Joe Hannan

Edie Gibson, RDH, MS, like an increasing number of Americans came to know addiction firsthand in her own home. On Monday during her session, titled “

Generation Rx: Uppers, Downers, And All Arounders

, discussed how her husband’s battle with alcohol dependency led her from her role as a dental hygienist to becoming a sounding board for women who have experience the same struggle.

She described how these experiences reinforced for her how dentists and dentistry are parts of the care continuum that can intervene in the lives of addicts and put them on a path to recovery. She also highlighted how dentists, now more than ever, have to be cognizant of addiction when dealing with their baby boomer patients.

“I am firm believer that pain is the driver of addiction,” Gibson said.

Whether that’s the physical pain of a third molar removal that leads to an opioid prescription and dependency, or emotional pain, like what her husband endured growing up in a high-pressure environment, this is the catalyst for dependency that dentists and hygienists are advantageously positioned to spot.

What other health care providers, Gibson asked, see their patients as often as dentists do?

“Are we not health care professionals?” Gibson asked. “Are we not human beings too? … We are human beings first,” she said, compelling the professionals gathered at her session to speak up when the see signs of addiction, and go a step further in rooting them out.

Discovering an underlying addiction problem begins with engaging with patients, she said. The best way to do that, she explained, is with open-ended questions. “I noticed you’re drinking 4-6 drinks a night. How is that affecting your life?” she asked, providing an example. This sort of approach is more likely to foster a discussion than the simple alcohol question on a patient intake form will.

At this point, it falls to the dentist to take a step back and listen to the patient’s response. She drew from her experience with her husband, saying that if she had actually asked about the source of his drinking problem rather than getting angry, they likely would have arrived sooner at a solution.

The final step, she said, is to come up with a plan. Do not let the patient leave without putting them on a path to address the issue, she said, noting that in the past she has provided patients with information on counseling and recovery when appropriate.

“Be a human being and get involved,” she said.

As the Baby Boom generation ages, Gibson said, they’re arriving in the dental chair with their own distinct set of health concerns, many of which are being addressed pharmacologically with a bevy of medications. This makes a detailed overview of their medical history that much more critical. Many recovering addicts, Gibson said, will be upfront about their status and warn dentists off prescribing pain killers or even nitrous oxide. Others, however, aren’t as aware.

Baby Boomers, she added, are increasingly returning to marijuana as its decriminalization continues across the US. This pot, however, isn’t want they were accustomed to when they were younger. Modern strains contain far more THC than typical marijuana did in the 60s and 70s. It’s also difficult to calculate just how many DUIs or traffic fatalities marijuana may be causing, post-decriminalization, she said.

Gibson left those who attended her session with this final thought: Regardless of the drug, the patient’s age, or the severity of their problems, dentists and dentistry fit into a greater picture of health. She noted that those whom she counsels for addiction often look to improve their smiles as part of their journey toward recovery.

“This,” she said, passing her hand around her mouth, “is connected to this,” she said, passing her hand around her head.

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Dentists are positioned to spot the signs of addiction better than most health care providers, said Edie Gibson, RDH, MS, at the Greater New York Dental Meeting.

How To Spot Addiction In Your Dental Patients

To Kirk Behrendt, BS, the steps to create a thriving dental practice are no secret. Dozens of dentists, hygienists, and dental practice employees got an expansive overview of best practices that translate to a bustling dental business on Monday at his continuing education session, titled “The Top 10 Secrets to Make Your Practice Thrive” at the 

, has made a career out of teaching dentists how to be more successful at what they do best. Value was at the heart of his message in this session: How dentists value their work, themselves, their patients, and their patients’ experiences. 

“When you undervalue what you do, people undervalue who you are,” Behrendt said, underscoring another theme that ran throughout his presentation: Dentistry is “the best job.”

Highlighting the flexibility and control dentists have over their career paths, 

recent reports that laud the profession’s longevity and stability

, and the lifestyle that dentistry can support, Behrendt hammered home just how fulfilling and rewarding the profession can be, especially if your desire is to do it better.

“In order for your practice to thrive, there’s one thing you have to do: you have to get better,” he said. Over the course of the 3-hour session, Behrendt delivered actionable steps on how to do just that.

