JOURNAL TRANSCRIPT

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Suffolk Dental The Official Publication of the Suffolk County Dental Society

Volume 46  Number 1 SPRING 2017

SUFFOLK COUNTY DENTAL SOCIETY OFFICERS - 2017

From left: Treasurer Dr. Jeff Seiver, President-Elect Dr. Jimmy Kilimitzoglou, President Dr. Ivan Vazquez, Secretary Dr. Claudia MahonVazquez & Vice President Dr. Marty Dominger

Dr. Harold Crossley - Wednesday, March 15th - 9:00am - 4pm "Street Drugs Exposed: What Your Patients and Your Kids Are Not Telling You!" (see pages 13-16)

Dr. Paul Chu - Wednesday, March 22nd - 6pm - 9pm Pediatric Dentistry and Children's Dental Health Month General Membership Meeting - Upsky Hotel (see page 8)

Avoid the Million Dollar Mistake - HIPAA Security Compliance: Protecting Your Patients, Your Practice and Yourself March 31, 2017 - 9:30 a.m. – 12:30 p.m. - Craig S. Ratner, DMD (see bottom of page 6)

SCDS CALENDAR 2017

Suffolk County Dental Society 150 Motor Parkway, Suite 105, Hauppauge, NY 11788 Tel.: 631-232-1400  Fax: 631-232-1402 e-mail: [email protected] website: www.suffolkdental.org

March Monday 6 Wednesday 15

Exec.Council/Board of Directors (7 pm) Seminar Series #1 (9 am – 4 pm) Harold Crossley, DDS General Membership Meeting (6 pm - 9 pm) CPR/AED (9am - noon) HIPAA course (9:30am- 12:30pm)

Thomas J. Bonomo, DDS Paul R. Leary, DMD Co-Editors

Wednesday 22 Friday 24 Friday 31

Jeffrey A. Sherman, DDS Photographer

April Monday 3 Exec.Council/Board of Directors (7 pm) Tues 25 - Wed 26 GLIDM - Hilton Hotel, Melville

Paul Markowitz, DMD Executive Director & Managing Editor

May Wednesday 10 Monday 15 Wednesday 17

Debbie Wasserman Executive Assistant Officers of the Society, 2017 Ivan Vazquez, DDS, President Dimitrios Kilimitzoglou, DDS, President-Elect Martin Dominger, DDS, Vice President Claudia Mahon-Vazquez, DDS, Secretary Jeffrey Seiver, DDS, Treasurer The Suffolk Dental Bulletin is the official publication of the Suffolk County Dental Society. It is published four times a year: Spring (March), Summer (June), Fall (September), Winter (December) by the Suffolk County Dental Society, 150 Motor Parkway, Suite 105, Hauppauge, NY 11788.

June Thur 1 - Sun 4 Wednesday 14

NYSDA HOD - Turning Stone, Verona, NY Golf Outing - Mill Pond, Medford

September Monday 11 Wednesday 27

Exec.Council/Board of Directors (7 pm) General Membership Meeting (6 pm - 9 pm)

October Wednesday 4

Seminar Series #3 (9 am – 4 pm) Steven Fallon, DMD October 11 Scrubs & Stilettos - Carlyle at the Palace Monday 16 Exec.Council/Board of Directors (7 pm) Thur 19 –Tues 24 ADA Meeting – Atlanta, GA

Periodical Postage rates at Central Islip Post Office. Subscription rates in the U.S. included in member dues and $75. per year for non-members.

POSTMASTER: Send address changes to: Suffolk County Dental Society 150 Motor Parkway, Suite 105 Hauppauge, NY 11788

November Wednesday 15 Monday 20

Neither the Society nor the Bulletin staff will be responsible for any opinions or statements which are published over the signature or initials of an author. Acceptance of advertising in the Suffolk Dental Bulletin does not constitute an endorsement by the Suffolk County Dental Society. The Editor and Publications Committee reserve the right to reject any copy, and as a matter of policy adhere to the advertising policies of the American Dental Association. Direct all communications to: Thomas J. Bonomo, DDS Paul R. Leary, DMD ) - Editors Suffolk Dental Bulletin 150 Motor Parkway, Suite 105 Hauppauge, NY 11788

Wednesday 24

General Membership Meeting (6 pm - 9 pm) Exec.Council/Board of Directors (7 pm) Seminar Series #2 (9 am – 4 pm) Howard Glazer, DDS CPR/AED (9am - noon)

December Wednesday 6

General Membership Meeting (6 pm - 9 pm) Exec.Council/Board of Directors (7 pm) Seminar Series #4 (9 am – 4 pm) Ben Miraglia, DDS

Members, American Association of Dental Editors

Please submit material for publication on a disk accompanied by double-spaced written copy six weeks prior to the month of publication.

And Like Us!

Requests for advertising rates should be directed to the Suffolk County Dental Society, (631) 232-1400.

