January-February 2026 Texas Dental Journal

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1 All programs subject to credit approval and loan amounts are subject to creditworthiness. Bank of America may prohibit use of an account to pay off or pay down another Bank of America account. Other underwriting standards and restrictions may apply.

2 Owner occupied commercial real estate will be determined in underwriting and requires occupancy by the borrower/guarantor. Please note SBA guidelines require at least 51% occupancy to be considered Owner Occupied. Flood insurance is required for properties located in a flood zone.

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All promotional and marketing materials are Bank of America Practice Solutions property and, as such, cannot be changed, altered or modified, orally or in writing. All questions regarding these materials should be directed or referred to a Bank of America Practice Solutions Sales Associate.

Sponsorship of endorser’s products and services is not an expressed opinion or approval by the Bank.

“Bank of America” and “BofA Securities” are the marketing names used by the Global Banking and Global Markets divisions of Bank of America Corporation. Lending, derivatives, other commercial banking activities, and trading in certain financial instruments are performed globally by banking affiliates of Bank of America Corporation, including Bank of America, N.A., Member FDIC. Trading in securities and financial instruments, and strategic advisory, and other investment banking activities, are performed globally by investment banking affiliates of Bank of America Corporation (“Investment Banking Affiliates”), including, in the United States, BofA Securities, Inc. which is a registered broker-dealer and Member of SIPC, and, in other jurisdictions, by locally registered entities. BofA Securities, Inc. is a registered futures commission merchant with the CFTC and a member of the NFA.

Investment products offered by Investment Banking Affiliates:

Bank of America is committed to the protection of personal information we collect and process. For more information about how we protect your privacy, please visit www.bankofamerica.com/privacy California residents may have additional rights and you can learn more at www.bankofamerica.com/ccpa-notice Bank of America and the Bank of America logo are registered trademarks of Bank of America Corporation. Bank of America Practice Solutions is a division of Bank of America, N.A. ©2025 Bank of America Corporation. MAP7953777 | 05/2025 | AD-05-25-0158.A Are Not FDIC Insured Are Not Bank Guaranteed May Lose Value

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Dr Henry Liao,

Dr Jeffery R. Brunson

Dr LeAnn Kolb Snody

Dr C. Brian Herring

Dr Blake M. Hutzler, New Dentist Member

Dr Kathleen Nichols, Consultant

Dr Ingrid Duebbert, Consultant

Dr Ron Hill, Board Liaison

Editorial Staff

Jacqueline M. Plemons, DDS, MS, Editor

Juliana Robledo, DDS, Associate Editor

Nicole Scott, Managing Editor

Barbara Donovan, Art Director

Lee Ann Johnson, CAE, Director of Member Services

Editorial Advisory Board

Ronald C. Auvenshine, DDS, PhD

Barry K. Bartee, DDS, MD

Patricia L. Blanton, DDS, PhD

William C. Bone, DDS

Phillip M. Campbell, DDS, MSD

Michaell A. Huber, DDS

Arthur H. Jeske, DMD, PhD

Larry D. Jones, DDS

Paul A. Kennedy, Jr., DDS, MS

Scott R. Makins, DDS, MS

Daniel Perez, DDS

William F. Wathen, DMD

Robert C. White, DDS

Leighton A. Wier, DDS

Douglas B. Willingham, DDS

The Texas Dental Journal is a peer-reviewed publication. Established February 1883 • Vol 143| No. 1

Texas Dental Association 8701 W Hwy 71, Ste 201-M, Austin, TX 78735 Phone: 512-443-3675 • FAX: 512-443-3031 Email: tda@tda.org • Website: www.tda.org

Texas Dental Journal (ISSN 0040-4284) is published monthly, except January-February, March-April, July-August, and November-December, which are combined issues, by the Texas Dental Association, 8701 W Hwy 71, Ste 201-M Austin, TX 78735, 512-443-3675. Periodicals Postage Paid at Austin, Texas, and at additional mailing offices. POSTMASTER: Send address changes to TEXAS DENTAL JOURNAL, 8701 W Hwy 71, Ste 201-M, Austin, TX 78735. Copyright 2026 Texas Dental Association. All rights reserved. Annual subscriptions: Texas Dental Association members $17. In-state ADA Affiliated $49.50 + tax, Out-of-state ADA Affiliated $49.50. In-state Non-ADA Affiliated $82.50 + tax, Out-of-state Non-ADA Affiliated $82.50. Single issue price: $6 ADA Affiliated, $17 Non-ADA Affiliated. For in-state orders, add 8.25% sales tax. Contributions: Manuscripts and news items of interest to the membership of the society are solicited. Electronic submissions are required. Manuscripts should be typewritten, double spaced, and the original copy should be submitted. For more information, please refer to the Instructions for Contributors statement at tda.org. All statements of opinion and of supposed facts are published on authority of the writer under whose name they appear and are not to be regarded as the views of the Texas Dental Association, unless such statements have been adopted by the Association. Articles are accepted with the understanding that they have not been published previously. Authors must disclose any financial or other interests they may have in products or services described in their articles.

Advertisements: Publication of advertisements in this journal does not constitute a guarantee or endorsement by the Association of the quality of value of such product or of the claims made.

Anesthesia Education & Safety Foundation

Two ways to register: Call us at 214-384-0796 or e-mail us at sedationce@aol.com Visit us on the web: www.sedationce.com

NOW Available: In-Office ACLS & PALS renewals; In-Office Emergency Program Live Programs Available Throughout Texas

Two ways to Register for our Continuing Education Programs: e-mail us at sedationce@aol.com or call us at 214-384-0796

OUR GOAL: To teach safe and effective anesthesia techniques and management of medical emergencies in an understandable manner. WHO WE ARE: We are licensed and practicing dentists in Texas who understand your needs, having provided anesthesia continuing education courses for 34 years. The new anesthesia guidelines were recently approved by the Texas State Board of Dental Examiners. As practicing dental anesthesiologists and educators, we have established continuing education programs to meet these needs.

New TSBDE Requirement of Pain Management

Two programs available (satisfies rules 104.1 and 111.1)

Live Webcast (counts as in-class CE) or Online (at your convenience)

All programs can be taken individually or with a special discount pricing (ask Dr. Canfield) for a bundle of 2 programs:

Principles of Pain Management

Fulfills rule 104.1 for all practitioners

Use and Abuse of Prescription M edications and Provider Prescription Program Fulfills rules 104.1 and 111.1

SEDATION & EMERGENCY PROGRAMS:

Nitrous Oxide/Oxygen Conscious Sedation Course for Dentists:

Credit: 18 hours lecture/participation (you must complete the online portion prior to the clinical part)

Level 1 Initial Minimal Sedation Permit Courses:

*Hybrid program consisting of Live Lecture and online combination

Credit: 20 hours lecture with 20 clinical experiences

SEDATION REPERMIT PROGRAMS: LEVELS 1 and 2

(ONLINE, LIVE WEBCAST AND IN CLASS)

ONLINE LEVEL 3 AND 4 SEDATION REPERMIT AVAILABLE! (Parenteral Review) Level 3 or Level 4 Anesthesia Programs (In Class, Webcast and Online available): American Heart Association Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) Initial and Renewal Programs

NOTE: ACLS or PALS Renewal can be completed by itself at any combined program Combined ACLS-PALS-BLS and Level 2, 3 and 4

Program

WEBCASTING and ONLINE RENEWALS AVAILABLE! Live and archived webcasting to your computer in the comfort of your home. Here are the distinct advantages of the webcast (contact us at 214-384-0796 to see which courses are available for webcast):

1. You can receive continuing education credit for simultaneous live lecture CE hours.

2. There is no need to travel to the program location. You can stay at home or in your office to view and listen to the course.

3. There may be a post-test after the online course concludes, so you will receive immediate CE credit for attendance

4. With the webcast, you can enjoy real-time interaction with the course instructor, utilizing a question and answer format

OUR MISSION STATEMENT: To provide affordable, quality anesthesia education with knowledgeable and experienced instructors, both in a clinical and academic manner while being a valuable resource to the practitioner after the programs. Courses are designed to meet the needs of the dental profession at all levels.

Our continuing education programs fulfill the TSBDE Rule 110 practitioner requirement in the process to obtain selected Sedation permits. AGD Codes for all programs: 341 Anesthesia & Pain Control; 342 Conscious Sedation; 343 Oral Sedation This is only a partial listing of sedation courses. Please consult our www.sedationce.com for updates and new programs. Two ways to Register: e-mail us at sedationce@aol.com or call us at 214-384-0796