The title of the session was actually a bit of a misnomer. There were far more than 10 secrets that Behrendt delivered in this energetic session that covered topics such as patient-doctor communication, defining and building upon success, and under promising/over delivering. One segment that delved into 5 steps that scientifically increase referrals particularly piqued the audience’s attention. Behrendt described those steps as follows:

 “The new on time is early,” Behrendt said. A 15-minute delay might not seem like a big deal to you, but to your patient who has carefully juggled and orchestrated their day, it could mean the difference between checking off crucial elements of their to-do list, or letting them slide. Behrendt said that it has been shown that timeliness is a major influencer of patient referrals. He used the example of a potential job candidate. If he or she showed up 15 minutes late for the interview, would they be getting the job in your practice?

 “I can’t even believe I have to put this on a slide,” Behrendt said, but was able to quickly rattle off reasons why it needs to be reinforced within practices. He illustrated his point using the popular chicken chain, Chick-fil-A, where employees have undergone extensive training and respond to every customer request with, “My pleasure.” Chick-fil-A, he pointed out, is now outpacing McDonalds in terms of profit. The difference-maker? Go to a Chick-fil-A and you’ll see well-trained employees—mostly teens—who are polite and happy to be there. Pull up to a McDonald’s drive-thru, and you’re likely to get a curt “’Sup?” from the employee at the window. Politeness goes a long way.

 Behrendt referred to this as “organizational integrity.” Effective communication is at the heart of it. Intent often gets lost in translation and that can prove costly for procedures that need to be redone. Patients, he said, need to be told up front, directly, and succinctly what to expect. Then it’s up to you as the practitioner to deliver.  

 Perfect, Behrendt said, often becomes the enemy of the good. He highlighted the example of an NJ dentist he works with who still does not have a website because he is too busy agonizing over the fonts, colors, and themes. “Get it done” became the mantra for this particular step. And if the website example doesn’t hit home hard enough for you, he provided this one: He can find $1-2 million in unfinished business in most restorative dental practices.

 “Your business either screams, ‘I care,’ or ‘I don’t care,’” Behrendt said. Making it known that you care about your patients is as simple as picking up the phone and following up on their most recent visit. He provided one example of a dentist who once told him that he doesn’t call patients because he’s afraid “they might pick up.” Thankfully, for those among us, there are mobile apps that ring right to voicemail. 

Dozens of dentists, hygienists, and dental practice employees got an expansive overview of best practices that translate to a bustling dental business on Monday at his continuing education session, titled The Top 10 Secrets to Make Your Practice Thrive at the Greater New York Dental Meeting. 

5 Steps to Boosting Referrals to Your Practice

HIPAA Violations: Taking a Proactive Approach to Guard Against Them

“Dentists have an equal obligation to maintain privacy and security of their patients’ dental records,” says Julia Hesse, a partner at Choate Hall & Stewart Health Care.

Study: Nursing Home Patients Are Skipping Dental Care, Even When It's Free

 This study looked at about 2,500 patients at one New York assisted-living facility between 2008 and 2012.

A Reading List for Increasing Your Financial Literacy

 There’s great information out there, but where do you start?

Manhattan Food Finds: More than Conventional Eats

If you’re attending the Greater New York Dental Meeting this week, you’ll probably work up an appetite. The following options cover all budgets and tastes.

One Dentist's Journey from Practitioner to Practice Owner

 “I like challenges,” said Josephine Chang Pallotto, DDS. “And I actually enjoy learning something new every day. Even when I make mistakes I admit it wholeheartedly to my team, and I make it known that we’re all learning and nobody is perfect."

These 5 stories were the most popular on Dentist's Money Digest last week. 

The DMD Top 5 for the Week Ending Nov. 25

The year 2016 is about to come to a close, and with its passing, you find yourself a year closer to retirement. As you contemplate your retirement strategy--accounting for factors such as 

, and how much money you will need—you also might be thinking about relocation.

5 States with the Highest and Lowest Property Taxes

Relocating to another state offers numerous advantages for retirees. Many states have a lower cost of living, lower 

, and better access to the services you will need as you enjoy your golden years. The data-crunching gurus at 

 have assembled a systemic ranking system to give you a better understanding of which states are retirement-friendly, and which aren’t. This story will focus on the 7 best states in which to retire.

WalletHub arrived at these rankings by looking at three dimensions for all 50 states and the District of Columbia: Affordability, Quality of Life, and Health Care. Each dimension was assigned a total point value: Affordability—40, Quality of Life&mdash;30, and Health Care&mdash;30. Each dimension was broken down into criteria, each eligible for a specific amount of points. Affordability was measured by 4 criteria, including Adjusted Cost of Living and Annual Cost of In-Home Services. Quality of Life was measured by 12 criteria, including Percentage of the Population Aged 65 and Older, among others. And Health Care was scored on 8 criteria, such as number of Dentists per 100,000 Residents.

