Dr. John Nosti graduated from UMDNJ-New Jersey Dental School, Newark, NJ in 1998 and did a General Practice Residency at Lehigh Valley Hospital, Allentown, PA.
He is currently practicing at Advanced Cosmetic and General Dentistry, Mays Landing & Somers Point, NJ and in Manhattan, NY. Dr. Nosti practices full time with an emphasis on Functional Cosmetics, full mouth rehabilitations, and TMJ Dysfunction. His down to earth approach and ability to demystify occlusion and all ceramic dentistry has earned him distinction among his peers. He has lectured nationally on occlusion, rehabilitations, and advanced diagnostic technology (JVA/JT and T-scan).
Have you been worried about treating patients who show signs of occlusal breakdown? Would you like to effortlessly add more cosmetic treatment to your dental office without the need for advertising? Join Dr. John Nosti as he reviews the main causes of occlusal breakdown in your patients. He will discuss ways to engage your patients and get them enrolled in their treatment, as well as review his initiating treatment protocol and preparation design on these complex cases. This lecture will teach you that you can be predictable in restoring worn dentitions and will allow you to enhance your Functional Cosmetic practice!
• Identify the most frequently prescribed FDA-approved medications.
• Review the basic mechanism of action, principle therapeutic indications, and potential adverse reactions and drug interactions of these medications. • Discuss the clinical dental considerations of these medications and their potential impact on dental therapy.
There was no MCDS Board Meeting or General Meeting in May, so there are no meeting minutes, pictures, and no Treasurer’s report in this newsletter. The usual newsletter format and content will return for the October issue.
In Memoriam: Leon Horlick
Born in New Brunswick he lived in North Brunswick before moving to Princeton over 30 years ago. He received his bachelors degree from Rutgers University and graduate and doctoral degrees from New York University. After serving in the United States Army, he opened his own dental practice in North Brunswick where he remained for over 45 years before his retirement.
Dr. Horlick was a founding member of Congregation B’Nai Tikvah in North Brunswick. He was past president of Shari Shalom Jewish Community Center in South Brunswick and was a member of the North Brunswick Lions Club.
In Memoriam: Sam Galkin
Dr. Samuel Bernard Galkin, 83, of Edison, passed peacefully on Sunday, July 3, 2016 at the NJ Veterans Memorial Home at Menlo Park. He was born in Newark, grew up in Hoboken, and lived a majority of his life in Colonia. He attended the University of Connecticut, received his DDS degree from Temple University and completed his orthodontic training at the University of Illinois in Chicago, where he also earned a masters degree. He served as a dentist in the US Navy from 1958 to 1961. He retired from his Orthodontics practice in 2005 after serving the community for over 43 years and was proud to leave his practice in the hands of his son Scott. He was a classic car collector, a longtime fan of professional wrestling, and a NASCAR fan. Samuel was a Life member of the American Dental Association, as well as a Diplomate of the American Board of Orthodontics. He was also one of the individuals instrumental in starting the General Practice Residency Program at JFK Medical Center years ago.
Samuel leaves behind his sons, Dr. Scott D. Galkin and his wife Dana of Little Silver, Seth Galkin, Esq. of Parlin, his two grandchildren, Jacob and Julianna and one brother, Dr. Edwin N. Galkin of Edison.
NJDA Board of Trustees Report - April 20, 2016
UNFINISHED BUSINESS
Drs. Rothong and Chinoy reported that they revised the term limits for ex-officio positions, everything else remains the same. A motion was made, seconded and unanimously ADOPTED by the Board (Vote #1 BT-16-4-12) to approve the revision of the Term Limts and recommend its passage at the June House of Delegates meeting. (Editors note: The term limits motion FAILED to pass at the June NJDA HOD Meeting)
NEW BUSINESS
Dr. Kevin Corry reported that he received a contract from a company called the Lending Club. They are in competition with Care Credit. He showed the contract to Mr. Meisel. He just wanted to bring this to everyone’s attention and let them know how important it is to read the entire contract before signing.
STAFF REPORTS
Membership – Mr. Brendan Breen
Mr. Brendan Breen reported that the Committee on New Dentists is in need of direction. They feel that many of its duties are duplicated by other Councils. Dr. Satwah, Chair of the Committee, would like to integrate committee members as a liaison to other committees/councils to coordinate information. Dr. Satwah would then, in turn, report back to the Board of Trustees.
He also reported that NJDA’s numbers were up overall and slightly down in Active Life and that revenue is also up.
Dr. Mark Vitale suggested a milestone recognition program for members with a letter for member’s first year, after five years and after ten years.
Dr. Shah asked that we target New Dentists and encourage each component to develop a New Dentist program and coordinate this with NJDA.
Dental Benefits – Dr. Joan Monaco
Also a new CE program has been developed to accommodate our members needs for the ICD 10 Medical coding transition. This will be presented June 15th at NJDA headquarters.
She is also working on a new project, a manual for Judicial Procedures. We have received a manual from Virginia Dental Association on this and the ADA code of ethics. There were problems where procedures were not followed. To prevent this, we should have a manual.
Mr. Jim Schulz, Dr. Vitale and Mr. Art Meisel met with representatives of two MEWAs (Multiple Employer Welfare Arrangements) located in NJ – Qualcare and the Association Master Trust – to learn more about how they work and, what, if any, advantages NJDA and its members would have in becoming a member of either. The MEWAs focus on delivering health insurance products and allow smaller employers in the self-insured marketplace.
The ADA is developing a credentialing program that can be used in the public and private insurance space. The intention is to centralize credentialing so as to speed the pace of this often slow and laborious process. There are several companies in the marketspace presently but it remains a challenge.
PROGRAMS & DEVELOPMENT – Mrs. Maureen Barlow
A request was made for the Board to approve the Bank of America Component Sponsorship Program now before components begin scheduling its monthly meeting for 2017. A motion was made, seconded and unanimously ADOPTED (Vote #2 BT-16-4-13) that we continue to support Bank of America to be the sole sponsor at component meetings.
2016 Annual Session -
Regarding the 2016 Annual Session, we have 404 registrants vs. 518 last year same time. However, the good news is that we are better on the revenue side. We are shy $6,300.00 in revenue from the total of last year. Monmouth-Ocean, Middlesex and Mercer registrant numbers are all down. She reminded everyone that it is important to have face time with the exhibitors; that is what the exhibitors are looking for.
Upcoming Programming -
Mrs. Barlow reminded everyone of some upcoming dates: September 28th is Resource Day and October 5th is the Business to Business Breakfast. Please mark your calendars.
Communications – Mrs. Lorraine Sedor
She is working on refreshing the website with the ADA and it should be more user friendly. With the help of Samantha Bove, our social media presence on Facebook has been steadily growing.
Governmental & Public Affairs – Mr. Jim Schulz
Mr. Jim Schulz reported that the most significant thing going on in Trenton at the moment are the Legislative Budget Committees. He is trying to push the Dental Director issue with the budget committee members. He reported that legislation regarding new regulatory requirements for handling “Hazardous Drugs” has been amended to remove dentists and dentistry from having to comply with the bill’s requirements. Mr. Schulz explained that he educated the legislators that the CDC protocols in this area don’t apply to dentistry as dentists rarely, if ever, come in contact with these types of drugs. Mr. Schulz also updated the Board on the ADA’s federal activity. He pointed out that the ADA and AAOMS have aligned on the non-covered services reform bill that was introduced in Congress (HR3323).
He also explained that while there are now 3 dentists in Congress, two new member dentists are running for office in Florida and Georgia.
The final touches on the Town Hall luncheon have been finalized. Senate Minority Leader Tom Kean and Senator Commerce Committee Chairwoman Nia Gill have accepted our invitation to speak at the Town Hall. They will be named as our Dental Champions for 2016.
Executive Director & Executive Director – Mr. Arthur Meisel
Mr. Meisel has received three calls on Stericycle. The company is putting pressure on dentists telling them that they need a black container for even the smallest amounts of liquids remaining in carpules. According to NJ Department of Environmental Protection, capsules must be handled the same as other sharps.
Mr. Meisel is seeking Board authorization for him to represent a member on an appropriate case. A motion was made, seconded and unanimously ADOPTED by the Board (Vote #3 BT-16-4-14) to give Mr. Arthur Meisel authorization to represent a NJDA member as his attorney.
Dr. Gregory LaMorte reported on the MOMs project. Originally we were going to do MOMS for veterans, however, we were approached by Delta Dental to do a MOMS project for indigent people. Delta Dental would supply the money and their expertise and NJDA would supply the volunteers. The Board was not comfortable with their proposal and would like to continue with the mini-MOM for veterans. A motion was made to tell Delta Dental that we cannot accept the change in the MOMS Program. An amendment to the motion was made, seconded and unanimously ADOPTED by the Board (Vote #4 BT-16-4-15) to continue with supporting the mini-MOMS Program for veterans. The original resolution was declared withdrawn.
GUEST: Dr. Feldman
The Dean reported that in January 70 – 80 students were going on to residency programs. The PGY1 for Rutgers is approximately 70% which is higher than nationally at 50 – 60%. She also added that about 60% of residency students stay in New Jersey. International students usually do not go into a PGY1 program.
Dean Feldman announced the official opening yesterday of the Dental Specialty Center which is located on the second floor at the dental school. This now puts all the specialties in one area. She invited everyone to visit the center; it is state of the art. Rutgers began construction on its new facility in New Brunswick and anticipates its opening around Labor Day. It will house its CODE Program and faculty practice.
She reported that last week they announced Rutgers Health, a health card entity for dental and medical. It is broken down into three divisions: Rutgers Health, Rutgers Health Group and Rutgers Health Network. Rutgers Health is to bring different practices together for value driven health care and to deliver high quality service to increase patient satisfaction. Rutgers Health Group is faculty practices for Rutgers’ two medical schools coming together. Rutgers Health Network is for forming partnerships with hospitals, covering all age groups.
Pemphigus and Pemphigoid: The Unique Role of Dentists
Pemphigus and pemphigoid (P/P) are rare, autoimmune blistering diseases that affect a very small percentage of the population. The average patient with P/P sees five doctors over ten months in search of a diagnosis for their condition. Delays in diagnosis and appropriate treatment can lead to a number of complications, including significant functional impairment, resistance to treatment, psychological stress, and a lower likelihood of achieving remission.
The majority of P/P patients present with oral symptoms before the onset of skin lesions. Because of this, dentists have a unique opportunity to help shorten diagnosis times by identifying signs and symptoms when they are first encountered.
Pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) are two forms of P/P with increased presentation in the mouth. Oral lesions of PV/MMP are often initially misdiagnosed as “allergies” to dental products, foods or environmental agents or “non-specific gingivitis”, further delaying diagnosis (a biopsy) and appropriate treatment.
A catch-all clinical descriptor often used in dental practice is “desquamative gingivitis.” This describes a chronic type of gingival inflammation in which the epithelium detaches, leaving exposed ulcers. Desquamative gingivitis can be caused by several diseases that affect the oral cavity, so the practitioner needs to obtain a definitive diagnosis.
Consider a diagnosis of P/P when a patient presents with a combination of:
• Multiple ulcerated or erythematous oral lesions that don’t resolve in 7-10 days
• Lesions outside the mouth, including those on other mucosal surfaces and the skin
• Lesions that develop following minor trauma (Nikolsky sign), such as gentle lateral pressure, which weakens the adhesion between epithelial cells and the underlying connective tissues
Care and Maintenance
PV/MMP patients require special care during dental appointments to manage sensitive areas of the mouth and prevent further lesions from forming. Oral lesions can be very painful for patients, making it difficult to brush teeth and maintain proper hygiene. Consequently, patients may experience increased incidence of dental caries and periodontal disease. Dental prophylaxis should be performed on a regular basis, even when lesions are present. Good oral hygiene is very important to positive treatment outcomes.
Care and maintenance tips for dental professionals:
• Do a complete oral mucosal examination. Evaluate for any abnormalities, including secondary complications of PV/MMP treatment, such as candidiasis.
• Be gentle during maintenance appointments.
• Schedule more frequent appointments to control plaque build-up.
• Consider scheduling extra time and using local anesthesia, as patients may experience pain and bleeding during dental treatment.
• Use simple hand scaling instruments to increase control and minimize trauma to the oral tissues.
• Polish teeth with a non-abrasive toothpaste, avoiding harsh abrasives and air polishers, as particles may become embedded in the ulcerated tissue and set off a foreign body reaction.
• Avoid alcohol-based mouth rinses.
• Oral hygiene instructions for home care should be tailored to the level of mucosal involvement. When significant oral disease is present, gentle home care -- including extra-soft toothbrushes, mildly flavored toothpastes, and mild mouth rinses -- may be all the patient can tolerate. Some patients may not be able to floss due to bleeding and pain, so soft interdental brushes may be recommended instead.
• If patients are on a soft diet due to presence of oral ulceration and pain, suggest intake of nutritious, non-cariogenic options such as vegetable soups, fruit smoothies, etc.
The International Pemphigus and Pemphigoid Foundation (IPPF) is the world’s leading organization dedicated to improving the quality of life for all people affected by pemphigus and pemphigoid.
More information can be obtained by visiting the IPPF Awareness Campaign website at www.pemphigus.org/awareness or by contacting [email protected]
For more information about this article, contact Jasmine Graham, Content & Evaluation Volunteer, International Pemphigus and Pemphigoid Foundation (IPPF), 855-473-6744