool to improve the health of both individuals and our community. As we know, COVID-19 has become highly politicized. This sad but true realization pushed me to personally learn as much as I could about the virus. I surrounded myself with experts like Dr. Luis Medina-Garcia, who shared his passion for creating an organization that would help our city to better combat Brian Knudsen is a COVID-19 and other incouncilman with the city fectious diseases. While of Las Vegas, Ward 1 I hold political office, I feel it is my duty to listen to doctors and scientists, not politicians or the media. More than 750,000 Americans have now died from COVID-19—more than those killed in our country’s four-year Civil War and more than the number of Americans who died during the 1918 flu pandemic. These are sobering statistics that should create a sense of urgency in all of us to realize more has to be done to prepare for not only the next pandemic, but to better respond to other infectious diseases as well. I commend Dr. Medina-Garcia for his tenacity and perseverance in working overtime to build a solid resource for public health and for the betterment of medicine in Southern Nevada. I am here to support him and our community’s health care community to advance this important initiative. Nevada is known as a can-do state, and Las Vegas is the land of opportunity. We have the ability to change on a dime, so why not build an effective infectious disease society that can help provide answers and give smart, science-based guidance during times of medical crises? Imagine Las Vegas not only as the Entertainment Capital of the World, but also as a destination for rock solid, progressive medicine.

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Reaching new heights with elective stature surgery BY LAGUARDIA MEDIA AND PUBLIC RELATIONS

Dr. Ronald Hillock is an orthopedic surgeon at Nevada Orthopedic and Spine.

estern culture is subconsciously biased toward taller people. Higher than average height has advantages in relationships, courtship and self-confidence— affording many advantages in life and business. Those who are taller even have better career opportunities and better income. A study of recruiters showed that when given the choice between tall and short candidates, they chose the taller applicant 72% of the time. Taller workers also receive a substantial premium in earnings or wages, which some studies attribute to noncognitive abilities or social skills that are correlated with stature and rewarded in the labor market. A survey of Fortune 500 companies showed that CEOs of those organizations were more than 90% more likely to be above average height than the general population. Greater height makes people feel more confident and assured in interpersonal interactions, and thereby more likely to succeed in their life goals. Dr. Ronald Hillock, an orthopedic surgeon with Nevada Spine and Orthopedic, is widely recognized for using the most innovative and advanced techniques for cosmetic limb lengthening. “Your stature is a product of many factors in a person’s life and development,” said Hillock. “Genetics, nutrition, birth weight, length of fetal gestation, hormones, geographic location and sunlight exposure are all shown to factor into one’s ultimate height.” While your height is not a reflection of your character or ability in life, there is now an option

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to add a few inches for candidates who are: n Adult (skeletally mature) n A nonsmoker for at least six months prior to treatment n In good health, no ongoing medical issues that are not optimized n Psychologically healthy, confirmed by a preoperative psychological exam n Supported by a network to help with daily living for a few weeks after surgery n Financially capable of covering the cost of treatment and the recovery time after surgery. “This is a bilateral simultaneous limb lengthening procedure through the use of the OrthoFix Expandable Intramedullary Nail,” said Hillock. “To be clear, this is elective cosmetic limb elongation for increased height, however, any healthy adult who has always wanted to be a few inches taller is a candidate for stature surgery.” Research and experience has shown that an increase of 2-3 inches is possible in most cases. Patients who attempted more than 3 inches in height were more likely to experience complications requiring additional surgery/treatment. Generally, only one treatment of lengthening should be carried out for safety reasons. And like any elective surgery, complications are possible. Risks include but are not limited to: n Nonunion of the distraction bone mass n Leg length discrepancy n Neuropraxia/nerve stretch and injury n Stiff joints at the hip and/or knee n Post-treatment arthritis n Deep vein thrombosis (blood clots) n Pulmonary embolism (lung blood clots) n Tight muscles n Premature bone healing While a patient can expect to be walking by the morning after surgery, they will typically remain in the hospital for about 72 hours for physical therapy to undergo movement and walking exercise. A wheelchair will be used for long distances and crutches or a walker for shorter distances until expansion and healing is completed. Lengthening begins five days after surgery and should be monitored every 10-14 days after surgery with an examination and X-rays. Patients can expect predictable results if the treatment protocol is followed as recommended, with lengthening complete after about 5-6 weeks. Patients are then followed with monthly X-rays for six months. Total recovery is generally predicted in 12-18 months after treatment is completed.