Here’s how the 7 most retirement-friendly states stack up, in ascending order:

This WalletHub ranking takes into account several factors, including Affordability, Quality of Life, and Health Care access.

The 7 Best States for Retirement

Even when it’s free of charge, it seems that some assisted-living patients may be electing not to receive the dental care that they require.

A recent University at Buffalo study finds that almost 90 percent of one long-term care facility’s patients didn’t elect to receive dental services, even when they came at no cost to the patients.

Groundbreaking Study Shows that E-cigarettes Damage Gums, Teeth

. The study looked at medical records from more than 2,500 patients at the 

 Nursing and Rehabilitation Center in Clarence, NY, spanning the years from 2008 to 2012. Researchers say that 10 percent of patients in the study received at least 1 dental exam.

On average, researchers say, patients stayed at this particular facility for 2 years. About half stayed less than a month. Among patients who stayed for just a month, 7% made use of free dental services. Thirty percent of those who stayed from a month to 2 years elected to receive treatment.

Frank A. Scannapieco, DMD, PHD, and lead investigator in the study, said in the news release that the study shows a lack of “appreciation for dental care.”

“The perception is that if you don’t have pain, you don’t have a problem,” Dr. Scannapieco said.

There was a bright spot in the research, the news release says. The longer patients stayed in this particular facility, the more likely they became to take advantage of free dental care. However, even if patients stayed in assisted living for years, only 55% received oral health care.

Animal Study Shows that Black Raspberries Fight Oral Cancer

Age also seemed to have a positive impact, researchers say. Those in the assisted living facility who were age 76 or older were twice as likely to receive dental treatment.

When considering why length of stay seems to affect dental care acceptance, Dr. Scannapieco says it may be because those in assisted living for shorter periods of time tend to have more pressing medical concerns.

“These patients were also likely to have their own dentists outside of the facility,” the news release says.

There are also other factors that need to be considered, Dr. Scannapieco says, such as the cost of care, particularly since Medicare does not cover a lot dental procedures. However, it does cover exams. Dr. Scannapieco adds that reinforcing the oral health/overall health connection may lead to an increase in those seeking dental care.

“We need to do the research that answers if excellent dental health translates into prolonged life, health, and perceptions of quality of life,” he said.

This study looked at about 2,500 patients at one New York assisted-living facility between 2008 and 2012.

Already faced with several sexual assault charges, a Worcester, MA dentist is once again accused of sexual assault and battery by another female patient.

. According to that report, Nikhilkumar “Nikhil” M. Patel, DMD, has been charged with indecent assault and battery on a person 14 or older, stemming from an incident that occurred in Oct. 2009.

2 Dentists Accused in Separate Sexual Assaults of Patients

 reports that a court statement accuses Dr. Patel of grabbing and pinching a female patient’s breast during an exam. He will be arraigned on Dec. 14.

 reports that this is not Dr. Patel’s first run-in with the law. In August, he was arrested on the same day he allegedly touched a woman’s breast during a dental procedure. Accusations from two other female patients surfaced in September, according to the 

. Those assaults were spread out over dates in 2013, 2015, and 2016. He has pleaded not guilty to 5 counts of indecent exposure.

The accusations against Dr. Patel are similar to those against Aziz Khan, DDS, a Suffolk County, NY dentist who has been charged with groping a female patient during an exam. That alleged incident happened in September. According to a statement from the Suffolk County Police Department, the alleged assault only stopped when the patient confronted Dr. Khan. 

A Worcester, MA dentist faces sexual assault charges from another female patient, who accuses him of groping her during an exam.

More Sexual Assault Charges Filed Against Dentist

The dentist’s trial is being held up by questions concerning his competency.

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Researchers at the University of Rochester Medical Center also say that flavoring additives may worsen cell damage.

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What’s in store for investors as they near retirement.

6 Steps for Managing Conflict in Your Office

What you can do to help make conflict resolution in your practice a simpler process.

The DMD Top 5 for the Week Ending Nov. 18

A New Jersey oral surgeon whose practice has been tied to 15 bacterial endocarditis infections and 1 death will remain under suspension until his case goes before an Administrative Law Judge and the New Jersey Board of Dentistry makes a ruling based on that Judge’s report.

The state’s Attorney General’s Office announced the continued suspension of John Vecchione, DDS, in a 

Between 2012 and 2014, 15 of Dr. Vecchione’s patients came down with endocarditis, according to the Attorney General’s Office. Twelve had to undergo heart surgery. One patient died.