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STUART B. SHAPIRO, D.D.S., J.D. Attorney at Law Master of Laws, Taxation

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516 316 8102 www.dentistlawyer.net

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PRESIDENT'S MESSAGE

ivan a. vazquez, dds

Family and Membership A

s I sit here on a Sunday morning drinking my coffee and still trying to catch up on my sleep from my Installation Dinner, all I can reflect upon is how incredible the night was. For those who attended, I thank you, and for those who could not, we missed you while celebrating a great night of camaraderie and unity. It was well attended and very well organized by our great staff, the dynamic duo, Dr. Paul Markowitz, our Executive Director, and his Executive Assistant, Debbie Wasserman. One of my goals has always been to make my parents, my wife Claudia, your new Secretary, my kids, Jose, Jackie, Chris, and Billy, my family, and friends proud. I think that so far, I have. In addition, I want to represent Puerto Rico well as the first native Puerto Rican to be president of the prestigious Suffolk County Dental Society. My parents always supported me in my dream of becoming a dentist. Even after being out of school for five years and working as a salesman for a pharmaceutical company, they persisted and pushed me to go to the New York University College of Dentistry where I received a great education and entered the profession I love. I also made great friendships that have lasted many years and some of these good friends attended my special night. I also met my best friend and lovely wife of 28 years, Claudia. Next move was to complete my residency program in Pediatric Dentistry at Interfaith Medical Center in Brooklyn and get a job. After working as an associate for five years, I decided to open my practice in Hauppauge where I have been for 21 years. I got involved in organized dentistry as an area representative from Islip and then as a member of the Board of Directors. Once I lost the fear of getting involved, I worked with other dentists from Puerto Rico and organized the Puerto Rico Dental Association, USA where I met other leaders that were influential in getting me involved at the local, state and national level.

In the Puerto Rico Dental Association I held the position of President for 5 years and at the same time rose through the ranks at Suffolk County. With encouragement from Suffolk County Dental Society leaders, I finally felt I had enough leadership experience to join the executive board and become your President. My sister, my brother, and I were fortunate to be raised by two loving parents who instilled the values of family, faith, and volunteering in each of us. Together with Claudia, we tried to instill the same values in our four kids. That brings me to my mission as President. My family is very important to me and the dental society has become my extended family. That is the reason membership is so important to me. Like in every family there is diversity. We are all dentists from diverse backgrounds who have different personalities and interests. We need to work as one to continue and preserve the work that the local, state, and national groups have done. I hope to bring everyone in Suffolk County together. However, I cannot do it alone. I need other members to get more involved in YOUR dental society, the Suffolk County Dental Society. If we work united, we can all shine as one and make this a great year!

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RASKIN AWARD

Congratulations to Dr. Maria Maranga, the 2017 recipient of the Suffolk County Dental Society’s Dr. Robert Raskin Meritorious Service Award. For those of you who do not remember Dr. Raskin, he was actively involved in our Society in all of our leadership positions for many years until he passed away in 1992. Dr. Raskin was a President of the Tenth District Dental Society, before we became a separate component of the Dental Society of the State of New York. He served as one of our two delegates to the ADA for 12 years and was a member of an ADA Reference Committee. Dr. Raskin represented us at DSSNY for 13 years and was a member and Chairman of numerous Councils and Committees on both the state and local levels. He was the Editor of our Bulletin for 11 years, wrote numerous articles and taught dental students, residents, hygienists and dental assistants. He was also granted Fellowships in all of the major national and international dental organizations. We attempt to keep his memory alive by presenting this award in his name to someone who has served this Society in a similar manner. This year’s recipient is Dr. Maria Maranga. Maria started her education at Brooklyn College and received both a BA in Psychology and BS in Biology. She obtained her DDS from NYU College of Dentistry. This was followed by a one year GPR at the VA Medical center on Northport and a two year post graduate program in endodontics back at NYU. Maria currently practices endodontics in her successful private practice in Aquebogue. In addition, she has been a teacher and mentor to countless dental students and residents at a few institutions including Stony Brook, NYU, the Northport VA, Jamaica Hospital and Brookdale Hospital since she completed dental school herself. Over the years Maria has been very involved in organized dentistry. She is a member of the ADA, the New York State Dental Association (NYSDA) and the Suffolk County Dental Society. She currently serves as the Chair of the ADA Council on Membership. She is a Fellow of the American College of Dentists, the Pierre Fauchard Academy and the Long Island Odontology group. She is a Trustee of the American Association of Endodontists and is a Past President of the NYS Association of Endodontists.

Locally, Maria has served the Suffolk County Dental Society as a line officer from 2007 until 2011 when she became President. She has continued to sit on our Executive Council since then. She has been on our Board of Directors since 1999 and had been the Liaison from our Board to the Executive Committee from 2003-2006. Maria was the Chair of our Membership committee for many years and was one of the two originators of the highly successful women's dental conference, "Scrubs and Stilettos". She continues to co-chair this event each year, which has won numerous awards for the two hosts, both Suffolk and Nassau County Dental Societies. She has also volunteered as a member of many of our Committees over the years. At the state level, Maria currently serves as a Board member of the New York State Dental Foundation and also the Empire State Political Action Committee (EDPAC). She was Chairman of the NYSDA Council on Membership from 2012 – 2014. She has also served as a Delegate to the NYSDA House since 2012. In addition, she volunteered at the 2014 NYSDA Mission of Mercy event in upstate New York, and has also attended numerous oral cancer screenings on behalf of the NYS Dental Foundation. Nationally, Maria has been an Delegate or Alternate Delegate to the ADA House of Delegates since 2011. She has served the past three years on the ADA Council on Membership and, as stated previously, is currently that Council's Chair. She has been a member and mentor for the ADA Institute on Diversity and leadership. She has also been the liaison to the ADA New Dentist Committee. Maria has been recognized numerous times for all of her efforts and has received awards including the National Mentorship Award from the Lucy Hobbs Project as well as the Organized Dentistry Advocate and the Post Graduate Endodontic Faculty Awards from the students at Stony Brook SDM. In addition, she has twice been named one of the 50 Top Most Influential Women of Long Island by the Long Island Business News. In her personal life, Maria is married to her husband, "Saint Ed" and has two children, Philip and Gabriella. We thank them for sharing Maria with us.

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Continuing Education Additional Courses 1.) March 31- 9:30am -12:30pm: Avoid the Million Dollar Mistake - HIPAA Security Compliance: Protecting Your Patients, Your Practice, And Yourself This is a NYDA sponsored course - all registration will be through the NYSDA offices - registration material and full course description is available on our website - www.suffolkdental.org 2.) Under a new Public Health Law, dentists in New York State who have a current Drug Enforcement Administration (DEA) number must take an opioid prescribing/pain management continuing education course by July 1, 2017. As the time this was written, we did not yet have a live version of this course available. An online course is available at http://www.nysdentalfoundation.org/. 6

EDITORIAL

PAUL R. LEARY, DMD

Advocacy for Your Profession The current state of the political landscape is filled with many obstacles. Consider the rhetoric we are exposed to on a daily basis and imagine trying to steer your profession on a course to influence public policies affecting your practice and the oral and systemic health of your patients and all Americans. There are many things your association accomplishes that has the strength of so many of our voices combined together, but none as significant as our booming voice when close to 70% of our profession join together to support our way of delivering healthcare. I just returned from a two day meeting in Albany where, joined by Maria Maranga, Sharon Pollick, Kerry Lane , Jeff Seiver and 7 students from Stony Brook School of Dental Medicine, we met with our local legislators in their offices; and brought 6 issues relating to bills they are currently considering. Our collective understanding about how these bills can benefit the profession we share and the delivery of oral health care to the patients, their constituents; is the benefit of having a united profession with your support, and allows us access at the highest levels to demonstrate our commitment to ideals hammered out at local and national meetings that sustain the way you practice every day. Our efforts are completely neutral from a political party perspective! Members of our State Senate and Assembly, and Federal Congressional and Senate representatives, from both sides of the aisle; are our representatives. We leave our personal inclinations at the threshold of their offices and enter to advocate for our profession and our patients. In this environment of severe party separation, relationships established over many years of applying this same standard opens many of our representatives' minds to listen to the ADA member dentists. We sustain such a high percentage of members and apply advocacy for oral

health care in front of all issues and adhere to the principles that we define in our local, state, and national meetings as the "Voice" of our members and their ability to deliver patient care. Imagine trying to have an equal effect as an individual or even a smaller fraction of this group and you can see the metrics of why we need to sustain membership percentage. To speak from a position of a majority has never become so clear as it is when you hear the daily bickering between factions that concentrate on what makes them separate instead of how we wish to concentrate on what makes us alike. Your members of the State and Federal government are keenly aware of your voice and I consider it a privilege to carry that voice on issues that protect our delivery of care. They invite us to a seat at the table of the ever changing environment as Health Care is dissected in its many varied delivery systems. We represent a delivery system of health care that works and try every day to sustain our treatment models under constant assault by many forces and ask only that you continue your support with membership because our greatest strength is speaking for a majority of Dentists to protect our profession.

Please keep your eyes open for our blast emails. We try to limit the number that we send, but we want to keep you informed about issues on a timely basis. This is the best way we have found to get the information disseminated. If you have not been receiving these emails, please check your spam or junk folders and contact us with the email address that you use most frequently. Send those addresses to [email protected]. Thank you.

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SUFFOLK COUNTY DENTAL SOCIETY of the State of New York, Inc.

150 Motor Parkway, Suite 105, Hauppauge, New York 11788 Tel: (631) 232-1400 Fax: (631) 232-1402 E-mail:[email protected] Web page: www.suffolkdental.org

WEDNESDAY, MARCH 22, 2017 at

THE RADISSON HOTEL (formerly the Upsky) (LIE Exit 53, follow Wicks Road signs to Vanderbilt Motor Parkway)

6:00 - 7:00 PM: 7:00 PM:

Buffet Dinner

Children’s Dental Health Month Presentations

Introduced by Dr. Howard Schneider, CDHM Chairperson 7:30 PM: (approx.) Business Meeting:  President’s Remarks – Ivan Vazquez, DDS  Introduction of New Members – Claudia Mahon-Vazquez, DDS, Chair, Membership Committee 7:45 PM: (approx.) Featured Educational Program (2 C.E. credit hours)

------Presented by Paul K. Chu, DDS-----A comprehensive review of some of the most commonly occurring childhood injuries seen in the dental practice. Presentation will include evidence based treatment options for traumatic dental injuries, including: avulsions, fractures, and lacerations. Scenarios will be culled from cases seen in both the hospital emergency department and private practice. Recommended for dentists, hygienists, assistants and students.

Dr. Chu maintains a private pediatric dental practice in Rye, NY. He is the Director of the Pediatric Dentistry Residency program at the St. Barnabas Hospital in the Bronx. He is also an Associate Professor of Pediatric Dentistry at Columbia University School of Dentistry and an Assistant Attending at Jacobi Medical Center in NY.

☺ IMPORTANT! – RESERVATIONS ARE REQUIRED! Fax page to 232-1402 or mail to SCDS, 150 Motor Parkway, Ste. 105, Hauppauge, NY 11788 by noon on Monday, 3/20!!!

--------------------------------------------------------------------------------------------------------------------------------------------General Membership Meeting, Wednesday, March 22, 2017

General Membership Meeting Registration / Dinner Reservation Form DENTIST’S NAME ....................................................................... ADA #:................................... (Please print)

[ ] DINNER AND THE EDUCATIONAL PROGRAM (no charge/SCDS members; non-members $100*) [ ] THE EDUCATIONAL PROGRAM ONLY (no charge/SCDS members; non-members, $75*). *mail back with check payable to “SCDS 8

EXECUTIVE DIRECTOR'S MESSAGE

From the desk of Paul Markowitz, DMD I

assume that you will notice a few changes in this Bulletin compared to the past. We

now have the ability to print in full color, including our advertisements and photographs. In addition, we have added a few additional commentaries in this addition. The first one, on page 17, has been written by a Half Hollow Hills High School senior who was a finalist in the prestigious national Siemens Competition in 2016. Ms. Wu's paper looks at the future of dental research and potential changes in the ability to treat dental disease.

Finally, the third commentary has been written by another one of our members who wishes to educate us regarding a topic that I have been mentioning for the past few issues. Dr. Berger unfortunately has had to deal with a serious environmental problem related to his amalgam separator and his cesspool. For those of you who still don't want to believe that this can be a serious concern for your practice and your pocketbook, I strongly recommend that you read his article on page 25 and take steps to protect yourself.

Her article segues into another one of the commentaries on page 23, that was recently written by one of members and was published in the December 2016 JADA. In case you did not read Dr. Iovino's article, we wanted to make sure that you had a chance to see what your local colleagues are involved in. His article recommends updating the ADA Code of Ethics to include an additional parameter to accommodate the recent advances in genetic research, such as Ms. Wu's.

I hope you enjoy the new appearance and the addition of these commentaries. I welcome each of you to submit material that you think might be of value to your colleagues in the future. We would be happy to share your knowledge and experiences.

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OFFICE COVERAGE AVAILABLE: Richard J. Stabile, DDS, PC and Associates will cover your office. Need time off for vacations, dental meetings or injury? You name it, we will accommodate you. Call Dr. Stabile at (631)988-9312, e-mail [email protected] or call Dr. George Tiernan at (631)724-8365.

AVAILABLE: Large Dental Office in Great Neck has equipped operatories available PT/FT. One block from LIRR. Extensive parking. Located on main thoroughfare, private restroom and lounge for doctors, large windows and waiting room. (516)849-2215 or e-mail [email protected]

SEEKING DENTISTS: Experienced General Dentists needed in E Islip and second office opening soon in Medford. Dentist/owner offers competitive per diem/commission to highly skilled, enthusiastic dentists interested in excellent income, managerial support and professional autonomy. Please send your c/v to [email protected]. indicating availability.

FOR RENT IN GARDEN CITY: Two operatories for rent, modern office. Great for specialist, start-up or down-size. Lab, consultation, attractive front desk. Busy building, easy access and parking. (516)222-1717, [email protected]

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NOVEMBER GENERAL MEMBERSHIP MEETING

Honoring Our Members Who Have Served This Country with Distinction

Lt. Commander Ricardo Alexander US Navy Captain Robert Benton US Army Lt. Commander Gregory Bohle US Navy Captain Edward Bram US Army Captain Mark Cherches US Army Lt. Commander Angelo Chiarenza US Navy Colonel Pamela Combs US Air Force Captain Richard Firestone US Army Captain Stephen Goldstein US Army Lieutenant Joseph Graskemper US Navy Captain Jeffrey Harnett US Navy Lt. Commander Steven Hill US Navy Captain Bruce Howard US Air Force Captain Richard Kardovich US Army Captain Jeffrey Kerman US Army Colonel Francis Kestler US Army Major Dimitrios Kilimitzoglou US Air Force Captain Aaron Kramer US Air Force Commander Paul Leary US Navy Captain Samuel Mann US Army Captain Anthony Maresca US Army

Captain Raymond Mascolo NY Guard Captain Alan Mazer US Army Captain Stephen Mitzner US Air Force Captain Lawrence Mogen US Army Captain Hugh Musof US Air Force Captain Joseph Nicols US Navy Lieutenant Jay Orlikoff US Navy Captain David Parker US Air Force Lt. Colonel John Primavera US Navy & US Army Captain Ralph Raphaelson US Air Force Colonel John Sawicki US Army Captain Irving Schultz US Army Lt. Commander Steven L. Schwartz U.S.Navy Lt. Commander Duane Shank US Navy Captain Arnold Sneticker US Air Force Colonel Stephen Sokoloff US Army Lt. Colonel Lester Stein US Air Force Captain Stephen Stein US Army Captain Marvin Stern US Air Force Captain Joseph Thaler US Air Force Captain Robert Wagner US Air Force

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TILLIS AWARD

Congratulations go out again to Dr. Maria Maranga, 2017 recipient of the New York State Dental Association's Dr. Bernard P. Tillis Award. This award was established by the NYSDA Council on Publications, at the request of the Association's Board of Governors. The Board had asked the Council to create a tribute to Dr. Tillis, who was the Editor of The Journal for 22 years, and who died in 1995, shortly after his retirement. The Council decided to establish the Bernard P. Tillis Award to recognize and honor a member of NYSDA, who through his / her writing in The New York State Dental Journal or in any of the component publications, promotes a positive image of organized dentistry - just as Dr. Tillis did throughout his tenure as Editor. This is an annual award, the winner of which is selected in the fall by a subcommittee of the Council on Membership and Communications. Last year's Tillis award recipient was Dr. Scott Firestone, Suffolk County Dental Society's immediate past president. Dr. Maria Maranga is the winner of the 2016 award. She was chosen for her essay, “The Lion Sleeps Tonight,” which appeared in the Fall 2015 Suffolk Dental Bulletin. An inscribed plaque was presented to Dr. Maranga at our January installation by Dr. Richard Andolina, President of the New York State Dental Association. {Reprints are available online at www.suffolkdental.org or upon request at suffolkdental @optonline.net.}

Two year old ultramodern implant practice looking for a periodontist with experience in implants and grafting. Office is looking for other locations to expand and practitioners who are ambitious and willing to grow. You must see this office to understand it’s potential. Please send CV to [email protected]

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TAX TIPS FOR DENTISTS

Stuart A. Sinclair

by Stuart A. Sinclair, CPA

Certified Public Accountant

An easily overlooked deduction is a self-employed health insurance deduction for Medicare premiums paid for you, your spouse and your dependents.

Taxes/Accounting Your Office or Mine Business/Personal Specialty - Dentists Personable CPA References

Also, long term care insurance premiums similarly qualify for the self employed health insurance deduction.

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You must have sufficient self employment income to absorb the amount of the deduction. This change in the law started with the 2010 tax returns.

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The Suffolk County Dental Society is proud to present

The Dr. Stephen B. Gold Memorial

Seminar Series 2017 Our 2017 Seminar Series features four important courses presented by prestigious, internationally-known speakers Harold Crossley, D.D.S., Ph.D. #SS2017-01 Wednesday, March 15, 2017 STREET DRUGS EXPOSED: What Your Patients And Your Kids Are Not Telling You! Howard S. Glazer, D.D.S. #SS2017-02 Wednesday, May 17, 2017 I HAVE IT..YOU NEED IT! (Must Have Products & Materials) Steven Fallon, D.M.D. #SS2017-03 Wednesday, October 4, 2017 FIXED IMPLANT REHABILITATION FOR THE TERMINAL DENTITION AND EDENTULOUS ARCH: From Initial Consult To Final Delivery (Sponsored by Nobel Biocare) Ben Miraglia, D.D.S. #SS2017-04 Wednesday, December 6, 2017 ORTHODONTIC OPPORTUNITIES FOR THE GP: Everything From Early Childhood Growth And Development To Adult Invisalign Suffolk County Dental Society 150 Motor Parkway, Suite 105, Hauppauge, NY 11788 Phone: (631) 232-1400 Fax: (631) 232-1402 Email: [email protected]

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Course #SS2017-01 Wednesday, March 15, 2017: 7 m.c.e. credits Harold Crossley, D.D.S., Ph.D. STREET DRUGS EXPOSED: What Your Patients And Your Kids Are Not Telling You! Course Synopsis: What questions should I be asking my patients to avoid drug interactions with street drugs? What is the impact on my practice of the recent resolutions, approved by the ADA, for providing dental care for patients who are and/or have been chemically dependent? What are some of the oral manifestations of street drug abuse? How will I know if a person is under the influence of street drugs? What are the characteristics of and how do I manage the “doctor shopper”? Do I have to take any precautions with the dental patient who is under the influence? Why is it so important that the dental staff be knowledgeable about street drugs? Why am I at risk? What are some characteristics of adolescent substance abuse and what do I do about it? The dental team is in a unique position providing dental care to a patient population that may be regular users or experimenting with mood altering drugs. This dynamic, brutally honest, and graphic presentation will take you from the streets and into the office to help you identify and manage the substance abusing patient. Discussion includes the origins, types, mechanisms of action, and signs and symptoms of commonly abused prescription and illicit drugs. Recommended: For dentists, dental hygienists, dental assistants, receptionists, and spouses* *Must be 18 years of age or older to attend-no exceptions Harold Crossley, DDS, MS, PhD, is Professor Emeritus at the Univ. of MD Dental School. Dr. Crossley received a BS degree in Pharmacy from the University of Rhode Island . He later was awarded the MS and PhD degrees in Pharmacology. The Univ. of MD Dental School in Baltimore awarded Dr. Crossley the DDS degree. The liaison between the classroom and his part-time dental practice produced a practical approach to understanding the pharmacology of drugs used in the dental office. Dr. Crossley has co-authored a number of articles and four books dealing with a variety of topics within the field of pharmacology. Other areas of expertise include the pharmacology of street drugs and chemical dependency. He serves on the MD State Dental Assoc.’s Well-Being Committee, is an active member of the OKU Honorary Dental Society, the ACD, ICD, and an honorary member of the Thomas B. Hinman Dental Society. He was the recipient of the 2008 Gordon Christensen Lecturer Recognition award presented by the Chicago Dental Society and the recipient of the 2012 Award of Distinction presented by the Academy of Dentistry International for his efforts in CDE. He has been a consultant for the US DEA and other law enforcement agencies since 1974. Drawing on this unique background, Dr. Crossley has become nationally and internationally recognized as an expert on street drugs and chemical dependency as well as the clinical pharmacology of dental drugs.

Course #SS2017-02 Wednesday, May 17, 2017: 7 m.c.e. credits Howard S. Glazer, D.D.S. I HAVE IT..YOU NEED IT! (Must Have Products & Materials) Course synopsis: This is a program about real dentistry for real people by a real dentist! Dr. Glazer will present a potpourri of the materials and techniques that he uses to make the day more productive, easier and fun! The entire dental team will benefit from learning together about the latest products and how they will benefit your patients. Dr. Glazer writes a monthly column by the same title for AGD Impact magazine, and reviews new products and materials on a regular basis for his column. Topics may include:

• Curing lights..to light up your life (dental) • Desensitization & Adhesives..a sticky subject made simple • Composites for esthetic fillings not just white ones • Impression materials..it’s true..first impressions are important • Provisional materials..provisionals should look great • Oral cancer prevention..dentists can save lives! • Lasers..simple, easy and quick w/ great results • Endodontic instruments..getting to the root of the matter • Cements..that which holds the relationship together • Tissue retraction and fluid control...essentials of clear fields • Reducing Sensitivity with topical paste application & Fluoride varnishes • Whitening systems..that work • Matrix bands for perfect, predictable contacts..contact perfect every time • Burs..so many and so little time • Patient communication…high-tech and really cool! • Going Digital..simple, easy and soon to be a must! • Loupes, instruments, equipment potpourri

Dr. Glazer is a Fellow and Past President of the Academy of General Dentistry, and former Assistant Clinical Professor in Dentistry at the Albert Einstein College of Medicine (Bronx, NY). He has been a visiting clinician at several universities around the country. He is a Fellow of the American College of Dentists; International College of Dentists; American Society for Dental Aesthetics, the American Academy of Forensic Sciences, and a Diplomate of the American Board of Aesthetic Dentistry. Dr. Glazer is an Attending Dentist at the Englewood Hospital (Englewood, NJ). Additionally, Dr. Glazer is the Deputy Chief Forensic Dental Consultant to the Office of Chief Medical Examiner, City of New York. For the past several years, Dr. Glazer has been named as one of the “Leading Clinicians in Continuing Education” by Dentistry Today, and most recently was named as one of the Top Dentists in New Jersey by New Jersey Monthly & 201 Magazine. He lectures throughout the United States, Canada, and overseas, on the subjects of dental materials, cosmetic dentistry, forensic dentistry and patient management. Additionally, Dr. Glazer is a frequent author of dental articles and has been published throughout the world. Currently he publishes a monthly column in AGD IMPACT entitled “What’s Hot and What’s Getting Hotter!” He maintains a general practice in Fort Lee, NJ.

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Course #2017-03 Wednesday, October 4, 2017: 7 m.c.e. credits Steven Fallon, D.M.D. FIXED IMPLANT REHABILITATION FOR THE TERMINAL DENTITION (sponsored by Nobel Biocare) AND EDENTULOUS ARCH: From Initial Consult To Final Delivery Course Synopsis: In today’s world, edentulous patients, and those with a terminal dentition, are seeking a fixed replacement solution for their failing arches. Practitioners with a thorough understanding of the physiologic, functional and esthetic fundamentals involved in full arch implant rehabilitation will be able to best serve this patient population. This course will provide the educational foundation and clinical pearls required to rehabilitate these patients using a simplified, safe and scientifically proven method. Dr. Steven Fallon has extensive experience in the field of implant surgery, with an emphasis on full arch rehabilitation. The course will focus on a team approach in the treatment planning and management of these cases. Practitioners will learn the critical keys for success in the surgical, laboratory and restorative techniques that are essential in providing a predictable, fixed and immediate solution for the edentulous patient including the All-on-4 and Branemark Zygoma Treatment concepts. After completing his undergraduate studies at the University of Pennsylvania in 1996, Dr. Fallon began his dental career at the University of Pennsylvania School of Dental Medicine and received his DMD in 2001. During that time, he received the Theodore Blum Oral Surgery award recognizing him for his clinical excellence in that field. He completed his oral and maxillofacial surgery training at the Medical College of Virginia in 2005 and has been practicing full scope oral and maxillofacial surgery. Dr. Fallon is board certified and enjoys practicing all aspects of oral and maxillofacial surgery. Dr. Fallon’s comprehensive training included all aspects of the specialty, with an emphasis on dental implant surgery, removal of wisdom teeth, corrective jaw surgery, outpatient general anesthesia and facial cosmetic surgery. Dr. Fallon is in private practice in Eastern Pennsylvania and maintains surgical privileges and is an active staff member at the Reading Hospital and St. Joseph Medical Center. He has also embarked on mission trips to Honduras where he treated underprivileged children born with dentofacial deformities, cleft lips and palates.

Course #SS2017-04, Wednesday, December 6, 2017: 7 m.c.e. credits Ben Miraglia, D.D.S. ORTHODONTIC OPPORTUNITIES FOR THE GP: Everything From Early Childhood Growth And Development To Adult Invisalign TOPICS/DESCRIPTION 1. Interceptive Orthodontic Techniques for Airway and Facial Development 2. Sleep Disordered Breathing in Children: The Dentist’s Role 3. Invisalign: The Cornerstone of Comprehensive Care Dentistry LEARNING OBJECTIVES: Airway and Facial Development: 1. Understand the origins of the malocclusions we struggle with daily 2. Understand the relationship between malocclusion and many childhood illnesses 3. Understand the relationship between sleep disordered breathing and early childhood development 4. Understand the difference between nasal breathing and mouth breathing and how severe the consequences are 5. Understand the relationship of sleep disordered breathing to ADHD 6. Understand how Myofunctional guidance appliances work to fully develop facial features and an appropriate airway 7. Understand the impact a fully developed airway can have on a child’s health and well being Invisalign: 1. Understand how to set up and treat severe spacing cases 2. Understand how to set up and treat moderate to severe crowding cases with little to no IPR 3. Understand how to incorporate Invisalign into moderate to severe perio cases 4. Understand how to use Invisalign for complex restorative cases 5. Understand how to use Invisalign for extensive amounts of molar expansion and rotation 6. Understand how to use Invisalign as a comprehensive orthodontic technique to treat a variety of malocclusions Dr. Ben Miraglia graduated from the SUNY at Buffalo School of Dental Medicine. He is a proud member of the OKU Dental Honor Society. Dr. Miraglia completed a general practice residency program at Danbury Hospital in Ct. He has 23 years private practice experience in Mt. Kisco, NY, including 12 years of interceptive orthodontic experience. Dr. Miraglia has been providing Invisalign with a comprehensive care philosophy for the last twelve years. Dr. Miraglia believes Invisalign is a comprehensive orthodontic technique and should be used to move all teeth into proper position to achieve a healthy, stable occlusion as well as a full, beautiful smile. His basic philosophy is to utilize Invisalign to establish proper arch form and proper arch width. His expansive Invisalign philosophy has proven to be successful, conservative, and efficient. Dr. Miraglia holds faculty positions with Align Technology and the United States Dental Institute and is on the Board of Directors of the American Academy of Cosmetic Orthodontics as well as the American Academy of Physiological Medicine and Dentistry. Dr. Miraglia holds a position on the President’s Council of Northern Westchester Hospital in Mt. Kisco, NY. In 2015, Dr. Miraglia was acknowledged as a “Leader in Continuing Education” by Dentistry Today Magazine.

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SEMINAR SERIES 2017 AGD Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. 12/19/2013 to 12/18/2017 Provider ID # 219113

Suffolk County Dental Society is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at www.ada.org/goto.cerp.

Location of courses:

Directions:

150 Motor Parkway Media Center – Lower Level Hauppauge, NY 11788

Take the Long Island Expressway to Exit 53. Follow signs to Wicks Road. This location is 1 traffic light east of the RADISSON Hotel (formerly the Upsky Hotel) on Motor Parkway.

Time:

Course #s run 9:00 a.m. – 4:00 p.m. Continental breakfast and check-in at 8:30 a.m. Buffet lunch 12 noon – 1:00 p.m.

Tuition:

Full Series of all 4 courses: ADA members $825 Non-ADA $1425 Aux: $400 Each individual course: ADA members $275 Non-ADA $475 Aux: $100

SEATING IS LIMITED!! MAKE SURE THAT YOU REGISTER EARLY!! NOTE: In the event of extreme inclement weather causing last-minute cancellation of a program, a recorded message of cancellation will be placed on the SCDS office answering machine. If in doubt, call 631-232-1400.

Registration form: Complete and mail with check or credit card information to SCDS, 150 Motor Parkway, Suite 105, Hauppauge, NY 11788. Phone registration with credit card number, call 631-232-1400, or fax with credit card number to 631-232-1402. Name:………………………………………………………………….…………….. ADA #...................................................................... Address:………………………………………………………………………………City:…………………….. State:….... Zip:………..……… Tel #:……………………………….. Fax #:……………………………. email:………..………………………………………….……………. Please register me for: [ ] Full series of all 4 courses

or [ ] Course #1 [ ] Course #2 [ ] Course #3 [ ] Course #4

[ ] Enclosed is a check payable to SCDS for $............... [ ] Charge my Visa/MC/AE #................................................CVV..............................Exp……………..…Zip Code…………….. Signature:…………………………..……………………………

Amount: $....................................

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SPECIAL GUEST REPORT

ALICE WU (Siemens Award Finalist)

Nanotopographical Control Of Dental Pulp Stem Cell Fate

For my project, I worked with two out-of state partners at Stony Brook University. When I first met my teammates, we connected through a mutual desire to apply materials science to the field of regenerative medicine. As we thought about potential problems that we could solve, bone and dental disease stood out to us, because we have all been affected by dental issues, either personally or through a close family member. Furthermore, dental caries is the most prevalent infectious disease worldwide, and chronic periodontitis afflicts nearly half of all adults in the United States. Yet despite these sweeping problems, existing solutions are limited to dental implants, which face the risk of implant rejection and require costly bone grafting procedures. My mother, a patient who received dental implants, recalls that the process was, “long, painful, and expensive.” Upon further brainstorming, we realized that stem cell based tissue engineering answers the need for a therapeutic alternative that promotes the renewal, rather than the replacement of, dental tissues. In particular, dental pulp stem cells (DPSCs) have gained significant attention in the medical world; DPSCs are stem cells present in the dental pulp, which is the soft living tissue within teeth. The ability to harvest the DPSC from waste tissue in wisdom teeth is an advantage in getting cells for fundamental or basic research. For clinical applications, they need to work with the patient's own cells to avoid rejection –– but those cells need to be expanded and stimulated properly. The in vitro work that is being done uses DPSCs extracted from wisdom teeth in order to develop future therapies which are autologous (using the patient's cells).

On day five post cell-plating, we stained DPSCs with a green fluorescent dye in order to visualize F-actin response. F-actin is a double-stranded filamentous polymer that is primarily involved in crucial cellular processes like morphogenesis, cell division, and migration. In the beginning stages of cell growth, the level of Factin response is an indicator of whether the cell is recognizing the topography of the surface that it is plated on. A strong F-actin response to a surface may lead to better differentiation in later stages of growth. We observed this behavior using confocal microscopy (CLSM), which revealed that DPSCs responded more favorably to porous surfaces in comparison to rougher surfaces. We reasoned that this may be that the bumps on rougher surfaces inhibited full expansion of the F-actin, while the holes on porous surfaces were easily stretched over by the same filament.

DPSCs are also multipotent, meaning that they can differentiate into a variety of cell types, such as neurons, blood cells, and bone cells. Previous research has demonstrated that the surface topography of substrates that DPSCs are plated and grown on is a crucial factor in determining the cell types that they can differentiate into. Thus, we developed a novel method for creating various surface topographies in order to discover the best surfaces for inducing osteogenic (bone) and odontogenic (tooth) differentiation in DPSCs.

On day thirty-five post cell-plating, we observed the substrates under the scanning electron microscope (SEM) to evaluate the distribution of biomineralization deposits on each surface. Biomineralization is the process by which living organisms produce minerals, often to harden or stiffen existing tissues. Thus, it is considered a prerequisite for osteogenic and odontogenic differentiation. Subsequently, we performed energy-dispersive xray spectroscopy (EDX) to analyze the elemental composition of the biomineralized crystals.

Initially, different solutions of polylactic acid (PLA) mixed with polystyrene (PS) were spun-cast onto silicon wafers to create thin film substrates. The substrates were then annealed in a vacuum oven to cause the PLA and PS to phase segregate and create the distinct surface topographies that we desired. Subsequently, the PS phase was dissolved out of the substrate, to reveal different topographical features, such as bumps and holes, within the resulting PLA substrate. Mass production of a large variety of surfaces is possible with our method, because identical surfaces can be produced in bulk by controlling the variables involved in the spin-casting and phase segregation process.

SEM images indicated varying levels of biomineralization on each surface. Surfaces that were characterized by bumps displayed nonuniform biomineralization, indicating inefficient differentiation of DPSCs. On the other hand, our porous, dentin-like surface was characterized by directional, fiber-like arrangements and exhibited the highest level of uniform biomineralization. Further EDX analysis of all surfaces confirmed the presence of hydroxyapatite, which is a calcium phosphate mineral found in bone that signifies osteogenic differentiation. Essentially, SEM and EDX analysis confirmed that surface topography alone has the ability to induce biomineralization and subsequent differentiation of DPSCs.

In our preliminary stage of testing, twenty different surfaces were created and then analyzed using the atomic force microscope and NanoScope Analysis software. After characterizing the different topographies, we chose two rough surfaces, two porous surfaces, and two flat surfaces for further DPSC plating in order to study their cellular behavior. Interestingly, our porous substrates shared topographical similarities with dentin, the calcified tissue of the body that surrounds dental pulp.

In conjunction with SEM and EDX, we conducted RT-PCR to look for the late osteogenic marker osteocalcin (OCN) and the late odontogenic marker dentine sialophosphoprotein (DSPP). Between the two rough surfaces, we concluded that larger bumps, compared to smaller bumps, induced higher levels of both osteogenic and odontogenic differentiation due to the greater expression of OCN and DSPP. However, the two flat surfaces expressed higher levels of OCN than some of the rougher surfaces, suggesting that flat topographies may be more advantageous than certain rough topographies in growing (continued on page 20 - left column)

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INSTALLATION 2017

NYSDA President Dr. Rick Andolina & NYSDA E.D. Dr. Mark Feldman ADA Trustee Dr. Chad Gehani

SCDS E.D. Dr. Markowitz, President Dr. Vazquez & Immediate Past President Dr. Guariglia

NYSDA Trustee Dr. Paul Leary

SCDS Past President Dr. Nick Vittoria

SCDS Past President Dr. Tom Bonomo SCDS Past President Dr. Tony Maresca

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INSTALLATION 2017

SCDS Past President Dr. John Lagner

SCDS Past President Dr. Ian Glaser

SCDS Past President Dr. Jeffrey Sherman

SCDS President & Secretary Drs. Ivan & Claudia Vazquez

SCDS Immediate Past President Dr. John Guariglia

SCDS Past President Dr. Chris Salierno

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(continued from page 17)

(continued from page 25)

osteoblasts. Most significantly, porous surfaces expressed the most significant amount of OCN and thus induced the highest level of osteogenic differentiation compared to both rough and flat surfaces. