April 2005 Newsletter

Chronic Musculoskeletal and Neuropathic Face Pain: A Practical and Contemporary Review
Featured Speaker: Dr. David Sirois
Dr. Sirois is Associate Professor and Chairman of the Departments of Oral Medicine and Urgent Care at New York University College of Dentistry and Adjunct Associate Professor of Neurology at the NYU School of Medicine. He is also Head, Division of Reconstructive and Comprehensive Care at NYU College of Dentistry. He is an Attending Physician in the Departments of Surgery and Neurology at NYU Medical Center – Tisch Hospital. Dr. Sirois received the DMD degree from the University of Pennsylvania in 1987 where he is also completed the Ph.D. in Neuroscience in 1993 and a Fellowship in Oral Medicine in 1992.
Dr. Sirois is a Diplomat of the American Board of Oral Medicine and serves in several leadership positions for the American Academy of Oral Medicine. His research and clinical interests include chronic orofacial neuropathic and musculoskeletal pain, oral mucosal (dermatologic) disease, oral cancer and optimizing the integration dental and medical science and practice. He is internationally recognized in Oral Medicine and lectures widely on topics related to chronic orofacial pain, oral mucosal disease, salivary gland disorders and the medically compromised dental patient. He has published widely in the medical and dental literature. His clinical practice focuses on orofacial pain, oral mucosal disease and salivary gland disorders and comprehensive dental / oral surgical care for patients with significant medical illness.
The prevalence of musculoskeletal and neuropathic face pain is such that every dental care provider will encounter patients with these problems. This program will review contemporary, biologically-based concepts of the causes, diagnosis and management of these disorders. At the conclusion of this course, the participant will be able to describe:
• Current disease classification and related diagnostic criteria for focal facial myalgia, myofascial face pain, fibromyalgia, and internal derangements of the TMJ • Current disease classification and related diagnostic criteria for the cranial neuralgias, burning mouth, and neuropathic (nerve injury) face pain • Characteristics of the disorders which suggest whether the disorder is self-limiting or progressive, and those characteristics which predict treatment outcomes. • Physical, behavioral, medical and surgical approaches to therapy based upon a biopsychosocial model of illness and care.

I’ve taken many lessons with me during my almost 15 years as a dentist in Middlesex County. The first of my top two are that dentists are extremely thankful for their lot in life and do an enormous amount of giving back to the community. Many of our MCDS members teach at dental schools, residency programs and the MCCC hygiene program. Others volunteer their time for donated dental service (DDS) and/or Give Kids a Smile, two NJDA sponsored programs that deliver much needed dental care access to the underprivileged. In addition, we have many members who give back to the community by volunteering at their local houses of worship, or attending clubs (e.g.-Rotary) and sitting on local government committees or boards. It is my belief that dentists, as a profession, stand out in these volunteer endeavors and their presence in this capacity only elevates our standing in the community.
The second lesson I’ve learned is that it’s never too late to help, even when it is. When I did my residency back in 1990, the vast majority of the patients that I treated were HIV+. It was a time before protease inhibitors, and the majority of these patients simply wasted away throughout the residency year. Worse than the ravages of the disease was the extinction of many of these patients support network of friends, often coupled with the rejection of their families due to their lifestyle. Even though I knew they would lose their battle with the disease, it was rewarding to care for their dental needs and treat them with dignity when the majority of society would not.
In addition, working in forensic dentistry allowed closure to be brought to the various families of those identified. The WTC Dental ID Unit showed a respect and dignity for the deceased after 9/11 that made me think back about my residency year. A career in dentistry affords us the opportunity to receive respect and dignity from the community we serve...I hope that we as a profession continue to return the favor.

-March 9, 2005-
Attendance: Ashmen, Courey, Galkin, Glickman, Kahn, Lawson, Schambra, Simos, Weiner
Acceptance of Minutes-vote unanimous.
President’s Report-Mitch Weiner
-The Crossley full-day course was a tremendous success in every way. Thanks again to Dr. Mark Vitale for all of his efforts in organizing such a successful full-day CE series. Due to his efforts and the caliber of speakers and sponsors he has attracted, MCDS has established much goodwill that will hopefully come back to us in more sponsorships and more big name speakers.
-The hygiene school at MCCC has proposed multiple valedictorians once again, putting us in the position of having to spend more for plaques. What is the history of us presenting the valedictorian plaque? Has it traditionally gone to only ONE person and is this not the definition of a valedictorian? Where do we draw the line with how many valedictorians we will allow? Given that WE are presenting the plaque(s), shouldn’t WE be the ones who determine the parameters by which it is given?
-A hygienist who teaches at MCCC approached me about attending the Sirois Course in April. At last months Board Meeting, we discussed the attendance of a non-dentist graduate student and declined attendance. Given that a this is a hygienist/educator and that we have some kind of affiliation with MCCC Hygiene Program, should we make an exception and allow her to attend?
-I will be away on vacation for the March dinner meeting and Dr. Ross Kline will be filling in- although there will be no business meeting, the slate of officers must be presented and voted upon. Marlene will need to bring copies of the officer slate to the Pines. This should be done immediately before getting Amsterdam up to speak or during a break. For the newsletter, we will need a picture of Dr. Amsterdam being presented the Sy Symanski Lecture Award.
Treasurer’s Report-James Courey
See full report on page 3.
Editor’s Report-Mitch Weiner, Bob Silverstein, Constantine Simos
Our printer required servicing to correct a problem with color banding. This has been resolved. The service call cost $100.70. As per the last Board meeting, a digital camera was purchased for the Society-a Canon Powershot S500-along with a 256MB memory card and carrying case. The total cost was $375.46. The camera will be stored at the Pines and will be used for Society related business.
Program Chairperson’s Report-Mark Vitale
-Dr. Harold Crossley would be interested in returning to give his street drugs lecture to doctors, spouses and staff. He was very impressed with last month’s program and looks forward to a return visit.
-As a result of prior issues with PAC, Jim Schultz is preparing a power point presentation on NJDA Governmental affairs and PAC. He is asking for about 30 minutes at the September 05 meeting for this presentation. He was very pleased with the response he received at the Crossley course.
-Kuwata Pan Dent will sponsor next year’s program with John Kois. They will provide $12,000.
-Marty from Benco cannot attend the OSHA lecture, but appreciates the offer. If we need a corporate sponsor for that meeting he will obtain one for us.
-Benco is sponsoring a lecture featuring Paul Homoly on October 21, 2005. They would like MDCS to co-sponsor at no cost to MCDS. The tuition is $99 and they will reimburse MCDS $50 for every member that attends. They will cover all costs and do all preparation.
-Preparation for staff night is proceeding. The grand prize will be a two night stay at a Ritz Carlton.
NJDA Council Reports:
Dental Benefits-Mark Vitale
The council met on January 19, 2005 and the following items were reviewed.
-CRP Statistics was reviewed from January 1, 2004 through December 31, 2004. There were 151 complaints submitted to NJDA for the year. 84 were resolved, 33 were for data purposes, 31 are pending, and 3 were not resolvable.
-The council discussed the Delta processing policies that correspond to the new CDT-2205 procedure codes. All participating providers agree to abide by these policies. Members are strongly encouraged to review these policies that were sent to them by Delta. They were published in the December 2004 issue of “Dental News”. Problems should be reported to NJDA.
-Met Life has continuing education resources available on line. Members are encouraged to visit the Met Life website. Of particular interest is the article on blood pressure monitoring in the dental setting. This article is being used to support the resolution that the council submitted to the NJDA Board of Trustees concerning the monitoring of patient blood pressure.
-CDT-2005 is available from the ADA(1-800-947-4746). These codes went into effect January 1, 2005. There are 39 new codes and 47 revised codes. The ADA will present a workshop at the annual convention in June.
-The council reviewed concerns with Met Life’s unusual and excessive request for “further information” on claims, and its failure to develop a list of documentation requirements. Met Life responded to an inquiry by NJDA stating that this will be corrected.
-Dr. David Pettigrew from Horizon of NJ met with the council. Horizon has been offering workshops on electronic claims. As an incentive for dentists to file electronically, Horizon does not require documentation on claims submitted electronically. An update was provided of Horizon’s efforts to promote oral health as part of its disease management programs. Dr. Pettigrew welcomes our members to contact him with any issues that are of concern.
-The council discussed legislative proposals to expand the NJ FamilyCare program over the next three years. This would be at an estimated cost of $224 million.
-The council discussed the NY times article which focused on the dental double standard in which the “haves are getting movie star smiles and the have-nots likely to be living with mouths full of bad or missing teeth.” The articles attributed this situation to the high cost of dental care and the lack of adequate dental coverage.
-The Public Health Council at its December meeting stated that it would make a decision on NJDA’s petition for rulemaking to fluoridate New Jersey’s drinking water at its January 10, 2205 meeting. At its February 14th meeting the Council again postponed its decision,
-The council endorsed a request for a new procedure code for a “gasket-retained partial denture”.
Respectfully Submitted, Bob Silverstein, Secretary

Council on Annual Session – Ricky Dibofsky
Children’s Dental Health Month celebration is scheduled for Sunday, March 6th at the Liberty Science Center. To date, 86 booths have been sold and the Council is still looking for sponsorships.
Council on Dental Benefits Programs – Mary Moskal
Ms. Mary Moskal reported that the ADA and FDA came out with new radiograph guidelines with emphasis on panographs. This is posted on the ADA website. HIPAA Security Guidelines must be implemented by April, 2005. The ADA offers a seminar on HIPAA compliance if needed. The Department of Health & Senior Services is updating the “Health Enterprise Zones”. The intent of this legislation was to provide economic incentives for new or expanded health care practices in underserved areas. In the December Delta Dental Plan Newsletter, new CDT codes were included. A CD Rom and a new handbook were distributed by Delta to those who participate in its network.
Dr. Joel Iserson, Chair of the Council on Dental Benefit Programs updated the Board on the Council’s activities related to incorporating oral health information into disease management programs, as well as the current status of this issue with various dental care plans. He then presented a resolution for the Board’s consideration, which was unanimously approved by the Council in light of the developments in disease management and the important role dentists can play in the health of their patients. The following resolution was presented to the NJDA Board of Trustees.
Resolved, that NJDA recommend to its members the routine monitoring of patients’ blood pressure during visits to the dental office.
The chairman explained that the Council was endeavoring to be cooperative and proactive in working with insurance companies and was looking to the NJDA Board for endorsement of the concept. Insurance companies are interested in this and are using it as a marketing tool. A motion was made, seconded and unanimously approved by the Board to Table the resolution to the next Board meeting to determine if there is any ADA policy on the subject.
Communications and Governmental Affairs – Mr. Eric Elmore
Membership Directory is a little behind schedule due to the fact that a lot of verification is required. Our anticipated deadline is approximately six weeks. Also the Internet Audit has been pushed back. The ADA Spokesperson Training program is scheduled for March 30th, between 10:00 am and 4:00 pm. There is room for 15 participants; first come, first serve.
Council on Membership & Assistant Counsel – Mrs. Tricia DeCotiis
Reported on the success of the programs involving the students at UMDNJ-NJDS. NJDA has met with the freshmen, sophomores and juniors and the programs have been very successful. Recently NJDA hosted a luncheon for juniors with Association Past Presidents conducting a question and answer session. Approximately 50 to 60 Juniors were in attendance. Both the students and the faculty of NJDS appear to recognize our commitment to the students.
The Disaster Victim Identification Team has made some great strides in integrating into New Jersey’s Emergency Management Plan. The Acting Medical Examiner and the Chair of the DVIT have developed a working relationship and DVIT members and NJDA staff will be meeting with the Department of Health officials regarding forensic dentistry issues.
The Employment Exchange Program has been expanded to hygienists and assistants and currently we have 142 hygienists and 71 assistants registered. To date 262 dentists are enrolled. Many of the hygienist and assistant registrations will not be visible on the system because they have requested confidentiality.
GE Medical Protective (professional liability insurance) has terminated its endorsement with the NJDA. It is still doing business with dentists. It felt it was not financially beneficial to continue the endorsement. The sub-committee of the Board has contacted and met with other brokers and a meeting is being arranged with TDIC from California. There is an increasing trend in dental liability suits and payments. For the first time an NJDA member has not been able to obtain professional liability coverage.
STATE BOARD OF DENTISTRY – Dr. Robert A. Hersh
On January 19, 2005 the primary issue discussed was the matter of information profiles mandated by the New Jersey Health Care Consumer Information Act. Currently, this act requires that New Jersey physicians, podiatrists and optometrists participate in a mandatory information profile, which is accessible electronically. The profile includes professional school attended, date graduated, disciplinary actions imposed by state boards, malpractice settlements and information unique to one’s practice such as hospital privileges or insurance plan participation.
Mr. Meisel and Dr. Hersh spoke in opposition to the inclusion of dentistry. The cost of implementing the profile for New Jersey dentists is estimated to be about $100,000.00. It was pointed out by Mr. Meisel that dentist profiles were not required by the statute and that an expenditure of this magnitude in order to provide the public with an electronic profile is a poor use of funds, particularly when the information is already obtainable through other sources. It was further pointed out that if the dentists of New Jersey are compelled to absorb the cost of this project, it will, in all likelihood, be passed through to the public in increased fees.
The State Board voted unanimously to reject increasing the budget for the profile project in anticipation that the New Jersey Legislature may include dentists in the future.
REPORT OF OFFICERS
PRESIDENT – DR. FRANK J. GRAHAM
In 2010 the ADA will hold its Annual Session meeting in New York combining it with the Greater NY Dental Meeting.
PRESIDENT-ELECT’S REPORT – Dr. August Pellegrini
The President-Elect’s Conference in Chicago the issues receiving the most attention were access to care and the independent practice of hygienists. There is nothing new on the Alaskan Health Aid issue. The 2004 market share was up to 71.4%, net membership was up 2,300 and female membership was up by 1,500. Regarding the PGY-l licensure requirement, the students in NY currently have an option whether or not to participate in a residency program but in 2007 the residency program will be mandatory.
EXECUTIVE DIRECTOR’S REPORT – Mr. Arthur Meisel
The year end membership number is 4,593 giving us a net increase at year end of 60 members over last year which had a net increase of more than 100 from the year before. At this time we are clearly ahead of last year’s number.
Regarding the PIP fee schedule, a new schedule was published and adopted by the Department of Banking and Insurance. The Department was urged to promulgate a comprehensive medical fee schedule before acting on its dental fee schedule proposal. The Department responded that it is not required to, and has determined not to, promulgate a new or revised medical fee schedule before adopting the proposed dental fee schedule.
The $75.00 malpractice fee to dentists has also been charged to lawyers. The Bar Association has brought suit, challenging that fee. He reviewed the brief filed by the Bar Association. In his judgment it is not likely to win. In addition to the $75.00 fee, there is also a charge of $3.00 per employee to every employee who participates in the New Jersey Unemployment Compensation Fund. The charge can be passed on to employees.
NEW BUSINESS
The Middlesex County Dental Society presented a resolution to the NJDA Board of Trustees:
Resolved to revisit the mechanism of distribution of the House of Delegates information packet and all other communications in order to reduce association costs with special consideration for the use of electronic communications. It is still suggested that one printed copy of the House of Delegates packet be
Kept on each delegate table for reference at the meeting.
APPROVED by the Board to refer this resolution to the House of Delegates Committee on Rules and Order.
Dr. Barbara Rich, National Board Examiner, gave a PowerPoint presentation about developing a uniform national board exam nationwide. To date, those on board with ADLEX are CRDITS, NERB, SRTA and some individual states. The only licensing exam not on board is WREB, from the western states. It was on board but withdrew and is working with the ADA on looking at national representation.
Dr. Cecile Feldman, Dean of NJDS
Dr. Michael Glick, professor and chair of the Department of Diagnostic Sciences at UMDNJ has been named the new JADA editor.
There were 1100 applications for acceptance into the dental school, the highest number to date. It accepted approximately 90 students and expects to graduate between 75-80 students. She reported that NERB changed to a curriculum intergraded format and the students recently took the mannequin portion of the NERBs. The average pass rate nationally was around 80%, while about 92% passed from UMDNJ. The licensing exam consists of three parts; written, testing on a mannequin and testing on a patient.
ANNOUNCEMENTS
Dr. Graham reported that “Access to Care” is the buzzword at the ADA and in the legislature. A Task Force to develop an Association Plan on how to deal with “Access to Care” was formed.
Dr. Graham in his President’s Report discussed what the ADA and other Societies were doing regarding the tsunami disaster and asked that NJDA consider making a donation. After a short discussion, a motion was made, seconded and unanimously ADOPTED by the Board to approve a $2,500.00 donation from the NJDA to the tsunami disaster relief fund through the ADA.

April 2005 Newsletter

President's Message

MCDS Board of Trustees Report

Treasurer's Report

Announcements/Articles