Those in the dental community who have recently passed

Peggy P Alexander

San Antonio

11/11/1937–12/8/2025

Good Fellow: 2006 • Life: 2019

Rupert Douglas Barron Jr

Amarillo

2/11/1935–1/3/2026

Good Fellow: 1991 • Life: 2002

Clifford Randy Bell

Athens

11/30/1946–1/27/2026

Good Fellow: 2000 • Life: 2011

Fifty Year: 2023

David A Duncan

Amarillo

5/29/1962–12/31/2025

Good Fellow: 2013 • Life: 2021

Bill T Greenhaw

Lubbock

9/11/1944–1/13/2026

Life: 2009 • Fifty Year: 2022

James Conaway Haller

Abilene

6/10/1934–10/26/2025

Good Fellow: 1989 • Life: 2000

Fifty Year: 2014

James Malcolm Hebert

Houston

10/19/1935–11/3/2025

Life: 2000 • Fifty Year: 2011

Bobby Harold Hughes

Baytown

5/7/1931–11/26/2025

Good Fellow: 1997 • Life: 1996

Fifty Year: 2009

Kenneth Earl Jarosz

Marble Falls

10/7/1940–10/7/2023

Good Fellow: 1999 • Life: 2005

Fifty Year: 2023

David Jade Kelly

Houston 11/6/1996–10/19/2025

Murray Lewis London Frisco

4/22/1938–10/25/2025

Good Fellow: 1990 • Life: 2003

Fifty Year: 2015

Elgene George Mainous Galveston

2/28/1931–7/31/2025

Life: 1996 • Fifty Year: 2009

James Silas Moore Baytown

6/5/1941–11/1/2025

Good Fellow: 1997 • Life: 2006

Fifty Year: 2021

David Michael Phillips Denison

6/21/1951–11/3/2025

Good Fellow: 2006 • Life: 2016

Roger Brian Salome

El Paso

7/30/1942–12/27/2025

Good Fellow: 1996 • Life: 2007

Fifty Year: 2019

Richard Madsen Smith Amarillo

5/16/1946–1/10/2026

Good Fellow: 1997 • Life: 2011

Fifty Year: 2022

Robert Eugene Sterns III

Portland

7/24/39–1/19/2026

Good Fellow: 1989 • Life: 2004

Fifty Year: 2014

Paul Glenn Swinney

Tyler

7/24/1936–11/7/2025

Good Fellow: 1984 • Life: 2001

Fifty Year: 2010

Craig Mathewson Wright

San Antonio

8/18/1949–12/13/2023

Life: 2014

Texas Dental Association

PRESIDENT Glen D. Hall, DDS 325-698-7560, abdent78@gmail.com

PRESIDENT-ELECT Elizabeth Goldman, DDS 214-585-0268, texasredbuddental@gmail.com

PAST PRESIDENT Georganne P. McCandless, DDS 281-516-2700, gmccandl@yahoo.com

VICE PRESIDENT, SOUTHEAST Matthew J. Heck, DDS 512-280-8800, matthewjheckdds@gmail.com

VICE PRESIDENT, SOUTHWEST Melissa Uriegas, DDS 956-800-1625, meluriegas@gmail.com

VICE PRESIDENT, NORTHWEST Adam S. Awtrey, DDS 325-672-2794, awtrey.adam@gmail.com

VICE PRESIDENT, NORTHEAST Drew M. Vanderbrook, DDS 214-821-5200, vanderbrookdds@gmail.com

SENIOR DIRECTOR, SOUTHEAST Ron Hill, DDS 713-626-8343, rhilldds@gmail.com

SENIOR DIRECTOR, SOUTHWEST Austin Lee, DDS 210-496-1919, austinvincentlee@gmail.com

SENIOR DIRECTOR, NORTHWEST Annie C. Wilson, DDS 817-860-4343, annie@anniewilsondds.com

SENIOR DIRECTOR, NORTHEAST Shane A. Ricci, DDS 972-381-1888, riccidds@hotmail.com

DIRECTOR, SOUTHEAST Jennifer Hathaway, DDS 979-776-6884, jp.hathaway@yahoo.com

DIRECTOR, SOUTHWEST Kenneth Gonzales, DDS 361-992-2421, bikerdent@yahoo.com

DIRECTOR, NORTHWEST Kevin Altieri, DDS 817-294-5513/817-991-1835, altdent@yahoo.com

DIRECTOR, NORTHEAST Celeste Latham, DDS 214-351-1500, drclatham@yahoo.com

SECRETARY-TREASURER* Oshmi Dutta, DDS 210-888-0700, odutta@gmail.com

SPEAKER OF THE HOUSE* Gregory W. Rashall, DDS 936-336-5171, rashdent@sbcglobal.net

PARLIAMENTARIAN**

Jodi D. Danna, DDS 972-377-7800, jodidds1@gmail.com

EDITOR** Jacqueline M. Plemons, DDS, MS 214-507-0815, drplemons@yahoo.com

LEGAL COUNSEL** Carl R. Galant

INTERIM EXECUTIVE DIRECTOR** Lee Ann Johnson 512-443-3675, ljohnson@tda.org

*Non-voting member **Non-voting Board of Directors

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EDUCATION

EXHIBITS

NETWORKING

SAN ANTONIO MAY 7 – 9, 2026

Welcome

TO THE 2026 TEXAS DENTAL ASSOCIATION MEETING!

We are delighted to welcome you to the Henry B. Gonzalez Convention Center, right along the beautiful San Antonio Riverwalk, May 7–9, 2026. The TDA Council on the Annual Meeting and Continuing Education Programs, together with the dedicated staff of the TDA, have worked tirelessly to design an event that blends top-notch education, hands-on learning, and opportunities to connect with colleagues from across Texas and beyond. Whether you are a dentist, hygienist, assistant, office manager, or predental student there truly is something for everyone at this year’s TDA Meeting!

This year’s program is packed with nationally recognized speakers as well as fresh new voices in dentistry. Over three days, you’ll have access to courses tailored to every member of the dental team. We’re especially excited to highlight some new and notable additions for 2026:

• Keynote Session: Kick off Friday morning with Dr. Chris Ramsey at 7:30 a.m. His dynamic presentation, “Master Your Passion for Excellence,” is sure to inspire all attendees. Free for all attendees!

• Pankey Institute Partnership: For the first time, dentists can begin the renowned Pankey Essentials curriculum all right here at the TDA Meeting.

MEET THE COUNCIL ON THE ANNUAL MEETING AND CONTINUING EDUCATION PROGRAMS

TDA’s Council on the Annual Meeting and Continuing Education Programs (CAMCEP) is comprised of six members, one early career dentist representative, and one consultant. They meet quarterly to plan all continuing education programs with TDA staff.

Throughout the year, they attend dental meetings nationwide to discover new speakers, exhibitors, and cutting-edge ideas. Their hard work behind the scenes ensures that each program exceeds expectations and provides the best experience for attendees. Look out for them at the meeting in their navy blue coats and be sure to say hi!

• Special Programs for Hygienists: A local infiltration anesthesia course will be available for eligible hygienists needing to renew their certification.

• Pre-Dental Opportunities: The popular Dental School Admissions Panel returns on Saturday morning. Don’t forget that predental students can attend for free when they volunteer!

The Exhibit Hall will once again be the lively hub of the meeting, showcasing hundreds of exhibitors with the latest products, technology, and innovations to support your practice. Be sure to join us Thursday afternoon for our Tropical Tiki Party a festive chance to relax, reconnect, and celebrate with colleagues. Pick out your favorite hula shirt and comb out those grass skirts, as costumes are encouraged and rewarded!

To help you make the most of your experience, download the TDA Meeting App for CE tracking, schedules, real-time updates, and exhibitor listings and show specials. For registration information, visit tdameeting.com and sign up early to take advantage of Early Bird Discounts!

While you’re here, we encourage you to enjoy San Antonio stroll the Riverwalk, explore historic sites and museums, take a river taxi to the Pearl Brewery District, and sample some of the city’s world-class dining. This offers a great opportunity for team building beyond the classroom. Whether you’re here to expand your clinical expertise, strengthen your team, or invest in your own growth, the 2026 TDA Meeting has something for you. Gather your team, bring your friends, and prepare for three unforgettable days of learning, networking, and inspiration in San Antonio.

Yeri Guak, DMD, FICD

2026 TDA Meeting Co-Chair

Partha Mukherji, DDS, FAGD, FICOI, FICD, FACD, FPFA

2026 TDA Meeting Co-Chair

Shelley Seidel, DDS, MD

Exhibits & Sponsorship Chair

Taylor G. Cook, DDS

Workshop & Volunteer

Recruitment Chair

Alicia Gray, DMD

Registration & Social Events Co-Chair

Courtni Tello, DDS, BSDH

Registration & Social Events Co-Chair

Xavier Walker, DDS

New Dentist Representative

Edwin A. McDonald, III, DDS, FAGD, FICD Consultant

Drew Vanderbrook, DDS

Board Liaison

2026 TDA MEETING SCHEDULE OF EVENTS

All events will be held at the Henry B. Gonzalez Convention Center unless otherwise noted.

THURSDAY, MAY 7

7:00 am–5:00 pm Onsite Registration

8:00 am–5:00 pm Continuing Education Courses

8:30 am–8:30 pm Alliance of the TDA Program, Marriott Rivercenter Hotel

10:00 am–6:00 pm Exhibit Hall

4:30 pm–6:00 pm TDA Tropical Tiki Party, Exhibit Hall 1

FRIDAY, MAY 8

7:00 am–5:00 pm Onsite Registration

7:30 am–8:30 am Keynote Session, Stars at Night Ballroom

8:00 am–5:00 pm Continuing Education Courses

8:30 am–4:30 pm Alliance of the TDA Program, Marriott Rivercenter Hotel

9:00 am–11:30 am TDA House of Delegates

10:00 am–5:00 pm Exhibit Hall

11:00 am Reference Committees

5:30 pm Divisional Caucus Meetings

SATURDAY, MAY 9

7:00 am–8:30 am TDA Past Presidents & Past Vice-Presidents Breakfast

8:00 am–10:00 am Onsite Registration

8:00 am–5:00 pm Continuing Education Courses

8:00 am–12:00 pm TDA House of Delegates

1:30 pm–2:30 pm TDA House of Delegates

3:00 pm–4:00 pm TDA House of Delegates

MEETING

THE TDA MEETING

Brought to you by the Texas Dental Association 8701 W. Highway 71, Ste. 201-M Austin, TX 78735

(512) 443-3675

tda@tda.org

tdameeting.com

8:30 am – 4:30 pm, Monday-Friday (Central Time)

MEETING INFORMATION

Meeting Location

Henry B. Gonzalez Convention Center 900 E. Market Street, San Antonio, TX 78205

TDA MEETINGS STAFF

This department is responsible for the organization, coordination, and council support of the TDA Meeting, conferences, regional events, and online continuing education programs.

Shannan Cook, CMP Director of Meetings and Continuing Education scook@tda.org

Nicole Gilbert, CMP Meetings & Exhibits Manager ngilbert@tda.org

2026 REGISTRATION AND HOUSING SERVICES

Eleventh & Gather is the official registration and housing provider for the 2026 TDA Meeting. Please do not call the hotel directly to make reservations, as TDA has secured special rates. For any questions about registration or hotel accommodations, please contact them using the information below:

Eleventh & Gather 170 Depot St., Suite A, Blue Ridge, GA 30513

678-341-3039

tda@prereg.net

prereg.net/2026/tda

9:00 am – 4:00 pm, Monday-Friday (Eastern Time)

Beware of scam emails trying to sell you registration lists or discounted hotel rates.

Meeting Parking

Parking is available at area hotels for overnight guests. In addition, there are multiple parking garages available within walking distance of the convention center. Visit www.sahbgcc.com/Visit-Us/Location-Directions-Parking for more information.

2026 TDA MEETING MEETING SPONSORS AND DONORS

Thank you to our TDA Meeting Sponsors. Their generous support and donations help us provide you with cutting-edge education and one of the best dental meetings in the country.

The TDA regrets the omission of any sponsors or donors due to print deadlines.

SIGNATURE SUPPORTING

EDUCATIONAL FUNDING PROVIDED BY:

Adit

Align Technology

Alliance of the TDA

AMD Lasers

Bank of America

BISCO

DentalHQ

EMS Dental

MedPro Group

Philips Oral Health Care

Shofu Dental Corporation

Texas Dental Association

Smiles Foundation Beverly Bane

Lecture Series

TruAbutment

REGISTRATION INFORMATION

REGISTRATION OPENS JANUARY 7, 2026

EARLY BIRD REGISTRATION

Register through February 18!

Register between January 7 and February 18 and SAVE!

TDA members and their staff register for FREE!

PRE-REGISTRATION

Register through March 31!

Register between February 19 and March 31.

Registration fees go up slightly.

STANDARD REGISTRATION

Register starting April 1!

Register between April 1 and May 9.

Full-price registration fees apply.

Register online at www.tdameeting.com from January 7 to May 9, 2026. Seats in continuing education courses are first-come, first-served, so register early to save money and secure your spot in popular courses!

Eleventh & Gather is our official registration provider. They will manage online and onsite registration of attendees and exhibitors. Be cautious of fraudulent companies that might try to contact you for registration or to sell attendee lists. Please note that the Texas Dental Association does not sell attendee lists or handle registration or hotel bookings through third parties.

For registration inquiries, please contact Eleventh & Gather at:

678-341-3039

tda@prereg.net prereg.net/2026/tda 9:00 am–4:00 pm, Monday-Friday (Eastern Time)

CANCELLATION POLICY

→ ↔ ←

A full refund (less a 20% administrative fee) will be issued if cancelled on or before April 10, 2026. No refunds will be approved after this date. In the event of an emergency or death, cancellations will be reviewed on an individual basis.

REGISTRATION POLICIES:

• Dentists may not register under any category other than “dentist”.

• You must be registered under a dentist or team member registration category in order to earn CE credits.

• Photo identification is required for onsite registration.

• 2026 TDA dues must be paid before you can attend the meeting at the member dentist rate.

• The deadline for early bird discounted registration is February 18, 2026.

• The deadline for pre-registration is March 31, 2026.

• Register on or before April 20 to receive your badge by mail. After this date, registration materials may be picked up onsite in the registration area.

• By registering for the meeting, you authorize the TDA to add you to their email marketing list to receive convention updates for 2026 and subsequent years. You can opt-out at any time, but you will not receive pertinent information regarding your registration.

REGISTRATION INFORMATION

2026 REGISTRATION FEES

*Non-member dentist registration fees can be applied toward active membership if you join within 30 days after the meeting. For more details, contact rdaigle@tda.org or (512) 443-3675 ext. 137.

HOTEL INFORMATION

TDA MEETING HOTELS

Support TDA by booking your room within the annual session hotel room block. TDA has secured special discounted rates with these official hotels.

Eleventh & Gather is the official housing provider for the 2026 TDA Meeting.

170 Depot St., Suite A, Blue Ridge, GA 30513

678-341-3039

tda@prereg.net

prereg.net/2026/tda

9:00 am–4:00 pm, Monday-Friday (Eastern Time)

Beware of fraudulent companies who may reach out to you to reserve hotel rooms or sell attendee lists. Eleventh & Gather is the only authorized company to solicit hotel reservations.

Open Wednesday, January 7

RESERVE YOUR ROOM

www.prereg.net/2026/tda

Grand

THURSDAY

Dental Assisting McDonald Art & Science of Provisional Restoration for Assistants: Hands-on Workshop

EXP02 Oral Surgery James Surgical Confidence for the GP: What They Didn’t Teach You in Dental School

EXP06

FRIDAY

EDUCATION

Restorative Pankey Pankey Essentials 1, continued

F01 Practice Mgmt Anderson Stop Cancellations! Build and Maintain a Productive Schedule NOW!

Implants Attia Avoiding & Managing Complications in Implant Dentistry

F03 Implants Attia AOX Full Arch Workflow and How to Avoid Complications: Hands-on Workshop

F04 Hygiene Auger Donuts, Diabetes and Dentistry: The Vital Role of Dental Professionals

Hygiene Auger The RDH Toolkit: A Modern Approach to Prevention

F06 Sleep Medicine Batoon Wake Up Your Practice to Dental Sleep Medicine Handson Workshop

F07 Risk Mgmt Clarke Managing Medical Emergencies in the Dental Office

A

Practice Mgmt Gardiner Medical History and Informed Consent

Hygiene Geisinger Killer Smile? The Oral-Systemic Connection

Dental Assisting

F25 Prosthodontics Orta Advanced Adhesive Onlays: A Biomimetic

F28 Oral Pathology Patel Common Lesions of the Oral Cavity

F29 Practice Mgmt Ramsey Master Your Sixth Sense: Understanding the Arts of Persuasion and Human Decision Making

Practice Mgmt Smith The Patient, The Person, The Promise, The Problem

F32 Esthetics Snyder Aesthetics and Occlusion

F33 Esthetics Snyder Posterior Direct Restorations: Contacts, Complications, Cosmetics and

F35 Practice Mgmt. Camacho Path to Practice Ownership: Identify the Route to Successful Practice Ownership in Today’s Marketplace

F36 Networking ACD/ICD/PFA Breakfast

EXP07 Practice Mgmt Revering From Maybe to Yes: Unlocking Case Acceptance

EXP08 Endo/Perio Bodapati/Ganne Endo/Perio Lesions: Diagnosis and Treatment

EXP09 Endodontics Ganne Management of Endodontic Emergencies

EXP10 Health Methven Chairside Calm: Breathwork and Mind-Body

EXP11 Orthodontics Reece Splints, Nightguards & Orthotics 3:00 pm–4:00 pm $30 $30 $30

SATURDAY

PANKEY Restorative Pankey Pankey Essentials 1 continued 8:00 am–5:00 pm

S01 Practice Mgmt Anderson Why Dental Teams Fail: Creating a Culture of Success

Periodontics Geisinger Smile Esthetics & the Importance of the Gingival Framework

S04 Periodontics Grisdale Contemporary Esthetic Functional Gingival Grafting Workshop

S07 Technology Otto Unleashing

CE EXPRESS: INDUSTRY INSIGHTS THURSDAY

SPEAKERS BY TOPIC

See the chart below for a full list of CE topics offered at the 2026 TDA Meeting, organized alphabetically. Scan across to find each session’s day and speaker’s last name.

TOPICS

THURSDAY

Anesthesia/Sedation Luce

FRIDAY SATURDAY

Caries Nový

Communication/Team Henry McDonald

Cosmetics/Esthetics Norris Snyder

Dental Assisting McDonald Henry

Endodontics CE Express CE Express

Ergonomics Klein

Human Trafficking Swarthout

Hygiene Auger Davis Geisinger Nanne Auger Estrada/Fox Geisinger Estrada/Fox

Implants Attia

Insurance/Coding/Billing Duncan

Medically Complex Niessen

Medical Emergencies Read-Fuller

Nutrition/Health/ Mental Health Odiatu

CE Express Swarthout

Occlusion Kwiecien Kwiecien

Oral Pathology/Oral Med Patel Schlieve Patel Schlieve

Oral Surgery CE Express

Orthodontics Blacher Norris CE Express

Pediatrics Otto

Periodontics Gardiner

Pharmacology

CE Express Grisdale

Read-Fuller

Practice Management Banta Smith

CE Express/Industry Insights

Prosthodontics

Anderson Camacho Duncan Gardiner Ramsey Smith

CE Express

CE Express Orta

Radiology CE Express

CE Express Geisinger Grisdale

Anderson

CE Express

Restorative Pankey E1 Pankey E1 Pankey E1

Risk Management Clarke Gardiner Clarke

Sleep Medicine Batoon Batoon

Team Building McDonald

Technology CE Express Otto

GOVERNANCE

The House of Delegates convenes four sessions during the Annual Session of the Texas Dental Association.

PRELIMINARY HOUSE OF DELEGATES SCHEDULE*:

*The start time of any meeting of the House may be changed by the TDA Speaker with House approval, depending on the extent of House business being considered.

TDA MEMBERS – GET INVOLVED

The House of Delegates is the legislative and supreme governing body of the TDA. The 2026 House of Delegates is composed of approximately 134 voting members, which includes duly elected and installed delegates from each of the 26 components of the Texas Dental Association and the 15 voting members of the Board of Directors. The Speaker of the House of Delegates is the presiding officer and is without vote. The TDA SecretaryTreasurer is also a non-voting office of the House of Delegates and serves as the Secretary of the House. Finally, there are four student delegates, each elected and installed by their respective dental school; student delegates have full privilege and access to the floor of the House of Delegates but are without the right to vote and may not introduce resolutions.

HOUSE MATERIALS

Delegates and alternates will receive their House book in a searchable PDF format. Reference committee reports will be emailed in PDF format to all participants and these reports can be downloaded from any location with internet access.

For more information, contact TDA Governance Manager, Amy Gamber at agamber@tda.org or (512) 443-3675, ext. 150.

ADA/TDA LEADERSHIP CANDIDATES FORUM

Friday, May 8 4:00 pm–5:30 pm

In the event there are no contested TDA statewide elections and no participation by candidates for ADA elected offices, the candidate’s forum will not be held.

CAUCUS MEETINGS

Friday, May 8 5:30 pm

Get involved by attending divisional caucus meetings and selecting your representatives on the state and national levels. ADA delegates and alternates from your division and the divisional directors of the TDA Board of Directors are nominated in this forum.

Friday, May 8

9:00 am–11:30 am

Saturday, May 9

8:00 am–12:00 pm 1:30 pm–2:30 pm 3:00 pm–4:00 pm

REFERENCE COMMITTEES

Reference committee hearings offer an opportunity for any member to participate in the TDA policy-making process. All members are encouraged to attend the hearings scheduled on Friday, May 8. All 2025-2026 resolutions will be discussed in up to potentially five Reference Committees before presentation to the 2026 TDA House of Delegates for policy-making decisions.

Reference Committee Hearings will begin at 11:45 am or 15 minutes after the adjournment of the first meeting of the House of Delegates.

Reference Committee assignments and starting times are subject to change, please visit www.tda.org for the latest information.

EXPLORE THE TDA MEETING EXHIBIT HALL!

Make the most of your Exhibit Hall time see what’s new in dentistry, chat with reps, test products, and find services to support your practice and career.

Enjoy games, giveaways, interactive experiences, and the TDA Tropical Tiki Party all happening right on the floor!

Be sure to visit the 200-aisle, home to the TDA Perks Program partners. Find exclusive member discounts and trusted resources across compliance, supplies, insurance, marketing, finance, real estate, and more. Look for the iconic Perks green carpet!

EXHIBIT HALL HOURS

Thursday, May 7 10:00 am–6:00 pm

Friday, May 8 10:00 am–5:00 pm

Scan the QR code to explore the interactive floor plan and search exhibitors by name, booth, or category.

EXPLORE THE TDA MEETING EXHIBIT HALL!

TDA EXPO – WHERE THE FUN HAPPENS!

FIESTA BINGO TRAIL

Spice up your Exhibit Hall adventure! Pick up your Fiesta Bingo card and follow the San Antonio-themed icons and matching floor decals to exhibitor booths. Complete your card and you’ll be eligible to win prizes all while discovering new products along the way. It’s like a treasure hunt fiesta style!

TDA TROPICAL TIKI PARTY ISLAND VIBES AND DENTAL TRIBES

Escape to the tropics with your dental tribe! Join us Thursday, May 7, from 4:30 pm–6:00 pm for island-inspired fun think tropical sips, tasty bites, and shaking your hula hips. Every attendee receives a free drink ticket so come ready to toast, mingle, and get your tiki on! Costumes are encouraged and rewarded with special prizes.

Special thanks to TDA Perks for sponsoring the Island Vibes

PUPPY SNUGGLE ZONE

Need a break? Take a “paws” and recharge at the Puppy Snuggle Zone! Cuddle up with our furry friends and enjoy a dose of calm, cuteness, and stress relief. Warning: you may not want to leave!

STRIKE A POSE FOR SOME PHOTO FUN TIMES!

Visit our themed photo prop areas to snap selfies and group shots that capture the spirit of the TDA Meeting. Share your pics by tagging us at #TDAMeeting2026 and let’s fill our feed with fun!

TDA Remembers the Legacies of Two Past Presidents

Friends and coworkers, Drs David Duncan and Richard Smith were giants in the world of organized dentistry

Dr David A. Duncan

May 29, 1962—December 31, 2025

Amarillo

Dr David Al Duncan, 63, died at his home in Amarillo on December 31, 2025, surrounded by his friends and family. He battled cancer until the end, and a celebration of life services was held on January 8, 2026.

He was born on May 29, 1962, and married Janet Lovvorn in 1982. He graduated from West Texas State University and then from UT Health San Antonio School of Dentistry in 1989. He and Janet welcomed their son Austin in 1991.

His local professional leadership quickly elevated him to state and national involvement in organized dentistry. In TDA, he served on DENPAC and committees and councils, including the Committee of New Dentists, Council on Dental Education, Trade, and Ancillaries, and the Council on Legislative and Regulatory Affairs (CLRA). He was on the board for TDA Financial Services, Inc (TDA Perks) from 2019 to 2020 and was president of TDA from 2014 to 2015. He was a fellow in the American College of Dentists and International College of Dentists. At ADA, he was a member of the Council on Dental Practice and ADPAC.

Word of Dr Duncan’s death reached all corners of organized dentistry. Former TDA President and fellow CLRA member Dr Matthew Roberts of Crockett remembered his friend. “As we navigate this earthly life, it is rare to find someone who truly connects at all levels as a confidant, a mentor, and a friend. Someone who has the expertise to advise and humility to be advised. For me, that was David Duncan, and he will be greatly missed.”

Another former TDA President and current Woody L. Hunt School of Dental Medicine at Texas Tech University Health Sciences Center El Paso Dean Dr Richard Black echoes the same sentiment. “David Duncan loved people and he loved the TDA. There was never a task too small or too large that he would not happily take on and do a beautiful job with it.“

Prior to dentistry, his first love was baseball, according to his obituary published by Boxwell Brothers Funeral Directors: “It was more than a recreational sport to him; it was his dream. After years of little league and club ball, David was proudly the only sophomore on the varsity baseball team at Amarillo High. The smell of fresh cut grass often caused him to reminisce about his love of the game and the comradery of his teammates. He felt most alive and most himself on the baseball field. After being accepted to Lubbock Christian College on a baseball scholarship, he decided before the end of the first day that it wasn’t the place he was meant to be. He accepted an offer to play baseball and attend Seward County Junior College in Seward, Kansas, where he began to regularly be followed by scouts.”1

He was involved in his church, Hillside Christian Church, loved horses, and was the team dentist for the Amarillo Gorillas hockey team and the Amarillo Bulls junior hockey team. After selling his private dental practice, he worked at Hawkins Dental Group during the last 5 years of his career.

On July 3, 2025, he married Linda Joy Carder, gaining 3 “bonus” children, Gina Astuto Thompson and husband Jacob of Fort Worth, Tony Astuto of Providence, Rhode Island, and Allie Astuto of Dallas, and a grandson, Jones Alan Thompson.

Donations in memory of Dr Duncan may be made to the Harrington Cancer Survivorship Center, 1732 Hagy Blvd, Amarillo, TX 79106.

Dr Richard “Dick” Madsen Smith

May 16, 1946—January 10, 2026, Amarillo

Dr Richard “Dick” Madsen Smith, 79, of Amarillo died at his home surrounded by family on January 10, 2026. A memorial service was February 7, 2026, at the First Presbyterian Church of Canyon in Canyon, Texas.

Dr Smith was born in Amarillo on May 16, 1946, and he married Jimmie Ruth Weir on May 6, 1967, and they have 2 daughters, Lee Anne and Leslie. He earned his BS in 1968 from West Texas State University and his DDS from the University of Texas Dental Branch at Houston in 1972. He earned his pilot’s license during his time at dental school.

According to his obituary published by Brooks Funeral Directors of Canyon, “after graduating from dental school, he moved back to Amarillo with his family and opened his first independent dental practice in September 1972. During the course of his private practice in Amarillo, he worked as a dentist at Cal Farley’s Boys Ranch and in Spearman. He taught at Amarillo College Dental Hygiene and Dental Assistant school. In 2004, Dr Brent Hawkins joined the practice. They became partners in 2008. In 2010, Dr Hawkins became the managing partner of the practice, and Dr Smith continued to work at the Hawkins Dental Group through October 2025.”2

Dr Smith was supportive of organized dentistry throughout his more than 50-year career. He was a founding member of Texas Mission of Mercy and served as the TDA treasurer and TDA president (2000-2001). He was also past president of Panhandle District Dental Society, the TDA Smiles Foundation, and the Texas Chapter of the international College of Dentists. He was chair of the American Dental Association Council on Insurance and Member Retirement, treasurer of the USA Section of the International College of Dentists (ICD), and president of the Global ICD.

Former TDA President Dr Paul Stubbs remembers his friend, a giant of the dental world. “Dentistry has lost a great man. All facets of dentistry, the Amarillo District, TDA, the ICD have been the beneficiary of Dick’s tireless dedication and focus. Since our early years of leadership together in TDA, his direction and expertise in management significantly promoted growth and increased financial stability. And the list goes on…”

Dr Wade Barker of Tyler describes Dr Smith as a role model in a tribute message to him

on Facebook. “Sadly, I lost one of my longtime mentors today. Dr Richard ‘Dick’ Smith was truly a legend, or as we say a GOAT…Dr Smith devoted his life to selfless service. Dick was a fearless leader and always had a solution to whatever the dilemma was. His rich legacy has affected thousands of Texans who badly needed dental care and had nowhere else to turn…Wish we could share one more scotch and tell a few more stories. Rest in peace, Captain Dickie. Prayers to his wife Jimmie Ruth and the Smith family.”