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To deliver holistic health care to seniors, it takes a team BY KAHREN DY-PATACSIL

enterWell Senior Primary Care offers senior-focused primary care at eight centers in the Las Vegas area. Its centers accept Medicare Advantage and are built around a care team approach, the benefits of which are explained by regional medical director, Dr. Tracy Wakefield.

Dr. Tracy Wakefield is the regional medical director at CenterWell Senior Primary Care. Kahren Dy-Patacsil is a family nurse practitioner at CenterWell Primary Care.

What is “team-based” primary care and how does it work? The National Academy of Medicine defines team-based health care as “two or more health care professionals who work collaboratively with patients and their caregivers to accomplish shared goals.” But not all teams are alike. They may vary in the number of health care workers involved and their areas of expertise. For example, our care team—which focuses on seniors’ health care—consists of access to physicians, nurses, social workers, pharmacists and behavioral health specialists. While each health care professional performs a different function, we all share a common goal: improving the physical, mental and social well-being of our seniors. How does team-based care compare to care received in a traditional doctor’s office? Research has shown that team-based

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health care is linked to improved patient outcomes and clinician well-being, confirming what I’ve experienced in my own practice. There are a few reasons for this. First, having a team you can count on relieves much of the administrative burden for physicians, decreasing the feeling of burnout and allowing them to focus more time and energy on their patients. Working with a care team allows me to spend an average of 45 minutes with each patient rather than the 17 minutes that is common with other primary care doctors. This allows patients to build a trusting relationship with their physician. Second, in a traditional primary care setting, transportation from a doctor’s office to the pharmacy, and then separately to a social worker or mental health professional, can be very difficult, especially for senior patients like mine. Having resources all under one roof allows for a more streamlined approach to health care. Finally, we assess for social determinants of health as part of our visits, meaning we have conversations with our patients on things like nutrition, housing, literacy and financial stability. For those lacking in any of these areas, our case managers can refer them to local resources for assistance. How has your health care team functioned during COVID-19? At first, we were concerned that seniors would stay away from the doctor for fear of going out, but we found that our patients were terrific with keeping up with their regular visits, whether coming into our centers or participating via telehealth. In fact, we actually saw an increase in annual wellness visits across all of our centers. Keep in mind that visits with a physician might be one of the only forms of social interaction that a senior has with others on a given day or over the course of several days. That’s why maintaining meaningful connections with my patients is so critical, both for the good times and the more challenging circumstances.

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Is IVF the best option to grow your family? BY EVA LITTMAN, MD, FACOG

T Dr. Eva Littman is the founder and practice director of Red Rock Fertility Center.

he process of reproduction is a private, intimate experience. Many patients can become overwhelmed as they explore the process of expanding their family. It’s important to understand your options in fertility treatment and develop a strong relationship with your fertility physician. One of the most common fertility treatments is in vitro fertilization. And while it may be a recognized term, patients should discuss their specific questions and concerns with the process and intended outcome with their fertility doctor. Here are some of the frequent questions I receive: Why would someone seek fertility assistance? There are a variety of reasons, like preservation of fertility, male factor issues, pelvic factor issues, tubal factor issues, egg quality issues, uterine factor issues, endometriosis, polycystic ovarian syndrome, congenital anomalies affecting the reproductive system and hormonal issues.

reproductive organs removed or operated on, men who have had a vasectomy, same sex couples, single men who would like to have a baby—the list is actually quite extensive of those who are candidates for IVF. How long is the IVF process from start to finish? The process generally consists of 2-3 weeks of birth control pills to synchronize the eggs, followed by an 8-10 day course of daily injectable hormone (FSH) to grow the eggs to maturity, and then an egg retrieval. After which the embryos are created and cultured in the lab for 5-6 days prior to being either transferred or frozen and tested for chromosomes. The process to prepare your body for placing the embryos back in usually takes about 3 weeks. Is IVF painful? The egg retrieval procedure is done under light sedation so that no pain is felt during the procedure.

What is IVF? In vitro means outside the body, and so, in vitro fertilization is the process of putting the eggs and sperm together and allowing them to fertilize outside the body.

Are there side effects to IVF? The main side effect can be ovarian hyperstimulation syndrome (or an exaggerated response to excess hormones); however, the incidence of that has significantly decreased now that we mostly do frozen embryo transfer cycles.

Who might consider undergoing IVF therapy? Couples having problems conceiving for over a year, ladies with irregular menstrual cycles, cancer patients needing cryopreservation, single women needing cryopreservation, anyone with a history of having

Is there anything that could negatively impact IVF success? Age and egg quality are the most important factors in IVF success. Endometriosis is hard to detect and can negatively impact IVF success, also excessive body weight can negatively impact IVF success.

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Where are eggs, sperm and embryos stored? They are stored in monitored liquid nitrogen tanks and can remain there until the patient desires to utilize them safely, without time impacting the condition. What are other fertility therapies? Intrauterine insemination (IUI) combined with controlled ovarian stimulation is an alternative way that some people can have success in conceiving. This treatment is often used to treat couples where male infertility is a problem or when the female has problems with ovulation. How successful are fertility therapies? Generally, the success of IUI is usually 20% per cycle when using injectable FSH. IVF can be very successful if normal genetic embryos are being transferred—usually above 70% per attempt. What are the chances of multiples when undergoing fertility treatment? With IVF we can control how many embryos are placed inside the uterus so the chances of multiples is low unless desired. With IUI it is more difficult to control the number of eggs being fertilized and implanting; however, the multiples rate is usually around 25% in this treatment group.

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Less pain. More gain. Joint care and support. You shouldn’t have to live with joint pain. Our joint care specialists have many ways to help you find relief. And if you need a joint replacement, they’ll go the extra mile to help you get back to doing what you love as quickly as possible. We even offer pre-surgery prep classes and post-surgery team rehabilitation. Learn more at strosehospitals.org/ortho.

HCQ Notes Domenic Martinello, MD,

Martinello

James

MBA, CPHQ, accepted the position of chief medical officer for MountainView Hospital. Martinello joins MountainView from Southern Hills Hospital, where he has been the CMO since April 2020. He is a board-certified emergency physician with experience in trauma life support and a certified professional of health care quality. MountainView

also announced that Carl H. James joined the hospital as its new chief financial officer. James joins MountainView from HCA Healthcare’s Regional Medical Center, where he served as the CFO since 2019.

Dr. Jonathan Baktari, of

Nevada Donor Network hosted its annual Inspire Gala, raising more than $450,000 to support its mission to maximize the gift of life and health through organ, eye and tissue donation. Community members were honored with awards during the gala including the Governor’s Award — Vegas Golden Knights; Life Award — the Jimmerson Family, in honor of donor hero Jacob Jimmerson; Strength Award — Massiel Smith; and Hope Award — UMC Transplantation Center. In addition, Nevada Donor Network Foundation received a $12 million philanthropic commitment from University Medical Center, which will be in the form of in-kind programs and services, along with a cash contribution component to help support a virtual transplant institute in Nevada.

Dr. Paul Krakovitz was

e7 Health, launched a podcast and YouTube channel, “Baktari MD.” Combining his expertise as a doctor, medical director and Baktari educator with over 20 years of clinical, administrative and entrepreneurial experience, Baktari shares the inside scoop on health care and covers a wide range of topics, including vaccine myths, the meaning of DNR and navigating the ER. The “Baktari MD” podcast can be found on Spotify, Apple Podcasts, Google Podcasts and Stitcher.

named the first president for Intermountain Nevada. He began in the role as interim earlier in 2021. “It is a great honor to serve the communities of South- Krakovitz ern Nevada,” said Krakovitz. “Intermountain is bringing integrated value-based health care to Nevada. I’m inspired by the innovative mindset of Las Vegas and the entire state. Through collaboration, we hope to dramatically improve the health care options for the people of Nevada. We are obsessed in improv-

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ing the quality, affordability, and experience to help people live the healthiest lives possible.” Krakovitz previously served as Intermountain’s vice president and chief medical officer for Specialty-Based Care in Utah and Idaho. Nathan Adelson Hospice celebrated more than 40 years of caring for people in the community with its 25th annual Serenades of Life — Doctors in Concert. Las Vegas headliner Daniel Emmet lit up the stage with his band and friend of the hospice and legendary comedian Brad Garrett acted as master of ceremonies. The evening showcased the extraordinary musical talents of local physicians, including Drs. Henry Wang and Linda Woodson, and the band Alter’d Ego,

Dr. Ronald Hillock Orthopedic Specialist • Dr. Ronald Hillock, MD, Orthopedic Surgeon with Nevada Spine and Orthopedic in Las Vegas, Nevada is now offering stature surgery. • Dr. Ronald Hillock is widely recognized for using the most innovative and advanced techniques for cosmetic limb lengthening. • “This is a bilateral simultaneous limb lengthening procedure through the use of the OrthoFix Expandable Intramedullary Nail. To be clear, this is elective cosmetic limb elongation for increased height, however, any healthy adult who has always wanted to be a few inches taller is a candidate for stature surgery,” said Hillock. • “Your stature is a product of many factors in a person’s life and development... Once you achieve adulthood and skeletal maturity height is fixed and you will grow no taller,” states Dr. Hillock. “Candidates no longer have to accept their natural height through the introduction of limb lengthening.”

• Patients can expect predictable results if the treatment protocol is followed as counseled/recommended. Complications if found early can usually be addressed without long term problems. Total recovery is generally predicted in 12 to 18 months after treatment is completed. For more information on Osseointegration contact Dr. Ronald Hillock 702-258-5567 Ron_Hillock@me.com www.nevadaorthopedic.com

Nevada Orthopedic & Spine Center

7455 W. WASHINGTON AVE. STE 160 • LAS VEGAS NV 89128

HCQ Notes continued featuring members Drs. Edwin Kingsley, David Miller and June Sigman as well as Ken Woloson, Esq., Phronsie Markin, Ira Spector, Larry Tindall and Brad Torchin. Proceeds benefit the Bonnie Schreck Memorial Complementary Therapies Program, which aims to improve the quality of life for patients and loved ones by relieving emotional and physical discomfort through various therapies, such as pet therapy, reiki energy work, massage therapy, art therapy, reflexology and aromatherapy. To encourage an active lifestyle and emphasize the importance of play in the lives of children, Health Plan of Nevada donated 170 pairs of athletic shoes to children with Big Brothers Big Sisters of Southern Nevada. HPN and special guest Johnathan Abram of the Las Vegas Raiders handed out 50 pairs of shoes to “Littles” with BBBSN at a donation event held at Springs Preserve. The “Littles” in attendance also enjoyed dinner, games and photo opportunities with Abram. The remaining 120 pairs of shoes were distributed in the following weeks to “Littles” unable to attend. CenterWell Senior Primary Care announced the addition of Dr. Hayley Kuhn, board-certified in family medicine with more than seven years of health care experience, to CenterWell’s South Nellis location at 2875 South Nellis Blvd. Prior to joining CenterWell, Dr. Kuhn practiced at P3 Medical Kuhn Group and provided outpatient primary care at Havasu Regional Medical Center in Lake Havasu City, Arizona.

Dietmar Cordes, Ph.D., Stacie and Chuck Mathewson Chair for Brain Imaging at Cleveland Clinic Lou Ruvo Center for Brain Health, was awarded an RF1 grant from the National Institute on Aging at the National Institutes of Health to develop statistical models for using novel 7-Tesla fMRI data to predict Cordes individuals at risk for Alzheimer’s disease. The five-year grant is expected to total $4 million and aims to better understand the underlying physiological process driving Alzheimer’s disease pathology and identify novel and reliable imaging biomarkers to better diagnose and characterize those at risk for developing the disease. The 2nd annual Dana Marshall Bernstein Courage Ball was held in memory of Dana Marshall-Bern-

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McPharlin

Shah

Thomas

Tom

Weltman

Wilson

UNLV School of Dental Medicine welcomed Drs. Rosemary P. McPharlin, Sonal S. Shah, Blair M. Thomas, Woodstock Tom, Robin L. Weltman and Gabriela Wilson to its teaching faculty. McPharlin previously worked as an assistant professor of Restorative Dentistry at Oregon Health & Science University School of Dentistry. She is now chair of the clinical sciences department. Shah worked in private practice as a clinical oral pathologist and oral medicine specialist and taught oral pathology remotely as an adjunct faculty member for Regis College. She also taught for 13 years at NYU College of Dentistry. Thomas is a diplomate with the American Board of Oral and Maxillofacial Surgery, a fellow with the American Association of Oral and Maxillofacial Surgeons, and taught for four years at the University of Oklahoma. Tom earned his DMD at UNLV and has treated patients in Las Vegas and Henderson for nearly seven years. Weltman is a diplomate of and examiner for the American Board of Periodontology. Prior to UNLV, she taught at University of Texas Health Science Center School of Dentistry at Houston and led its Advanced Education Program in Periodontics. Wilson earned her DMD at Case Western Reserve University and completed a General Practice Residency at Louis Stokes Veterans Hospital in Cleveland, Ohio, with an emphasis on oral surgery and the treatment of medically complex patients.

stein, who lost her battle with Crohn’s disease in 2017. The event helped to raise more than $1 million for the Crohn’s & Colitis Foundation. The mission of the Crohn’s & Colitis Foundation is to find cures for Crohn’s disease and ulcerative colitis, and to improve

NOVEMBER 2021

the quality of life for children and adults affected by these chronic diseases. The money raised funds breakthrough research, patient education and patient advocacy. Cleveland Clinic Lou Ruvo Center for Brain Health

contributed $48.9 million to Nevada’s economy in 2019, according to Cleveland Clinic’s recent economic and fiscal impact report released in September. In 2019, the center’s economic activity was accountable for $5.7 million in federal income taxes, $2.5 million in state and local taxes, and more than 300 jobs generating approximately $22 million in wages and earnings were directly and indirectly attributed to the center. Furthermore, households supported by Cleveland Clinic spent more than $20 million in goods and services, and the organization purchased $6.3 million of goods and services from Nevada businesses. Valley Health Specialty Hospital, an extension of Spring Valley Hospital, opened for orthopedic surgical patients. The hospital features five surgical suites and a 10-bed inpatient nursing unit for post-operative orthopedic patients; a 56-bed acute rehabilitation center and outpatient services for physical, occupational and speech therapy services for

adults will open later. Optum Care Orthopaedics and Spine welcomed Drs. Abby Howenstein, an orthopedic surgeon, John DeVries, an oncology orthopedic surgeon, and Ian Elliot, a trauma surgeon, as well as Brittany Hough, a physician assistant, to its medical practice to help meet the growing need for health services in the Las Vegas community.

Kelly

The Nevada Hospital Association board of directors selected Patrick ‘Pat’ Kelly, as the new president and chief executive officer of the Association. Kelly succeeds

Association where he served as the chief financial officer and vice president of shared services. Spring Mountain Treatment Center appointed John T. Sannuto, RN, MBA, ND to chief executive officer/ managing director of Spring Mountain Treatment Center and Sahara Behavioral Health Hospitals. Sannuto joins Spring Mountain from Highlands Behavioral Health located in Denver, Colorado, where he served as CEO for almost 2 years. Dr. Jasmin Kohli joined Southwest Medical, part of Optum Care, at its Horizon Ridge Healthcare Center in Henderson. Kohli specializes in adult medicine. Southwest Medical also welcomed Dr. Chihiro Hirai-Adachi at its Nellis Healthcare Center. Hirai-Adachi specializes in OB/GYN care.

Bill M. Welch

who will continue as a consultant through Dec. 31, when he retires. Kelly comes to the NHA from the West Virginia Hospital

Dr. Lanette Rickborn joined Urology Specialists of Nevada at its 2010 Wellness Way, 3150 Tenaya Way and 8410 W. Warm Springs Rd. locations.

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TOP

2021 Vegas Inc. Top Doctor

DOCTORS 2021

At Southern Nevada Pediatric Center (SNPC), the board-certified pediatricians and medical professionals work collaboratively to provide the best possible pediatric care to patients in the Las Vegas Valley. They also offer telehealth/ virtual visits for those outside Las Vegas Valley in more rural locations and have difficulty with transportation.

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