NDA JOURNAL Spring 23 Volume 25, Issue 1 Official Magazine of the Nevada Dental Association and Component Societies A Peer Reviewed Journal
SPRING 23 NDA JOURNAL Editor’s Message Daniel L. Orr II, DDS, MS (anesth), PhD, JD, MD 2 News Project Veritas Report on Pfizer Experimental 6 Formulation Protocols Featured Articles Cochrane Library Analysis on Functionality of Physical Barriers to Respiratory Disease Transmission 8 Front Office’s Guide to Having a Dental Practice 9 Video Filmed For Your Practice Role of Radiology in Assessing Periodontal Defects 14 Reports NDA President and Executive Director 18 Jason R. Doucette, DMD; Michele M. Reeder SNDS President Ronald J. Laux, DDS 20 SNDS Executive Director Esther Johnson 21 NNDS Executive Director Lori Benvin 22 NNDS President Hannah Beus 23 Sections Event Calendars 24 Administrative Offices & NDA Committees 25 On the Cover Dentistry using cable-driven handpieces and spitoon. Nevada Dental Association 600 E. William Street, Ste 202 Carson City, NV 89701 PH 702-255-4211 FAX 702-255-3302 EMAIL [email protected] WEB www.nvda.org NDA Journal is published four times each year by the Nevada Dental Association and state component societies. All views expressed herein are published on the authority of the writer under whose name they appear and are not to be regarded as views of the publishers. We reserve the right to reduce, revise, or reject any manuscript submitted for publication. Materials: All articles, letters to the editor, photos, etc. should be sent to Daniel L. Orr II, DDS, via email to [email protected]. All chapter and committee reports and business communications should be sent to Michele Reeder, Executive Director, Nevada Dental Association, 600 E. William Street, #202, Carson City, NV 89701. Ph: 702-255-4211. Materials may be reproduced with written permission. Subscription: Members receive each publication as a membership benefit paid by membership dues. Non-members may subscribe to the Nevada Dental Association Journal for $50 annually. Advertising Policy: All advertising appearing in the NDA Journal and other Nevada dental publications must comply with the advertising standards of the Nevada Dental Association and its component societies. The publication of an advertisement is not to be construed as an endorsement or approval by the publishers of the product or service being offered in the advertisement unless the advertisement specifically includes an authorized statement that such approval or endorsement has been granted. The publishers further reserve the right to cancel any and all contractual advertising agreements should an advertiser be engaged in litigation concerning their product or service, or should the product or service be in conflict with the standards of the NDA or its component societies. Advertising rates and specifications are available upon request. Contact Grandt Mansfield, LLM Publications, at 800-647-1511 ext 2226 or email [email protected]. Mailing: Send address changes to: 600 E. William Street, #202, Carson City, NV 89701. © 2023 Nevada Dental Association Editor Daniel L. Orr II, DDS, MS (anesth), PhD, JD, MD [email protected] Publisher LLM Publications 800-647-1511 www.llmpubs.com Design: Shelby Bigelow NDA JOURNAL
NDA Journal 2 Dr. Orr practices Anesthesiology and OMS in Las Vegas, is an Adjunct Professor (Surgery) at UNLV SM and Touro University SM (Jurisprudence), Professor Emeritus at UNLV SDM, and a member of the CA Bar and Ninth Circuit Court of Appeals. Editor’s Message Daniel L. Orr II, DDS, MS (anesth), PhD, JD, MD [email protected] NDAJ Exclusive Rethinking History and Physical Examinations in the Age of Covid Experimental Formulations Recently a fascinating paradigm has surfaced nationwide, and that is when politicians, administrators, regulators, and other non-doctor types deign to opine, even command, what doctors should be doing. That model is not new and historically rarely ends well for citizens interested in their health, such as with the military anthrax vaccinations of decades past.1,2 On January 01, 2018 then Governor Brian Sandoval signed into effect a new controlled substance (CS) prescribing law, AB 474.3 The law’s promotional apparatchiks promised to make CS writing safer for patients in Nevada. Predictably, the law made things worse, far worse, including documented increases in illegal drug use, ER visits, overdose deaths, pet abuse, and more.4 Many doctors and the NDAJ had preemptively warned about these potentiated side effects of the proposed law, but to no avail. To put teeth into their feckless legislation, politicians sought to control the rascally doctors (remember the fake news “prescription opioid crisis”?5), by passing laws that made it virtually impossible to legally prescribe CS in Nevada. This of course prompted a huge number of doctors, formerly drug diversion watchdogs but now categorically grouped as drug diversion targets, to stop writing for CS.6 However, illicit drug dealers, the actual problem in the first place, benefited immensely from less competition. Taking a cue from Sandoval, subsequent Governor Steve Sisolak decided to tell health professionals what to do during the non-emergency Covid non-crisis. 99+% of individuals that contract Covid recover with no side effects, and most of those never knew they had the disease. But this didn’t stop Sisolak from mandating this and that. In Nevada we were told to mask-up, social distance, what to prescribe or not to prescribe, and what surgical procedures were allowed…all without any evidence at all supporting the mandates. There has not been one study to date that shows masking does anything at all to limit the spread of the virus,7 which can march through mask fibers 10-abrest. No study has been shown that 6' of social distancing, an arbitrarily made-up prophylaxis, does anything to prevent the spread of Covid. And anyway, if 6' is so great why not command 7'?8 Then, of course, there were the Coo-coo for Co-co poke promoters, layers upon layers of financially and otherwise conflicted, ingenuous, or intentionally deceitful politicians, doctors, regulators, administrators, and investors who routinely assured us the injections were “safe and effective.”9 Sadly, we now know that neither descriptor was remotely true. A few of the former pro-experimental formulation crowd are now anxiously backpedaling,10 perhaps realizing that the legal immunity the federal government granted to itself and Big Pharma does not extend to others. In fact, lawsuits have already been filed and grand juries impaneled.11 Legal immunity is generally a non-starter if a crime is proven (perhaps fraud or conspiracy to start?). Remember that on September 1, 2021, mid-level CDC staff intentionally mislabeled the experimental Covid formulations as “vaccines,” by changing the definition