Endocarditis is a serious infection of the heart’s inner lining, 

. It typically happens when bacteria from other parts of the body travel through the bloodstream and attach to vulnerable areas of the heart.

“Left untreated, endocarditis can damage or destroy your heart valves and can lead to life-threatening complications,” the Mayo Clinic says.

Endocarditis is typically treated with antibiotics or surgery.

An investigation during the summer revealed that Dr. Vecchione’s practice wasn’t following proper infection control practices, “including failure to use sterile water or sterile saline during surgical procedures, improper handling and storage of multi-does medication vials, non-sterile preparing of instruments, and improper handling and disposal of needles and syringes,” according to the NJ Attorney General, adding that these failures led to the infections.

Dr. Vecchione’s license has been under suspension since August, the Attorney General’s Office said, when the state arrived at his practice unannounced for an inspection. This was the third such inspection in 21 months. During this most recent visit, authorities discovered that lapses in infection control continued at the practice, despite his agreement to address the issues in July.

On July 20, a Department of Health inspection linked the lapses to the endocarditis infections. This link and the findings from the August inspection prompted the Attorney General to initiate court proceedings and the license suspension. 

Despite an earlier agreement to improve infection control practices, breaches of protocol at the practice continued, authorities say.

After 1 Death, 15 Infections, Oral Surgeon's License Remains Suspended

A purloined oven led Georgia police to discover an illegal dental practice operating in an Atlanta-area warehouse. Two men were arrested as a result: the alleged unlicensed dentist and the landlord who allegedly harbored him.

) reports that Yuri Aleksandruk, who is accused of practicing dentistry illegally, and Peter Kiriliuk, the accused landlord, were each charged with practicing unlicensed dentistry.

The discovery of the illegal practice began as a result of a burglary victim’s online search for stolen property. According to the news report, the victim contacted Gwinnett County police, saying that he’d come across a stolen oven in his search. The victim confirmed that the oven had been stolen when he met the seller at an area warehouse and matched the serial number to that of the stolen oven. The victim then contacted police.

When officers responded to the report of the oven, the came across a locked door, the 

 reports, and could hear people moving behind the door. They ordered the people inside to open the door, the 

 said, but they didn’t comply. After forcing their way through the locked door, officers discovered that the space was being used as a dental practice.

 reports that authorities said Aleksandruk confirmed he was practicing dentistry in the space, and that he had a license “overseas.”

’s report as saying it appears Aleksandruk had been practicing there for a relatively short time.

“The detective assigned to this case believes that he was only performing dentistry at this location for about a month. … It’s unclear if he was at a different location prior. He had an appointment book showing upcoming dentist appointments.”

 reports, the oven that brought officers to the warehouse had nothing to do with the dental practice. The status of the search for the oven thief is unclear.

Officers discovered the illegal practice after responding to a report of a stolen oven.

Stolen Oven Leads to 2 Arrests at Illegal Dental Practice

An archeological dig at a monastery in Tuscany unearthed a surprising dental discovery: a 17

Italian researchers published a study on the dental appliance in the November issue of 

The Truth About George Washington's Teeth

Researchers say they discovered the appliance, among other human remains, while excavating a tomb at the 

. The tomb belonged to a well-to-do family by the name of Guinigi. The Guinigi, the study says, ruled Lucca from 1392 to 1429. Researchers were unable to pinpoint the exact age of the dental prosthesis, but the estimate it to be an artifact of the 17

 century, based on the approximate age of objects found on the same layer within the tomb.

What makes this device so remarkable, researchers say, is the way it is assembled. 

 explains that the device incorporated 5 human teeth, “3 central incisors and 2 lateral canines aligned in the incorrect anatomical sequence.” A gold-alloy band was used to link the teeth together. A slot was cut longitudinally into the bottom of each tooth, allowing them to sit on the gold band. Gold-alloy pins anchor each tooth to the band. You can see photos of the device, as well as CT scan images 

What makes this find so significant, researchers say, is that it confirms accounts of “gold band technology for the replacement of missing teeth.” Up until now, now examples of the technology had been found. Seeker.com notes that dental pioneer 

 had described such devices in his accounts.

Lead researcher Simona Minozzi, PhD, told Seeker.com, “This is the first archaeological evidence of a dental prosthesis using gold band technology for the replacement of missing teeth.”

Accounts of such devices existed in the historical record, but this is the first confirmed discovery of one.