His dental leadership and impressive CV were incomparable to the impact he had on his family and community. Dr Smith enjoyed traveling, golfing, and flying, and he built his own ¾-scale P51-D Mustang. He was on the board of directors for the Amarillo Symphony, the Amarillo Little Theatre, and the Samaritan Pastoral Counseling Center, according to his obituary. He and Jimmie Ruth were members of the First Presbyterian Church of Canyon,

of which he served as a deacon and an elder. Perhaps his greatest roles were as husband to Jimmie Ruth, father to his daughters Lee Anne and husband Damon Ross and Leslie and husband Shane Richmond, and grandfather to Devon, Dakota, Joshua, Brynlee, and Declan.

Dallas County Dental Society Executive Director Jane Evans remembers Dr Smith’s soft side. “My thoughts go back to the first time I met him, when he was treasurer of TDA. I was attending a meeting, and Ms Mary Kay Linn invited him to join us for lunch. I must admit, I was a bit apprehensive—perhaps it was his serious demeanor, or maybe those eyebrows,” says says. “Later, after volunteering with TMOM, I came to know the true Dr Smith. He has a heart bigger than Texas and is really just a big teddy bear. I knew I had been accepted the evening I was walking to dinner with him and Jimmie Ruth in San Antonio, when he asked if I would be interested in serving on a committee

with the TDA Smiles Foundation. I said yes immediately. That moment marked the beginning of our friendship and my discovery of his soft, loving side.”

Dr Stubbs says he will be forever thankful for his friendship with Dr Smith. “Yes, I shall mourn with the many of his departure from this earthly life, yet I am particularly grateful for his devotion to dentistry, his high moral character and, certainly, his unconditional friendship to me and Jena,” says Dr Stubbs, adding a poignant tribute to Dr Smith, an avid reader, with a line from Shakespeare’s Hamlet (Act 5, Scene 2). “Farewell, my dear friend. ‘May flights of angels sing thee to thy rest.’”

Donations in Dr Smith’s memory may be sent to the First Presbyterian Church of Canyon.

Sources

1. Boxwell Brothers Funeral Directors, https:// www.boxwellbrothers.com/obituaries/drdavid-duncan

2. Brooks Funeral Directors of Canyon, https:// www.brooksfuneral.com/obituaries/drrichard-dick-smith

ethics corner

TDA Council on Ethics and Judicial Affairs

So…you got a call from the judicial committee, now what?

Dr Henry Liao, Chair; Dr Jeffery R. Brunson; Dr LeAnn Kolb Snody; Dr C. Brian Herring; Dr Blake M. Hutzler, New Dentist member; Dr Kathleen Nichols, Consultant; Dr Ingrid Duebbert, Consultant; Dr Ron Hill, Board Liaison

Picture this: you’re minding your own business, sipping coffee, maybe thinking about lunch, and suddenly your phone rings. It’s someone from the Judicial Committee. Your heartbeat jumps a little. Do you freeze? Pretend you’ve entered the witness protection program? Call your attorney and whisper dramatically, “It’s happening”?

Before you do any of that, take a deep breath. A call from the Judicial Committee isn’t a plot twist in a courtroom drama. It’s usually much simpler—and a lot less intense— than it sounds.

Let’s break it down.

Why Are They Calling You?

Believe it or not, the Judicial Committee isn’t out to ruin your day. They actually have a few practical, helpful reasons for reaching out:

1. They want your side of the story. When someone files a complaint, the Judicial Committee isn’t going to jump to conclusions. They’re calling to hear what happened from you. Think of it as a calm chat—not an interrogation with a spotlight in your face.

2. Their big goal? Prevent a state board complaint. If things can be resolved early, everyone wins.

• Yes, the patient still has the option to go to the state board afterward.

• But if that happens, you’ll already have the results of the Judicial investigation to share. It’s like showing your homework ahead of time.

3. They act as the middle-person. Think of them as the Switzerland of dental disputes—neutral, steady, and just trying to help everyone get on the same page.

4. It’s not a legal process.

This isn’t a courtroom, a deposition, or anything requiring a dramatic “I plead the fifth.” It’s simply an informal, good-faith way to sort out concerns and offer guidance.

A Simple Rule to Remember

If your phone lights up with a call from the Judicial Committee, don’t panic, don’t hide, and definitely don’t start practicing your courtroom monologue. Just pick up, chat, and know they’re working to help everyone reach a fair, calm resolution.

The Judicial Committee and the Council on Ethics and Judicial Affairs are here for support, not stress. If you’re ever unsure, curious, or just need someone to talk you down from imagining worst-case scenarios, you’re never on your own. You can reach the Council on Ethics and Judicial Affairs’ staff liaison, Debbie Rogers at 512.443.3675 x 152 or send a note to drogers@tda.org. We’re always happy to help you navigate the process—minus the stress.

Council on Ethics and Judicial Affairs

Dr Henry Liao, Chair

Dr Jeffery R. Brunson

Dr LeAnn Kolb Snody

Dr C. Brian Herring

Dr Blake M. Hutzler, New Dentist member

Dr Kathleen Nichols, Consultant

Dr Ingrid Duebbert, Consultant

Dr Ron Hill, Board Liaison

If your phone lights up with a call from the Judicial Committee, don’t panic, don’t hide, and definitely don’t start practicing your courtroom monologue.

P R E V I E W SPEAKER

About the Speaker

Dr Geisinger is a professor, Director of Advanced Education in Periodontology, and Acting Chair of the Department of Periodontology in the University of Alabama at Birmingham. She is a Diplomate in the American Board of Periodontology and a Fellow in the International Team for Implantology, the International College of Dentists, and the American College of Dentists. She has authored over 80 peer-reviewed publications and serves on the editorial board of several journals.

Mia L. Geisinger, DDS, MS

will be presenting 4 sessions at the TDA Meeting:

Tik Tok Toothpaste? Evidence-Based Oral Hygiene Recommendations in the Age of Dr Google

Thursday, May 7

Up in Smoke: Smoking, Vaping and Cannabis and Their Effects on Oral Health

Friday, May 8

Killer Smile? The Oral-Systemic Connection

Friday, May 8

Smile Esthetics and the Importance of the Gingival Framework

Saturday, May 9

killer smile? the oral-systemic connection

friday, May 8 • time?

Oral health is a critical component of overall health and oral disease can impact systemic health for patients. While dental healthcare professionals have long focused on treating oral diseases, particularly periodontitis, to reduce periodontal attachment loss and subsequent tooth loss and improve oral function and esthetics, we now know that periodontitis has been credibly linked to over 57 systemic diseases and conditions in longitudinal studies. Chronic inflammation and microbial burden associated with periodontal disease reverberate throughout the body, contributing to the development, progression, and severity of multiple systemic illnesses. For dental healthcare professionals, this link between periodontal and systemic health transforms periodontal care from a niche treatment of progressive oral disease into a cornerstone of holistic patient health.

At the heart of this connection lies the biology of the periodontal pocket. As periodontal disease develops, the epithelial lining of the pocket becomes ulcerated, creating a portal through which oral bacteria and their byproducts can enter the bloodstream. Everyday activities such as chewing or toothbrushing can induce transient bacteremias and endotoxemias, seeding distant organs with periodontal pathogens like Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. These microorganisms are not passive travelers; they carry virulence factors that enable them to invade tissues, evade immune defenses, and stimulate inflammatory cascades. The oral cavity, in effect, becomes a reservoir of bacteria and bacterial byproducts that can travel throughout the body.

Periodontitis also impacts systemic health through the common inflammatory burden shared by many of these diseases. Periodontitis is characterized by a persistent immune reaction, with elevated levels of cytokines such as interleukin-1β (IL-1 β), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6). Such pro-inflammtory mediators do not remain confined to the gingiva or the tissues around teeth; they circulate systemically, contributing to endothelial dysfunction, insulin resistance, and heightened C-reactive protein (CRP) levels. Through this inflammatory pathway, periodontal disease can exacerbate inflammatory systemic conditions like cardiovascular disease, diabetes mellitus, and obesity and those diseases may also result in worsening periodontal conditions and/or poorer periodontal treatment outcomes. Dental healthcare professionals should recognize that every inflamed periodontal pocket is not only a local lesion but also a contributor to the patient’s overall inflammatory load.

The systemic conditions most clearly influenced by periodontal health illustrate the breadth of this impact. Common conditions that have been linked to periodontal health include, cardiovascular disease, diabetes mellitus, pregnancy outcomes, and rheumatoid arthritis. The bidirectional impacts of periodontal disease and such conditions as well as the underlying mechanisms differ

based upon the pathophysiology of disease, but many commonalities linking oral and systemic health exist.

Cardiovascular and cerebrovascular disease are more common in patients with a history of periodontitis—patients with periodontitis exhibit higher rates of atherosclerosis, myocardial infarction, and stroke. The mechanisms are multifactorial: direct bacterial invasion of vascular tissues has been documented, while indirect effects include systemic inflammation that destabilizes atherosclerotic plaques. For cardiologists, the mouth is increasingly recognized as a site of vascular risk, and for dentists, periodontal therapy can act as a preventive measure against major cardiovascular events.

Diabetes mellitus and periodontitis demonstrate a bidirectional relationship wherein inflammatory burden impacts both periodontal disease progression and severity and insulin resistance and glycemic control. Hyperglycemia impairs neutrophil function, alters collagen metabolism, and compromises wound healing, all of which increase susceptibility to periodontal breakdown. Conversely, the inflammatory mediators released in periodontitis exacerbate insulin resistance, making glycemic control more difficult. Clinical trials have demonstrated that effective periodontal therapy can lead to measurable improvements in HbA1c levels, underscoring the therapeutic potential of dental intervention.

Adverse pregnancy outcomes, including preterm birth, low birth weight, and preeclampsia, have also been linked to maternal periodontitis. The proposed mechanisms involve both direct translocation of oral pathogens across the placental barrier and systemic inflammatory responses that disrupt fetal development. For obstetricians, establishing periodontal health and identifying a dental home for patients who are newly pregnant or seeking to become pregnant is recommended as standard of care and for dental healthcare professionals, treating expectant mothers carries implications far beyond the oral cavity.

Rheumatoid arthritis (RA) represents another important systemic condition linked to periodontal disease. Research has shown that Porphyromonas gingivalis produces peptidylarginine deiminase, an enzyme that can citrullinate host proteins, leading to enhanced autoimmune response in genetically susceptible individuals and, eventually, RA pathogenesis. Patients with RA often exhibit higher rates of periodontitis, and conversely, periodontal therapy has been associated with improvements in joint symptoms and reductions in systemic inflammatory markers. Dementias, including Alzheimer’s disease, have also been linked to periodontal health. Chronic oral infection and inflammation may

contribute to neurodegenerative processes through several mechanisms. Oral pathogens and their byproducts have been detected in the brain and spinal fluid of individuals with dementias, suggesting direct microbial invasion. In addition, systemic inflammation originating from periodontal disease may accelerate neuroinflammation, a key driver of cognitive decline. Elevated cytokines and bacterial endotoxins can cross the blood-brain barrier, promoting neuronal damage and amyloid plaque formation. Emerging studies suggest that effective periodontal therapy may reduce systemic inflammatory burden and potentially slow cognitive deterioration.

There are also recent studies linking periodontitis and other systemic conditions, including certain cancers, including pancreatic and colorectal malignancies, chronic kidney disease, COVID-19 morbidity and mortality, obesity and infertility. While these links are still being clarified, they highlight the potential impact of periodontal diagnosis and treatment on systemic health.

Given these connections, the implications for dental practice are profound. Diagnosis of periodontal disease must be approached not only as an assessment of oral health but also as a screening for systemic risk. Comprehensive periodontal examinations should be accompanied by discussions about the impacts that periodontal disease and its treatment can have on overall health. By framing periodontal care within the broader

context of systemic health, dental healthcare providers can motivate patients to adopt healthier behaviors and adhere to treatment plans.

Interprofessional collaboration is essential to achieving optimal wellbeing for patients. Dental healthcare professionals should establish communication pathways with primary care and specialist physicians and other healthcare workers. Co-management of patients with comorbidities ensures that periodontal therapy is integrated into broader treatment strategies. Such collaboration not only improves patient health but also strengthens the role of dentistry within the healthcare system.

For dental healthcare professionals, the evolving understanding of periodontitis as a systemic health influencer represents both a challenge and an opportunity. The challenge lies in expanding our perspective beyond the oral cavity, recognizing that periodontal disease is part of a larger web of chronic conditions. The opportunity lies in positioning periodontal care as a vital component of preventive medicine, with tangible benefits for cardiovascular health, metabolic control, pregnancy outcomes, autoimmune disease, cognitive function, and overall wellness. By embracing this holistic perspective, dentists can elevate their role within healthcare, becoming integral partners in the fight against chronic disease.

value for your profession

Provided

R A

The Reptile Theory Wriggles its Way into Dental Malpractice Litigation

By Marc Leffler, DDS, Esq. Lead Dental Risk Solutions Consultant for MedPro Group

Trial attorneys, particularly those representing plaintiffs, have effectively modified their litigation techniques over the years to be able to appeal to changing views of jury pools. One of the more recent of those approaches — initially on the medical malpractice front, but then involving dental

malpractice cases — is the use of the Reptile Theory as a method of convincing jurors that doctors ought to be held liable, and for large sums of money, when treatment results are not ideal. The strategy is based upon emotion, playing on jurors’ fears, and not necessarily on the case merits, thereby leading them to reach (large) verdicts in favor of plaintiffs.

How did the Reptile Theory get its name? As the theory goes, humans have a primitive portion of the brain which is focused on safety and survival; reptiles’ brains are similar in that regard. And there you have the name, because the litigation theory, as noted before, tries to work jurors so that they essentially view themselves as though they were the plaintiff, in the “unsafe” environment that led to the injury at issue. (Even though some members of the scientific community argue that the human-reptile brain comparison is not as presented by the theory, the name has, nevertheless, stuck.)

How is the theory put into use during litigation? In general, most trial litigators view depositions as the most important and significant part of the litigation. Just as during a courtroom trial, questions are posed to parties at deposition by the opposing lawyer, and the witness responds under oath, with those responses being transcribed, able to be used later on during trial; many attorneys would argue that the only difference between trial and deposition questioning is that witnesses tend to be far more prepared for trial than they are for their deposition. That is unfortunate, because the trial impact of a witness who was unprepared at deposition can be huge. So, savvy lawyers will put the difficult theory questions to the defendant dentists during deposition, hope that they were not adequately prepared to offer answers that support their own cause, and lock in those potentially plaintiff-helpful answers forever more, able to be read back in full to the trial jury, hopefully swaying them in their clients’ favor.

What does the Reptile Theory look like in practice? Let’s take the all-too-common example of the extraction of a lower third molar, which results in a lingual nerve paresthesia. At the dentist’s deposition, the reptilian lawyer asks the dentist, “Would you agree that protecting the safety of your patients must be your top priority?” “Of course it is.” “Would you agree that protecting nerves from injury during dental procedures is a way to keep your patients safe?” “Yes.” “In this case, would you agree with the oral surgeon who examined the plaintiff after you treated her, that there is paresthesia associated with the lingual nerve?” “I suppose so.” “And would you agree that paresthesia is an injury to the nerve, when it did not exist beforehand and came about as a result of the procedure

you performed?” “I guess so.” “So, wouldn’t you agree that you failed to keep your patient safe, allowing the nerve immediately adjacent to your area of treatment to become injured?” The answer almost doesn’t matter, because jurors already know it in their own minds. There is no question that this technique, in the hands of a trained, experienced, and knowledgeable attorney, can be a powerful weapon.

So, for those who are sued for dental malpractice these days, both those dentists and their attorneys will best prepare for the defense of their cases by including — among a whole host of factors — ways to fend off the reptiles. And, yes, there are ways to fend them off.

As the nation’s leading dental malpractice insurance carrier, MedPro Group has unparalleled success in defending malpractice claims and providing patient safety and risk solutions. MedPro is the nation’s highest-rated malpractice carrier, rated A++ by A.M. Best. The Berkshire Hathaway business has been defending dentists’ assets and reputations since 1899 and will continue to for years to come.

For more information regarding MedPro Group, please call (800) 677-8644 or visit tdamemberinsure.com (Go to: Practice Coverage, Professional Liability).

The content within is not the original work of MedPro Group but has been published with consent of the author. This document should not be construed as medical or legal advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions. MedPro Group is the marketing name used to refer to the insurance operations of The Medical Protective Company, Princeton Insurance Company, PLICO, Inc. and MedPro RRG Risk Retention Group. All insurance products are underwritten and administered by these and other Berkshire Hathaway affiliates, including National Fire & Marine Insurance Company. Product availability is based upon business and/or regulatory approval and/or may differ among companies.

©MedPro Group Inc. All rights reserved. 10/2025

classifieds

Opportunities Online at TDA.org and Printed in the Texas Dental Journal

CLASSIFIEDS INFORMATION

DEADLINE

Copy text is due the 20th of the month, 2 months prior to publication (ie, January issue has a due date of November 20.)

MONTHLY RATES

PRINT: First 30 words—$60 for ADA/TDA members and $100 for non-members. $0.10 each additional word.

ONLINE: $40 per month (no word limit). Online ads are circulated on the 1st business day of each month, however an ad can be placed within 24 business hours for an additional fee of $60.

SUBMISSION

Ads must be submitted, and are only accepted, via www.tda.org/MemberResources/TDA-Classified-Ads-Terms. By official TDA resolution, ads may not quote specific incomes or revenues and must be stated in generic terms (ie “$315,000” should be “low-to-mid-6 figures”). Journal editors reserve the right to edit and/or deny copy.

PRACTICE OPPORTUNITIES

ALL TEXAS LISTINGS FOR MCLERRAN & ASSOCIATES. AUSTIN (ID #745): Established, 2-location GD practice in the Austin area. The practice serves a large, diverse, FFS/ PPO patient base with excellent new patient flow, a combined 14 equipped operatories across both locations (with substantial room for expansion at one of the locations). The practice comes fully equipped with digital radiography, digital sensors, digital scanners, digital Pano, CBCT, and paperless charts.

AUSTIN (ID #749): Established GD office located in the heart of central Austin. The practice has an impeccable online reputation in the community and features a strong hygiene recall program with multiple avenues for future growth. 3,000+ sq ft office, 4 active operatories, ample room for expansion, equipped with a digital scanner, intra oral cameras, digital x-ray sensors, and paperless charts. AUSTIN (ID #762): Established GD office in the heart of central Austin with a majority PPO patient base, 1000+ active patients, a robust hygiene recall program, and a strong reputation online and in the community they serve. The 1,500 sq ft office space contains 3 total operatories, computers throughout, a digital x-ray scanner, and intra-oral cameras. The practice has consistently generated revenue of mid-6 figures with abundant upside opportunities to expand production/cash flow through launching strategic marketing and advertising initiatives, driving new patient flow, and offering additional

advanced procedures in-house. AUSTIN (ID #777): Legacy, GD office in the hill country west of Austin. FFS/PPO patient base, about 1,000 active patients, and features a spacious Approximately 2,000 sq ft facility with upgraded equipment/technology. The office contains 4 equipped operatories with computers in each, digital x-ray sensors, a CBCT, a digital scanner, and paperless charts. This is a well-established, turn-key practice with solid growth potential.

AUSTIN (ID #787): Large, GD practice with a great reputation in north Austin. Large facility in a free-standing building with great visibility featuring 8 fully equipped operatories with computers in each, digital radiography, an iTero digital scanner, and a 3D CBCT unit. FFS/ PPO patient base, 25+ new patients per month, and a stellar online reputation. AUSTIN (ID #790): Established periodontic practice in highly sought after central Austin with abundant upside potential. The well-appointed 1,840 sq ft space has 5 fully equipped operatories with room for future expansion, computers throughout, digital x-ray sensors, and paperless charts. The 100% FFS practice is built on an impeccable foundation with a diverse referral network, solid hygiene recall, and virtually no investment in marketing and advertising.

DALLAS/FORT WORTH-ORTHO (ID #780): Rare opportunity to purchase a 100% FFS orthodontic practice and real estate in an established DFW suburb. 4,000+ sq ft office, 8 chairs, computers throughout, digital x-ray sensors, a CBCT, digital scanner, 3D printer,

dental laser, and paperless charts. This is an expertly engineered, highly profitable ortho office that is primed for continued success, with real estate included, in a great suburb of DFW. HOUSTON-SOUTH (ID #682): Established, multi-specialty dental office in a suburb approximately 20 miles south of Houston. Large (4,000 sq ft), easily accessible office condo with 13 equipped operatories, computers throughout, CBCT, and digital scanner. Massive PPO/FFS patient base (3,000+) with over 50 new patients visiting the office per month. The practice revenue averages over seven figures annually with strong net cash flow, and there

classifieds

is room for expansion through enhancing the hygiene recall and focusing on standardizing the procedural mix. With approximately 55% of the dentistry being restorative, 25% pediatrics, 10% ortho, and 10% OMS, the office is on a stable foundation with the opportunity to take it in whatever direction you choose. HOUSTONEAST (ID #769): Unique opportunity to purchase an established, GD practice about 80 miles east of Houston. Large office containing 9 total chairs, advanced modern technology including computers throughout, digital x-ray sensors, digital pano, 3D cone beam CT, digital scanner, intra oral cameras and paperless charts. The large 5,000+ active patient base lays the foundation for exceptional growth opportunities by expanding the procedure mix and focusing on restorative procedures as well as adding in basic specialty procedures.

HOUSTON (ID #772): Legacy GD practice and free-standing real estate located north of downtown Houston. Majority PPO patient base, 1,300+ active patients, and 20+ new patients visiting the office per month; about 3,000 sq ft facility contains 6 total operatories (5 equipped), computers in each operatory, digital x-ray sensors, pano, digital scanner, dental laser, and paperless charts. The practice has consistently realized revenue mid-6 figures with robust net cash flow (45-55% on average) and upside opportunities to expand production through adding additional specialty procedures, equipping the open operatory, and implementing a strategic marketing initiative.

HOUSTON-SOUTHWEST (ID #782): Large, modern GD practice located in a high-visibility retail center on the southwest side of Houston. The spacious 3,900 sq ft practice features 6 fully equipped operatories (with several additional ops built out and ready to equip), is fully digital with CBCT, digital scanner, digital radiography, intra oral cameras, and computers throughout. The practice serves a mix of PPO/FFS patients, has realized revenue of approximately 7 figures over the last several years, and has a fantastic reputation within the community and online.

SAN ANTONIO (ID #788): Thriving, highly profitable GD practice in the heart of San Antonio. Primarily PPO, more than 2,300 active patients, net cash flow of over seven figures annually over the last 3 years. The practice features 2,000 sq ft, a digital panoramic x-ray, digital sensors, and paperless charts. The owner currently refers out all or nearly all perio, endo, ortho, and implant placement, representing significant upside for an incoming buyer.

SOUTH TEXAS COAST (ID #754): Exceptional GD practice located in a serene coastal town. Rare opportunity to acquire a thriving, wellestablished business in an underserved area with consistent collections of 7 figures with a primarily FFS active patient base and strong new patient flow. Hygiene production is robust, having exceeded 25% each of the last 3 years. The spacious, modern facility is outfitted with state-of-the-art technology and is also available for purchase. The owner will be retiring at some point over the next few years but is available to

stay for a transition of the buyerís preference.

SOUTH TEXAS COAST (ID #783): Established GD office in a quaint town near the Texas Gulf Coast. 100% FFS office, multi-generational active patient base (1,000+), in a 1,600+ sq ft facility containing 3 operatories with computers in each, digital x-ray sensors, a pano, and fully digital charts. The practice has impressive net cash flow margins (75%+) and there are several opportunities for post-sale growth. This is a unique opportunity to step into a growing practice with outstanding fundamentals and maximum upside potential. TO REQUEST MORE INFORMATION ON MCLERRAN & ASSOCIATES’ LISTINGS: Please register at www.dentaltransitions.com or contact us at 512-900-7989 or info@dentaltransitions. com.

CENTRAL TEXAS HILL COUNTRY: For sale by owner, thriving fee-for-service general dental practice. Established rural 4 operatory dental practice for sale in the heart of the beautiful Texas hill country. This all-digital practice with a new pano produces mid-6 figure income with just 2 days per week of operation, offering great room for expansion and growth. The recently renovated real estate which offers a modern, welcoming environment for patients is also for sale. This is a perfect opportunity for a dentist looking to step into a successful, modern and established dental practice with plenty of room to expand. Contact dentalofficesale2024@gmail. com for more information and showings.

KERRVILLE: Well established general practice and real estate located in a scenic hill country town. This 3-operatory practice was completely remodeled in 2016. There is a steady new patient flow with a mid-6 figure yearly production on a 4-day week. This is a great opportunity for someone wanting to escape a big city practice or begin and grow. Contact Dental Practice Sales 713-504-7117.

MANSFIELD: Explore a remarkably unique dental practice for sale in the DFW area. Great start-up opportunity for GP or specialist. Discover the possibilities online at www. yournewdentalpractice.com

WATSON BROWN PRACTICES FOR SALE:

Practices for sale in Texas and surrounding states, For more information and current listings please visit our website at www. adstexas.com or call us at 469-222-3200 to speak with Frank or Jeremy.

INTERIM SERVICES

HAVE MIRROR AND EXPLORER, WILL TRAVEL: Sick leave, maternity leave, vacation, or death, I will cover your general or pediatric practice. Call Robert Zoch, DDS, MAGD, at 512-517-2826 or drzoch@yahoo.com.

Official call to the 2026 Annual Session of the Texas Dental Association House of Delegates

HOUSE OF DELEGATES: In accordance with Chapter IV, Section 70, paragraph A-1 of the Texas Dental Association (TDA) Bylaws, this is the official call for the 156th Annual Session of the Texas Dental Association House of Delegates. All sessions of the House will be in the Stars At Night Ballroom of the Henry B. Gonzalez Convention Center, 900 E. Market Street, San Antonio, Texas. The opening session of the House will convene at 9:00 a.m. on Friday, May 8, 2026. The second meeting of the House will be at 8:00 a.m. on Saturday, May 9, 2026. The third meeting of the House will be at 1:30 p.m. on Saturday, May 9, 2026, followed by the fourth meeting at 3:00 p.m. until close of business.

IMPORTANT NOTE: This year’s House of Delegates will take place in a 2-day format. Please check dates & times carefully while planning your attendance.

Please see the TDA Meeting website for details and additional information (www. tdameeting.com).

Component Societies are urged to certify an accurate list of Delegates and Alternates to fill each of their seats on the floor of the TDA House of Delegates.

REFERENCE COMMITTEE HEARINGS: Reference Committee hearings will be combined and will follow the First Meeting on Friday, May 8, 2026, and open to all members who are present in the Stars At Night of the Henry B. Gonzalez Convention Center, 900 E. Market Street, San Antonio, Texas (same room as the House of Delegates meetings). Hearings will conclude when no further testimony is presented.

Combined Topics:

• Administration, Budget, Building, House of Delegates, Membership Processing

• President’s Address, Miscellaneous Matters, Component Societies, Subsidiaries, Strategic Planning, Annual Session

• Dental Education, Dental Economics, Health and Dental Care Programs

• Legislative, Legal and Governmental Affairs

• Constitution, Bylaws, Ethics & Peer Review

The agenda for the Reference Committee hearings will be included in the Reference Committee section of the House Documents.

REFERENCE COMMITTEE REPORTS: Reference Committee Reports will be made available in PDF format to the members of the House of Delegates (reports may be downloaded from any location with Internet access). Printed copies will not be provided.

TDA CANDIDATES FORUM: The ADA/ TDA Leadership Candidates Forum will be held on Friday, May 8, 2026, from 4:00 p.m. to 5:30 p.m. in the in the Stars At Night Ballroom of the Henry B. Gonzalez Convention Center, 900 E. Market Street, San Antonio, Texas (same room as the House of Delegates meetings).

In the event there are no contested TDA statewide elections and no participation by candidates for ADA elected offices, the candidate’s forum will not be held.

DIVISIONAL CAUCUSES: Divisional Caucuses (Northwest, Northeast, Southwest, Southeast) will be facilitated at 5:30 p.m. on Friday, May 8, 2026, in the Convention Center and open to all current members - please see the TDA website for details and additional information. (Room assignments:SW-301C; NE-302A; NW-302B; SE-302C).

DELEGATE MATERIALS: In accordance with TDA Bylaws, the House documents will be available 30 days prior to the Annual Session of the House of Delegates. The supplements to the House documents, containing the agenda and subsequent reports, will be sent after the April 2026 TDA Board of Directors meeting. The minutes of the TDA Board shall be posted on the members’ side of the TDA website and made available to the general TDA membership once the minutes are approved by the TDA Board of Directors in accordance with Policy 26-2018-H. Delegates and alternates will receive all House Documents in PDF format. Printed copies of the House Documents will not be provided. Wireless internet access will not be available in the House chamber— please download all House materials on a fully charged laptop or device prior to attendance (charging stations will be centrally located in the meeting rooms).

OFFICIAL CALL FOR NOMINATIONS

OFFICIAL CALL FOR CANDIDACY ANNOUNCEMENTS AND SUBSEQUENT NOMINATIONS:

SPEAKER OF THE HOUSE, SECRETARY-TREASURER, AND EDITOR

OFFICIAL CALL FOR SPEAKER OF THE HOUSE CANDIDACY ANNOUNCEMENTS AND SUBSEQUENT NOMINATIONS

Candidacy announcements for the statewide elective office of Texas Dental Association (TDA) Speaker of the House may be submitted to TDA Secretary-Treasurer Dr Oshmi Duta for the upcoming 2026 House elections. Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must be submitted, and the candidate will also have to sign a conflict of interest statement. Nominations are in order at the first meeting of the House of Delegates and remain open until the close of the second meeting of the House of Delegates; however, announcements of candidacy should be made as early as possible so that membership eligibility may be verified. To become a nominee, a delegate must place the name of the candidate in nomination at the first meeting of the House of Delegates. Please see the Manual on Caucus, Campaigns, Nominations and Elections at tda.org for full details.

Duties of the Speaker of the House are enumerated in the Bylaws and include the following (excerpt):

1. To serve as an ex-officio member of the Board of Directors without vote or the privilege of proposing resolutions.

2. To serve as an ex-officio member of the Executive Committee without vote or the privilege of proposing resolutions.

3. To preside at all meetings of the House of Delegates.

4. To determine the order of business for all meetings, subject to the

approval of the House of Delegates, in accordance with Section 140B of this chapter.

5. To appoint tellers to assist him/her in determining the result of any action taken by vote.

6. To appoint members of reference committees in consultation with the president, president-elect, and the immediate past president by the Board of Directors’ first meeting of the calendar year.

7. To notify the divisional officers and the Committee on Credentials, Rules and Order, prior to the annual session, the number of delegates and alternates necessary to constitute a quorum.

8. To meet with the divisional officers prior to the meeting of the divisional caucuses at the annual session to review the Rules for Caucus Procedures, Nominations, And Elections.

9. To appoint a parliamentarian pro tem, should it become necessary for the parliamentarian to be absent during a session of the House of Delegates.

10. To serve as presiding officer of the TDA Candidates Forum, unless the Speaker is in a contested race, at which time the Speaker Pro-tem will preside.

11. To be a certified parliamentarian or be in the process of certification

Candidacy announcements are to be mailed to TDA Secretary-Treasurer Dr Oshmi Dutta, Texas Dental Association, 8701 W Hwy 71 Ste 201-M, Austin, Texas 78735; or, emailed to TDA Interim Executive Director Lee Ann Johnson: ljohnson@tda.org.

(See TDA Bylaws, Chapter IV, House of Delegates—Sections 100 (Officers), 110A (Duties), 150C(3), 150D, Chapter V, Board of Directors—Sections 10 (Composition); TDA House Manual; Speaker Manual).

OFFICIAL CALL FOR SECRETARYTREASURER CANDIDACY

ANNOUNCEMENTS AND SUBSEQUENT NOMINATIONS

Candidacy announcements for the statewide elective office of Texas Dental Association (TDA) Secretary-Treasurer may be submitted to TDA Secretary-Treasurer Dr Oshmi Dutta for the upcoming 2026 House elections. Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must be submitted, and the candidate will also have to sign a conflict of interest statement. Nominations are in order at the first meeting of the House of Delegates and remain open until the close of nominations at the end of the second meeting of the House of Delegates; however, announcements of candidacy should be made as early as possible so that membership eligibility can be verified. To become a nominee, a delegate must place the name of the candidate in nomination at the first meeting of the House of Delegates. Please see the Manual on Caucus, Campaigns, Nominations and Elections at tda.org for full details.

Duties of the TDA Secretary-Treasurer are enumerated in the Bylaws and include the following (excerpt):

1. To serve without vote as member of the Board of Directors and the House of Delegates.

2. To serve without vote as chair of the Budget Committee.

3. To examine the income and expenses of this Association and report at each meeting of the Board of Directors.

4. To ensure that the minutes of the House of Delegates and the Board of Directors be maintained.

5. To be responsible and perform such other duties as shall be specified by the Board of Directors and the Bylaws

Other duties as Secretary include the following:

• Serve as recording officer and custodian of the records of the House of Delegates and the Board of Directors.

• Serve as secretary to the Executive Committee, without the right to vote.

• Serve as secretary to the House of Delegates.

• Serve as the secretary of the American Dental Association Fifteenth Trustee District Delegation.

Candidacy announcements are to be mailed to TDA Secretary-Treasurer Dr Oshmi Dutta, Texas Dental Association, 8701 W Hwy 71 Ste 201-M, Austin, Texas 78735; or, emailed to TDA Interim Executive Director Lee Ann Johnson: ljohnson@tda.org.

(Ref. TDA Bylaws, Chapter IV, House of Delegates—Sections 70A-B (Notice and Publication-Official Call & Publication of Actions, 110B (Duties); Chapter V, Board of Directors—Sections 10 (Composition), 80B (Officers-Secretary); Chapter VI, Elective Officers—Section 90G (Duties); Chapter VIII, Fifteenth Trustee District American Dental Association Delegates and Alternate Delegates—Section 80 (Delegation Secretary); Board Manual; Secretary-Treasurer Manual).

OFFICIAL CALL FOR EDITOR CANDIDACY ANNOUNCEMENTS AND SUBSEQUENT NOMINATIONS

Candidacy announcements for the statewide elective office of Texas Dental Association (TDA) Editor may be submitted to TDA Secretary-Treasurer Dr Oshmi Dutta for the upcoming 2026 House elections. Only an active, life, or retired member in good standing of this Association shall be eligible. A curriculum vitae (CV) must be submitted, and the candidate will also have to sign a conflict of interest statement. Nominations are in order at the first meeting of the House of Delegates and remain open until the close of nominations at the end of the second meeting of the House of Delegates; however, announcements of candidacy should be made as early as possible so that membership eligibility can be verified. To become a nominee, a delegate must place the name of the candidate in nomination at the first meeting of the House of Delegates. Please see the Manual on Caucus, Campaigns, Nominations and Elections at tda.org for full details.

Duties of the editor are enumerated in the Bylaws and include the following (excerpt):

1. To be editor-in-chief of all journals and publications of the Association and exercise full editorial control over such publications, subject only to policies established by the House of Delegates, Board of Directors, and these

Bylaws and provided such content is not in conflict with or contrary to the TDA’s established policies, legislative agenda, or advocacy efforts.

2. To control the selection of scientific material published in the Journal. The editor may appoint associate editors, with the concurrence of the Board of Directors, to gather and/or review material for publication. Such associate editors shall serve as long as the editor deems necessary; but never longer than the term of the editor.

3. To attend all open meetings of the Board of Directors and the House of Delegates of this association, and the annual session of the American Dental Association.

4. To hold no other office in this association or the American Dental Association while serving as editor, except the editor may be elected as delegate or alternate delegate to the ADA House of Delegates from his/her respective division.

5. To cooperate with his/her successor upon termination of the Editor’s term of office.

Candidacy announcements are to be mailed to TDA Secretary-Treasurer Dr Oshmi Dutta, Texas Dental Association, 8701 W Hwy 71 Ste 201-M, Austin, Texas 78735; or, emailed to TDA Interim Executive Director Lee Ann Johnson: ljohnson@tda.org.

(Ref. TDA Bylaws, Chapter VI, Elective Officers—Section 90I (Duties); Policy Manual).

Guest Editor Rade D. Paravina, DDS, MS, PhD

Is There Space for Resin Composite Restorations in a World of CAD-CAM and Digital Dentistry? Two-Year Follow-Up of Clinical Outcomes Using the Direct–Indirect Technique

Andrés Dávila-Sánchez, DDS, Newton Fahl Jr, DDS

Read this article in full at: https://doi.org/10.1111/jerd.13430

ABSTRACT

Objective

This clinical report seeks to elucidate the versatility and mid-term outcomes of the direct–indirect technique. It presents a comprehensive step-by-step protocol for restoring anterior dentition across various clinical scenarios in accordance with the principles of the polychromatic layering technique.

Clinical Considerations

This clinical report was divided into two phases. First, an urgent procedure due to the debonding of an interim restoration in tooth #10 was followed by crafting a direct–indirect veneer. Then, in the six-month follow-up appointment, a complete esthetic improvement in the anterior dentition (teeth #8, #9) with two techniques and different materials for each tooth was observed: In tooth #8, a direct incisal edge augmentation was performed, while in tooth #9, a thin contact lens-type direct–indirect fragment was created to improve the form of the tooth. The restorations were followed up for a 24-month mean, with the following criteria: Color, wear, adaptation, marginal discoloration, and integrity.

Conclusions

The direct–indirect technique showed optimal clinical outcomes after a mid-term follow-up, making it an option to traditional direct veneering, ceramics, and CAD-CAM materials.

Clinical Significance

The direct–indirect technique amplifies the scope of resin composite restorations, providing optimal esthetic performance, broad indications, and mid-term longevity regardless of the selected restorative composite material or veneer type.

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