Spring 23 www.nvda.org 3 Editor’s Message of vaccine after 250 years of prior use. Sadly, for many this unethical move then further called into question any agent at all that is dubbed a vaccine, even the traditionally accurate ones, as far as the confused public is concerned.12 Further, this conflicted group suppressed less expensive, safer, and more effective treatments13,14 with tyrannical decrees, and crippling penalties including license revocation.15 For many, the promoters have lost all credibility not only regarding Covid matters, but any health-related topic they opine on. In one of the planned moves to legitimize the Covid narrative, dentists were recruited to start “vaccinating” Covid-phobic patients deceived into believing the safe and effective narrative. Most dentists have never been trained to administer anything parenterally except placing technically and anatomically demanding intraoral local anesthetic agents. The emergent expansion of dental scope was not necessary. Covid was not an emergency in reality, but only because politicians called it one (“malum prohibitum,” or “it’s bad because we say it is”). Plus, pharmacies now inject clients with safely perform essentially all other injections, including subcutaneous vaccinations. To be clear, the NDAJ supports the NDA’s 2023 legislative goal of a statutorily recognized ability of trained dentists to administer historically defined actual vaccines. However #2, the NDAJ does not support anyone at all administering an experimental formulation that their choice of formulation at no charge. For multiple reasons, including financial,16 the NDAJ opined against succumbing to the call of the Covid injection crowd dentist scope expanders.17 A big “however”, however…any health professional that can administer an intraoral inferior alveolar nerve block is technically gifted enough to Although the NDAJ strongly supports recognizing that dentists are able to administer subcutaneous injections, the NDAJ does not support anyone injecting experimental formulations absent peer reviewed controlled studies confirming both safety and efficacy. »
NDA Journal 4 Editor’s Message government apparatchiks arbitrarily dub a “vaccine.”18 The report that dentists worldwide personally refused the experimental formulations more than other health professions is heartening in that dentists as a group appear to be circumspect about accurately translating the experimental formulation spin.19,20 Now we know, secondary to the most accurate mortality tables in the world, those of the life insurance industry,21,22 that not only did those who received the experimental formulations die from Covid, but are now known to be dying at a greater rate from all causes than those who did not.23,24 The formulations were neither safe nor effective, no matter how many unplanned boosters were subsequently recommended. The statistically significant increase of adolescent inflammatory myocardial disease after administration of the experimental formulations is devastating,25,26,27 as acknowledged by more and more cardiologists.28,29 Many other patient populations are seeing similar life-threatening effects. Particularly sad are the sequels of pregnant women that accepted the narrative from the government (CDC) and professional societies (American College of Obstetricians and Gynecologists, Society for MaternalFetal Medicine, the United Kingdom’s Royal College of Obstetricians and Gynaecologists) that the injections were not only safe but even strongly recommended,30 all without any meaningful studies in place. There have been more VAERS Covid experimental formulation reports submitted in two years than for all other historically recognized vaccines since 2000.31,32 This and issues such as the rise of inflammatory heart conditions may prompt dentists to modify their office health history and physical examination (H&P) forms. » One change could be by inserting a disclaimer that the dental office cardiovascular system H&P is more limited than one might receive via a cardiologist utilizing a 12-lead ECG and laboratory blood work studies. Further, dentists who are trained to do H&Ps, often as a public service for entities like the Boy33 and Girl Scouts, church groups, school athletes, etc., may want to re-evaluate that voluntary practice. Members of the University of Nevada Las Vegas (UNLV) Sports Medicine (SM) faculty annually evaluate UNLV’s college athletes, generally a singularly healthy crowd. In 1987, UNLV SM was asked to examine Simon Keith, a great soccer player from England.34 Keith offered a history that included a heart transplant and a pacemaker. He wanted clearance to run around for 90-minute games at 115° in Las Vegas. Keith was referred to the SM cardiology consultant. With trepidation from everyone involved, except Keith, he was ultimately cleared to play and became an All-American for Coach Barry Barto. Now, adolescents that have been potentially compromised by any of the experimental Covid formulations perhaps should not be cleared for activity that requires an H&P without a full cardiac work-up, including a 12-lead ECG and hematologic lab studies. Sudden cardiac compromise under stress is an increasing phenomenon in this group of patients. No dentist needs to be reminded that many patients avoid dentistry all- together at times because of severe anxiety. Are these patients now at greater risk of cardiovascular compromise during dental visits? The NDAJ welcomes circumspect commentary. Fight On!0
Spring 23 www.nvda.org 5 Gundry S, Abstract 10712: Mrna COVID Vaccines Dramatically Increase Endothelial Inflammatory markers and ACS Risk as Measured by the PULS Cardiac Test: a Warning, Circulation, 2021: 144, Nov 8 2021. AHA Report, mRNA Covid-19 vaccines by Pfizer and Moderna have serious side effects, shows study, OPIndia, Nov 26, 2021, https://www. opindia.com/2021/11/mrna-covid-19-vaccines-increase-possibility-ofcoronary-diseases-study/amp/, accessed FEB 21, 2023. Leake J, McCullough P, Cardiologists Come to the Same Conclusion Regarding COVID Jab Side Effects, Epoch Health, 20 NOV 2022, https:// www.theepochtimes.com/health/cardiologists-come-to-the-same- conclusion-regarding-covid-jab-side-effects_4874934.html?utm_ source=healthtop5noe&src_src=healthtop5noe&utm_campaign= htop5-2023-02-05&src_cmp=htop5-2023-02-05&utm_medium= email&est=Qaca0b%2BFNrjuEJNprNKzRqm1V5ooGHK4fE9O% 2FmDhDu%2F6knr5OuEBCLVku%2BmlGRc%3D, accessed 07 FEB 2023. Malhotra A, Dear Prime Minister, The Covid mRNA Vaccine Scandal, DEC 18, 2022, https://twitter.com/DrAseemMalhotra/status/160440862569 8676736?s=20&t=QNr-UWiYe3A8hnmD7mQQlw, accessed FEB 21, 2023. References Roos R, GAO: Military anthrax shots caused many reactions, prompted some pilots to quit, University of Minnesota CIDRAP, NOV 8, 2002. Malone R, By a Midwestern Doctor: The First Mandatory Vaccination Campaign That Crippled America’s Pilots, February 16, 2023, https://rwmalonemd.substack.com/p/the-first-mandatory-vaccinationcampaign, accessed FEB 21, 2023. Orr D, A Bad Rx, NDAJ, 20:2, 2-9, Summer 2018. Price, L, Fagan S, Investigation the Relationship Between Nevada’s restrictive Opioid Prescription Laws and Deaths from illicit Opioids, NDAJ, 22:1, 12-13, Spring 2020. Orr D, A Bad Rx: AB474, Nevada’s Star Chamber Solution to a Fake News Problem, NDAJ, 20:2, 2-9, Summer 2018. Gillette D, Foutz S, Vanier C, Trends in Physician Opioid Prescribing Since Implementation of Nevada’s New Controlled Substance Laws, NDAJ, 21:2, 6-9, Summer 2019. Balmakov R, Dr. Fauci Admits In Closed-Door Testimony That He Can’t Name Studies Showing Masks Work, Facts Matter, Epoch TV, NOV 29, 2022. Stieber Z, Fauci Flagged Article Saying 6-Foot Social Distancing in Schools “Not Supported by Science,” Epoch Times, MAR 28, 2022. Fauci, A, We Just Need to Get More People Vaccinated, CNBC Closing Bell, JUL 21 2021, https://www.cnbc.com/video/2021/07/21/fauci-vaccinesare-safe-and-effective-against-delta-variant.html, accessed JAN 11 2023. Burack B, Doctor Rattles CNN Hosts With Reporting U.S. Vastly “Overcounted” Covid Deaths, OutKick, JAN 17 2023, https://www.outkick. com/doctor-rattles-cnn-hosts-with-reporting-us-vastly-overcounted-coviddeaths/, accessed JAN 18 2023. Saunders J, Florida Supreme Court impanels grand jury on COVID-19 vaccines, WUSF Public Media, DEC 23, 2022, https://wusfnews.wusf.usf. edu/health-news-florida/2022-12-23/florida-supreme-court-impanels-grandjury-on-covid-19-vaccines, accessed FEB 21, 2023. NDAJ News Brief, CDC Changes the Definitions of “vaccine” and “Vaccination,” 23:3, 4, Fall 2021. Crump A, Ivermectin: enigmatic multifaceted “wonder” drug continues to surprise and exceed expectations, The Journal of Antibiotics, 70: 495-505, 2017. Boschi C, Scheim D, et. al., SARS-CoV-2 Spike Protein Induces Hemagglutination: Implications for COVID-19 Morbidities and Therapeutics and for Vaccine Adverse Effects, Int. J. Mol. Sci., 23(24), 2022. Editorial Board, Wall Street Journal, California to Doctors: Agree With Us or Shut Up, OCT 11, 2022. Drukier C, Vaccine Injury (In)Justice: Empty Government Promises, Looming Financial Fallout, The Nation Speaks, Epoch TV, OCT 15, 2022. Orr, D, Kane’s Caution, NDAJ 22:1, 2-4, Spring 2020. CDC, Our Definition of “Vaccines” is Problematic, NDAJ, 24:1, p4-6, 2022. Busch M, Dentists, Dental Students Worldwide Resistant to COVID-19 Jabs, NDAJ Literature Review, 24:1, 8, Spring 2022. Fife J, How Will Covid Vaccine Mandates Impact the Healthcare Workforce? Adaptive Medical Partners, https://adaptivemedicalpartners. com/how-will-covid-vaccine-mandates-impact-the-healthcare-workforce/, accessed 07 MAR 2022. Austin M, Expert Expects Insurance Companies to Take Legal Action Against COVID Vaccine Makers Over “Early” and “Unexpected” Deaths, Western Journal, AUG 07, 2022. Jekielek J, Dissecting Life Insurance Industry Excess Death Data, 2021-2022, American Thought Leaders, JAN 24, 2023, https://www. theepochtimes.com/josh-stirling-dissecting-excess-death-data-and-howinsurance-industrys-trillions-could-be-deployed-to-help-the-vaccine-injured_5006731.html, accessed JAN 24, 2023. Cox C, Amin K, Kates J, Michaud J, Why Do Vaccinated People Represent Most Covid-19 Deaths Right Now?, KFF, NOV 30, 2022. Diamond, F, More vaccinated than unvaccinated died from COVID-19 in August: analysis, Fierce Healthcare, NOV 19, 2022, https://www. fiercehealthcare.com/payers/more-vaccinated-unvaccinated-now- dying-covid-19, accessed JAN 11 2023. Chiu SN, Chen YS, Hsu CC, et. al., Changes of ECG parameters after BNT162n2 vaccine in the senior high school students, European Journal of Pediatrics, 2023. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 Editor’s Message Demasi M, Whatever happened to Pfizer’s covid vaccine trial in pregnant women? https://maryannedemasi.substack.com/p/exclusive-whateverhappened-to-pfizers, accessed FEB 24 2023. Nelson C, Florida Surgeon General Warns Life-Threatening VAERS Reports up 4,400 Percent Since COVID-19 Vaccine Rollout, Epoch Times, FEB 17 2023, https://www.theepochtimes.com/florida-surgeon-generalwarns-life-threatening-conditions-up-4400-percent-since-covid-19-vaccinerollout_5064362.html?ea_src=ai&ea_med=search, accessed FEB 21 2023. Wang M, Serious Adverse Events and Death Reports for Major COVID Vaccines Increase on VAERS, Epoch Health, DEC 12, 2022, https:// www.theepochtimes.com/serious-adverse-events-and-death-reports-formajor-covid-vaccines-vaers_4918643.html?ea_src=ai&ea_med=search, accessed FEB 21, 2023. AAOMS Forum, Boy Scouts of America Recognize Dentists’ Right to Perform H&P, Autumn 1993. Keith S, Cole S, Yaeger D, Heart for the Game, Nexus Publishing, 2012.
NDA Journal 6 News Project Veritas Report on Pfizer Experimental Formulation Protocols 2. “Don’t tell anyone. Promise you won’t tell anyone. The way it [the experiment] would work is that we put the virus in monkeys, and we successively cause them to keep infecting each other, and we collect serial samples from them.” 3. “You have to be very controlled to make sure that this virus [COVID] that you mutate doesn’t create something that just goes everywhere. Which, I suspect, is the way that the virus started in Wuhan, to be honest. It makes no sense that this virus popped out of nowhere. It’s bullsh*t.” 4. “From what I’ve heard is they [Pfizer scientists] are optimizing it [COVID mutation process], but they’re going slow because everyone is very cautious— obviously they don’t want to accelerate it too much. I think they are also just trying to do it as an exploratory thing because you obviously don’t want to advertise that you are figuring out future mutations.” 5. “Because if the regulators who have to approve our drugs, you know that once they stop being a regulator they want to come References Malone, R, https://rwmalonemd.substack.com/p/project-veritas-hasbroken-pfizers, accessed 02 FEB 2023. Malone, R, https://rwmalonemd.substack.com/p/secret-decoder-pfizerlegal-document, accessed 02 FEB 2023. Malone, R, https://rwmalonemd.substack.com/p/third-dr-j-twalkerpfizer-project, accessed 02 FEB 2023. Shaw, J, https://hotair.com/jazz-shaw/2023/01/29/pfizers-response-toproject-veritas-left-much-to-be-desired-n527164, Accessed 02 FEB 2023. 1 2 3 4 work for the company, they’re not going to be as harsh on the company [inaudible 00:01:44] they’re getting a job.” 6. “Covid will probably be a cash cow for us for a while going forward which I obviously like.” 7. “So, in the pharma industry, all the government officials who review our drugs, mostly they come work for pharma companies.” The 2nd Project Veritas video and transcript is now also posted,2 as cis the 3rd. 3 Finally, Pfizer’s response can be viewed from links in J Shaw’s article.40 Project Veritas has broken Pfizer’s Gain-of-Function Research program wide open.1 Transcripted quotes from the first of three interviews from Jordon Triston Walker, MD, Pfizer Director of Research, Development, and Strategic Operations include the following: 1. “One of the things we’re exploring is like, why don’t we just mutate it [COVID] ourselves so we could create—preemptively develop new vaccines, right? So, we have to do that. If we’re gonna do that though, there’s a risk of like, as you could imagine—no one wants to be having a pharma company mutating f**king viruses.” “Because if the regulators who have to approve our drugs, you know that once they stop being a regulator they want to come work for the company, they’re not going to be as harsh on the company [inaudible 00:01:44] they’re getting a job.”
Spring 23 www.nvda.org 7 News
NDA Journal 8 Featured Article Cochrane Library Analysis on Functionality of Physical Barriers to Respiratory Disease Transmission A writing by Robert Malone, MD, reports that the Cochrane Library has been reviewing the use of physical interventions to interrupt or reduce the spread of respiratory viruses since 2010. By physical interventions, they mean masks, shields, gowns, hand-washing, etc.1 According to the Library: “Viral epidemics or pandemics of acute respiratory infections (ARIs) pose a global threat. Examples are influenza (H1N1) caused by the H1N1pdm09 virus in 2009, severe acute respiratory syndrome (SARS) in 2003, and coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 in 2019. Antiviral drugs and vaccines may be insufficient to prevent their spread.” “The high risk of bias in the trials, variation in outcome measurement, and relatively low adherence with the interventions during the studies hampers drawing firm conclusions. There were additional RCTs during the pandemic related to physical interventions but a relative paucity given the importance of the question of masking and its relative effectiveness and the concomitant measures of mask adherence which would be highly relevant to the measurement of effectiveness, especially in the elderly and in young children.” “The pooled results of RCTs did not show a clear reduction in respiratory viral infection with the use of medical/surgical masks. There were no clear differences between the use of medical/surgical masks compared with N95/P2 respirators in healthcare workers when used in routine care to reduce respiratory viral infection. Hand hygiene is likely to modestly reduce the burden of respiratory illness, and although this effect was also present when ILI and laboratory-confirmed influenza were analyzed separately, it was not found to be a significant difference for the latter two outcomes. Harms associated with physical interventions were under-investigated.” “There is a need for large, well- designed RCTs addressing the effectiveness of many of these interventions in multiple settings and populations, as well as the impact of adherence on effectiveness, especially in those most at risk of ARIs.” Diseases evaluated included influenza and COVID-19 during the pandemic, and these researchers failed to find even a “modest effect” on infection or illness rates from any type of mask. Furthermore, the effects that masking is having on health, childhood development, speech development, etc. are unknown and are under- investigated. The answer to the damage done may never be documented. Many mask mandates are gone, but many still remain, and governments will reinstate the directives at a whim.2,3,4 The CDC is still recommending masking in areas with “high” transmission levels and also recommends indoor masking to protect high-risk contacts in “medium” counties. Currently, that means 27% of all counties in the USA. Luckily, more and more Americans aren’t drinking the Kool-Aid. Only 15.5% of Americans have received the bivalent recent booster. The CDC has now removed the category of six months to under five on its vaccine tracker page, but the data can be found on a deep dive. It appears to be about 8% vaccinated for this age cohort. References Jefferson T, Dooley L, et.al. Physical interventions to interrupt or reduce the spread of respiratory viruses, Cochrane Library, https://img.theepochtimes. com/assets/uploads/2023/02/03/2_Malone_Masks-1200x625.jpg, accessed 07 FEB 2023. Shamus K, Ann Arbor schools require masks as several others recommend masking, Detroit Free Press, 10 JAN 2023. Tilley C, Masks make a comeback: Hundreds of thousands of students across the US will be forced to wear face coverings when classes go back this week as schools revive controversial mandates, Dailymail.com, 02 JAN 2023. Coviello J, University advises masking indoors as winter illnesses spike across Connecticut, Charger Bulletin, The University of New Haven, 01 FEB 2023. 1 2 3 4 0
Spring 23 www.nvda.org 9 Jeremy Tuber, Marketing Director Arizona Dental Association Vice-President American Association of Dental Editors and Journalists (AADEJ) So, your dentist(s) has decided they’d like to have a promotional video filmed for the practice. Great, right? Well, oftentimes the communication and coordination responsibilities on putting the video shoot together fall directly onto the front office staff. Maybe that’s the position you find yourself in and you’re not certain how to manage it all. If you’ve not worked with a video production professional or company before, it can be a little nebulous and perhaps even a little intimidating. However, with a little insider information, you can make the process easy for your team, your dentist(s), and any patients you might have come in and participate. Covering all aspects of working with a video crew is beyond the scope of this condensed article. However, one of the first questions the front office staff has been, “Who should we include in the video?” The answer isn’t as obvious as you might expect. The answer is, “Whomever you select, choose wisely.” TEAM MEMBERS If you have team members who are beyond just being a little camera shy— they’re either terrified or ticked off about being on camera, don’t force them. Adept videographers can do a lot to make people look and sound their best. However, there’s very little they can do to hide if someone is self-conscious or annoyed about being on camera. Choose team members who genuinely want to represent the practice in the video. If you have a larger office, it might not be necessary to include everyone in the video. In fact, trying to ensure that everyone gets into the video might be counterproductive and time-consuming. Special note about team members in the video: An additional question the front office routinely asks is, “What happens if we had a video filmed but one or more dental team members are no longer with the practice?” It depends on their role in the video. For dental team members who are just featured in some of the non- speaking/action footage part of the video, (also called “bRoll” by video professionals), it’s not a big deal. However, if you had the team members being interviewed on camera, you might need or want to remove them if they leave the practice. Therefore, be wary about asking the dental team to speak on camera. Most dental practices typically just have the dentist(s) speaking on camera—on a rare occasion a long-time office manager. PATIENTS OR “PATIENT STAND-INS” If you’re interested in having actual patients come in and help out with the video (either providing a video testimonial or just being in some of the bRoll), choose wisely. Choose patients who are comfortable on camera, who love your practice, and who have the time to come in for an hour or so and participate. Featured Article » Front Office’s Guide to Having a Dental Practice Video Filmed for Your Practice
NDA Journal 10 If you’re asking patients to provide a video testimonial, it may feel like an unnecessary step, but consider initially asking them, “What do you enjoy about the practice? What might you share about this practice on camera?” Your goal in asking them this question is to learn ahead of time what they’ll say on camera and to get them to start thinking about what they’ll say. All too often, well-intentioned patients blurt things out on camera like, “I love this practice because they are so cheap,” or “Dr. Smith is great because I can call them on their mobile phone over the weekend and they respond!” Yikes, both statements might be true, but they should be kept on the DL and not included in the final edit of the video. Of course, statements like this can be easily edited out, but you want to ensure you don’t invest time in having a patient provide a testimonial that is bland, flat, or even one you can’t use. Gently suggest to patients offering a testimonial that they do a little thinking about what they’ll say before the cameras start rolling—maybe even practice what they’ll say in front of a mirror or a friend/family member just a little bit. Patients, dentists, and just about everyone who hasn’t been on camera before assume that they can just “wing it.” And in truth, some can. However, for most of us, doing a little preparation and visualizing what we’re going to say ahead of time will help tremendously. You don’t need to give patients the third degree about what they’ll say on camera—let it come from their heart but guiding them a little and helping to clarify what they’ll say might make a mediocre video testimonial a great one. Just asking them ahead of time, “What do you think you’ll share/say?” is enough to get them to do a little don’t ask friends and family members to provide fake patient testimonials). Friends and family members usually are more willing to help, and they don’t often require any compensation! Nevertheless, it might be nice to provide anyone outside of the dental team with a gift card, free whitening, or some small token of appreciation for taking time out of their day to help you. BONUS TIP: Consider bringing in a veggie/fruit plate or some doughnuts for people to nosh on while they are not on camera. BEING PREPARED ON THE DAY OF FILMING It usually takes a film crew about an hour or so to set up, so if you’re filming first thing in the morning, perhaps plan on having at least one person arrive an hour early to let the crew in to move their gear in and set up. Note: expect the video crew to need 20–40 minutes to pack up their gear after the shoot has wrapped up. Building off this first point, video crews typically have a lot of gear, so they must find a safe out-of-theway place in the practice to store it. Before the video crew arrives, consider a lower-traffic area of the office where they could store their gear. Make certain there isn’t any printed/ digital sensitive information (or valuables) lying about. It might be tempting to squeeze a few patients in, perhaps schedule a prophy or two, during the shoot, but it’s not recommended. You won’t be able to give your full attention to your patients or to your video crew, so outside of an emergency patient, avoid scheduling appointments during the video shoot. If you are conducting interviews (often called “aRoll”) or patient testimonials, make sure you can thinking before they get on camera, and that often results in a better testimonial. If you do ask patients to appear on camera, ask them to sign a media release form. Yes, every patient who appears on camera should sign one of these forms. Your video professionals should provide you with one to hand out. If they don’t, ask for one. More important, provide these to patients BEFORE the day of the shoot so they have time to review, sign, and then return them via email. Having patients sign one of these forms right before they jump in front of a camera just adds a layer of stress, so it’s best to have them sign the form before the day of the shoot. It’s important to note that if you don’t acquire signed media releases, anyone who is not an employee of the practice could potentially change their mind about being in the video long after it’s been uploaded and on your website. They can request that you remove them from the video, which means you’ll need to contact the video professionals and pay to have the video edited without the person who no longer wants to be in the video. Having non-employees sign a release form can help guard against this, so it’s worth the bother. As a last note about who is and isn’t in your video, many practices don’t recruit actual patients to come in. Instead, they opt for friends and family members to pose as patients while bRoll footage is filmed (no, they Featured Article » Ensuring everyone shows up on time is like oral care: “An ounce of prevention is worth a pound of cure.”
Spring 23 11 Featured Article mute the phone, background music, or anything else that might interfere with the audio recording. You might even consider making sure local landscapers aren’t working during the time of your video shoot (yes, this has happened to other practices). To make the best use of everyone’s time, ask the video crew to provide you with a schedule for the day. Ask them when you, the team, the doctor(s), and perhaps the patients need to be available. Review the showing up late, announcing they suddenly must leave early, or someone just not showing up at all. Ensuring everyone shows up on time is like oral care: “An ounce of prevention is worth a pound of cure,” so consider sending out gentle reminders a few days before as well as the day before the shoot so that everyone is aware of their responsibilities. schedule for the day and make sure there aren’t large time windows when people are standing around doing nothing. Gently remind the video crew that you want to be respectful of everyone’s time, which means getting them in and out as efficiently as possible. Make certain that everyone who is going to be on camera is aware of (and has agreed to) their start time and finish time. Nothing derails a video shoot more than someone »
NDA Journal 12 In working with a video crew, it’s important to recognize that they don’t know your profession—most don’t “get” dental. To be fair, you might be unfamiliar with the video profession as well, so it’s important that you respect one another’s expertise, you communicate (even over communicate) so that everyone’s on the same page, and that you politely ask questions or raise concerns if they arise. At the very least, consider at least one “pre-production” phone, Zoom, or in-person meeting so you can the day begins—consider applying the same approach to having a video filmed for your practice. In the end, the video crew and the dental team should have the same goal: to film a compelling promotional and/or educational video for the practice. Communicate, be honest (be open when you’re confused or need advice), and work together.0 discuss your vision, logistics, etc. If it’s possible, ask if the video crew would be open to visiting the office before the day of filming to “scout” the location. The truth is, something always goes sideways during a video shoot, and that’s okay. An accomplished video crew will easily be able to manage any hiccups in the process. However, having discussed a plan of attack for the day before you begin filming will go a long way in reducing the likelihood that something will go sideways on you. Most offices have a morning huddle before » Featured Article *The NDAJ thanks Mr. Tuber and the Arizona Dental Association for the use of this article.
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NDA Journal 14 Featured Article Dr. Mago is an Oral and Maxillofacial Radiologist (OMR) and an Assistant Professor in Residence in the Department of Clinical Sciences at the UNLV SDM. She obtained an M.S. in Dental Sciences and completed residency training in OMR at the University of Connecticut School of Dental Medicine. She also worked as a faculty member at the University of Iowa. Dr. Mago has completed a Masters in Oral Medicine and Radiology at Maharishi Markandeshwar College of Dental Sciences and Research in India. Dr. Mago holds a specialty license to practice OMR in Nevada. Jyoti Mago, DDS Asst. Professor UNLV SDM Periodontal disease is generally a chronic bacterial infection that affects the alveolar bone and the neighbouring gingiva. The biggest challenge is to detect the bone defects and furcation involvement, especially on the lingual aspect. With two-dimensional radiography, determining the buccal or lingual location of the defect can be very challenging. The information that is derived from probing the gingival tissues in association with conventional diagnostic imaging provides guidance in assessing alveolar bone height and evaluating the presence of vertical bone defects.1 But, the prior knowledge of these defects with optimal radiographic assessment is valuable to help improve the prognosis of surgical regenerative therapy. Advanced radiographic techniques can play a crucial role in identifying some of these hidden defects. Initially, the radiographs that were most commonly used were intraoral bitewings. (Fig. 1) But now there are other extraoral modalities as well, which plays an important role in diagnosis, shown by current research. (Fig. 2) These modalities include extraoral bitewings generated by a panoramic machine and extraoral bitewings generated by cone beam computed tomography (CBCT). Extraoral bitewings generated by CBCT have much higher dose than other imaging modalities and this needs to be considered. A question arises of we can improve the images to visualize the periodontal structures including the periodontal ligament space, cortical bone, Figure 1, Intraoral bitewing radiograph by different machines Figure 2, Extraoral Bitewings Role of Radiology in Assessing Periodontal Defects
Spring 23 www.nvda.org 15 Featured Article Figure 3, Bone defects seen in CBCT 360 degree rotation alveolar crest, and alveolar cortical plate, and what parameters play a role in improving the images without causing burn-out of thin cortices? In advanced modalities such as CBCT, higher definition and smaller voxel size are needed, resulting in increased milliamperage and kilovoltage values.2-4 Small voxel sizes create images with high diagnostic results that can detect several minute changes such as root fractures and missed canals.5 Voxel size is associated with the spatial resolution of an image. In general, the smaller the voxel size, the better the results for both the resolution and sharpness.6 The larger the field of view (FOV) the greater the amount of scatter in the image. Mol7 reviewed the more advanced digital technologies, such as tuned-aperture computed tomography (TACT), digital subtraction, and conventional CT scanning, and stated there is a potential for an increase in diagnostic efficacy and classification of the periodontal bone status. He also evaluated and outlined the practical limits of these technologies and explained in which arena these technologies will be particularly useful in the practice of dentistry.7 Vandenberghe and co-workers8 studied periodontal bone architecture using 2D charge-coupled device directors (CCD) and 3D full-volume CBCT-based imaging modalities. They assessed the periodontal bone » Figure 4, CBCT seen by 180 degree rotation
NDA Journal 16 Featured Article Contact us today! www.llmpubs.com | 800-647-1511 Advertise to Support Your Association! Make your company stand out while supporting your association so they can change your industry for the better! • Speak to your entire association’s member base • Complimentary graphic design services • Modify an existing ad or have a new one created • Multi-publication discounts Grandt Mansfield 503-445-2226 [email protected] levels and defects and evaluated them against human skulls. They also evaluated the visualization of lamina dura, crater defects furcation involvements, contrast, and bone quality. In their study, they concluded that CBCT image measurements of periodontal bone level and defects were comparable to intraoral radiography. They also found that CBCT images verified more potential in the morphologic description of periodontal bone defects and conversely, the CCD images provided more bone details. Using a dry skull and by means of artificial defects evaluated by full-volume CBCT, Misch and colleagues9 found similar results. Their » References Kolsuz ME, Bagis N, Orhan K, Avsever H, Demiralp KO. Comparison of the influence of FOV sizes and different voxel resolutions for the assessment of periodontal defects. Dentomaxillofac Radiol 2015; 44: 20150070. 10. Katsumata A, Hirukawa A, Okumura S, Naitoh M, Fujishita M, Ariji E, et al. Relationship between density variability and imaging volume size in cone-beam computerized tomographic scanning of the maxillofacial region: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 420–5. doi:10.1016/j.tripleo.2008.05.049 Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB. Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. DentomaxillofacRadiol 2006; 35: 219–26. doi: 10.1259/ dmfr/14340323 Ballrick JW, Palomo JM, Ruch E, Amberman BD, Hans MG. Image distortion and spatial resolution of a commercially available cone-beam computed tomography machine. Am J Orthod Dentofacial Orthop 2008; 134: 573–82. doi: 10.1016/j.ajodo.2007.11.025 Da Silveira PF, Fontana MP, Oliveira HW, Vizzotto MB, Montagner F, Silveira HL, et al. CBCT-based volume of simulated root resorption— influence of FOV and voxel size. Int Endod J Oct 2014. Epub ahead of print. doi: 10.1111/iej.12390 Hatcher DC. Operational principles for cone-beam computedtomography. J Am Dent Assoc 2010; 141: 3S–6S. doi: 10.14219/jada.archive.2010.0359 Mol A. Imaging methods in periodontology. Periodontol 2000;2004(34):34–8. Vandenberghe B, Jacobs R, Yang J. Diagnostic validity (or acuity) of 2D CCD versus 3D CBCT-images for assessing periodontal breakdown. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:395–401. Misch KA, Yi ES, Sarment DP. Accuracy of cone beam computed tomography for periodontal defect measurements. J Periodontol 2006;77:1261–6. 1 2 3 4 5 6 7 8 9 investigation demonstrated that CBCT was as accurate as direct measurements using a periodontal probe and as reliable as radiographs for interproximal areas. While measuring the buccal and lingual defects, CBCT proved superior to conventional radiography. The major disadvantage of using CBCT is the radiation dose. Newer machines, have capacity to acquire the images with half of the rotation as compared to the full rotation that was used conventionally. (Fig. 3, 4) Till now, there is no research demonstrating the efficacy by using a smaller rotation arch, but this is the new area of investigation.0
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NDA Journal 18 NDA President and Executive Director’s Spring Article When was the last time in recent memory did Las Vegas rock gardens and green turf turn white with Valentine’s Day snow? Or when Northern Nevada mountain communities had to dig into the snow to reach their front doors? And when was the last time Truckee temperatures dropped below zero? It’s been a while. But with water so well-needed right now, a long winter of snowfall is worth the benefit for the summer season. The NDA started the year with its MidWinter House of Delegates meeting on Saturday, January 28. Delegates from all over Nevada gathered in Reno to discuss immediate NDA business and upcoming opportunities for members. Thanks to all delegates, volunteers, and guests participating in this year’s meeting. With the Winter of 2023, the NDA has come into the year like a Lion. The 2023 Legislative Session is underway with pre-COVID protocols and “faceto-face” meetings. The NDA lobby team, Tri-Strategies, the NDA Council of Government Affairs, and NDA leadership are fighting hard for our members and organized dentistry in Nevada. This work is a battle as we move legislative priorities in a forward direction. It includes two insurance reform bills: “Patients Before Profits” (DLR) and Code Changes Need a Clinical Cause and our Modernization of Dentistry and Expanded Function Dental Assistant bills. In early March, the NDA represented Nevada at the ADA and Student Lobby Day in Washington, DC. NDA leaders and UNLV dental students met with several key U.S. legislators to discuss the Resident Education and Deferred Interest (REDI) Act, the Dental and Optometric Care Access (DOC Access) Act, and Ensuring Lasting Smiles Act (ELSA). In addition, ADA members and dental students from around the country rallied in Washington, DC, to ensure organized dentistry remains the leader in advocacy for dentists and patients here in the U.S. Looking ahead into Spring, we hope members will join us for Oral Health Day at the Capitol on April 6 in Carson City. This full-day event will put our members in front of legislators, allowing them to share stories about how harmful insurance practices impact your practice and your patients. We will end the day with a reception giving a final mix and mingling with legislators in a more relaxed atmosphere. Head to the NDA website to register for Oral Health Day, nvda.org. Lastly, the NDA has been on a fullcourt press to get every NDA member renewed for 2023. This is no small task; it takes not only association staff but also help from our dental society boards and NDA Council on Membership to make this effort successful. We have stemmed the year-over-year loss of members, so NDA President and Executive Director’s Article Michele M. Reeder Jason R. Doucette, DMD
Spring 23 www.nvda.org 19 NDA President and Executive Director’s Article we can now refocus our efforts to grow our membership. Growth only happens when current members educate their colleagues about why they chose to be members of their dental society and its “tangible” and valuable benefits at a local, state, and national level. Don’t hesitate to contact the NDA office if you have questions about membership benefits or want to get more involved in NDA leadership and decision-making. We look forward to Spring as we continue working hard, planting seeds, and watching the NDA grow.0
NDA Journal 20 SNDS President’s Spring Message Ronald J. Laux, DDS SNDS President’s Message It was snowing in Las Vegas earlier in the day in February when I was writing this report. Not Arctic snow, just some flurries, but still, this is Vegas. Of course, none of it stayed around and the sun is shining now. Things are back to normal, and the same can be said of the Southern Nevada Dental Society. Our Executive Director Ms. Esther Johnson has done a tremendous job since starting last September. The meeting schedule is back to normal, relationships with sponsors have been restored, the SNDS office and website are operating as they should, and membership is being addressed. The Executive Board is extremely thankful for all Esther has been able to learn and accomplish in a short period of time. Primary focus now is on the 2023 Nevada State legislative session. SNDS has worked with the NDA and its lobby firm Tri-Strategies, Inc. to develop a battle plan for the session. A very informative membership meeting in January featured a presentation by Tri-Strategies outlining proposed bills concerning dentistry. One of the proposed bills supports dental loss ratio in dental insurance plans. Basically, dental insurance plans will be forced to pay 80% of paid premiums to actual patient care, or have to pay a refund. They can keep up to 20% for administrative services. In addition, they will have to keep records of paid services and be held accountable. We are very optimistic all our supported bills will pass, and the dentists and their patients will benefit. Relations between the SNDS and the UNLV School of Dental Medicine continue to evolve. SNDS started hosting meetings at the school in January, and will continue at least through the Spring. The School has provided some great speakers for our Continuing Education programs and many faculty members serve on the Executive Committee of SNDS. Dr. James Mah, interim Dean, has been instrumental in fostering a great working relationship. I believe this serves both sides well. The new graduates will be the future of dentistry and we want to help develop them as leaders. Please keep an eye on your social media outlets for notices about upcoming events. There will be membership meetings, Opioid and Infection Control CE classes, and the CE CAFÉ summer series. Remember, we are here to serve you for the betterment of our members and the protection of your patients. Your success is our reason to exist. Respectfully submitted, Ronald J. Laux, DDS0
Spring 23 www.nvda.org 21 SNDS Executive Director’s Spring Message Esther Johnson SNDS Executive Director’s Message Hello SNDS Members! We want to say thank you so much to those members who have renewed their memberships for the 2023 year! Our renewal deadline was January 31 and it was exciting to see so many dentists agree to continue being a part of the SNDS community. January was a big month for fresh starts. Not only were we fresh into a new year but we kicked off the year with a “Town Hall” meeting. We were able to share with attendees not only what SNDS was doing for them, but what the NDA is doing for them on a legislative level! Tri-Strategies, the NDA Lobby Team, came to speak with attendees at the January 19, 2023 Town Hall meeting about upcoming legislation and strategies. Dentists engaged in a Q&A, many sharing their own experiences and thoughts about the long fight for legislation that benefits Nevada Dentists. At the close of the event, many dentists’ hope and involvement were renewed. The honesty and authenticity of the event was truly moving. We recognize that as the world continues to move faster, we must find new ways to reach our dentists. SNDS has launched our first podcast, “Closing the Gap.” This podcast is designed to bring updates from the Tripartite, offer business building and honing tips, and create a sense of community for the Southern Nevada Dental Community. This media provides dentists an audio and visual means to connect in a quick 30–45 minute episode you can listen to at your leisure. Episodes will air monthly with new speakers, interviews, and much more. With License Renewals in June in mind, SNDS is offering CE monthly (including Substance Abuse and Infection Control courses) to help you meet your licensing requirements! These events can be found at our website or by calling our office: 702-901-1495. We have great things ahead and hope to continue enrich and improving the lives of our dentists. Thank you for being a valued part of this community! Wishing you, yours, and your businesses well, Esther Johnson SNDS Executive Director0
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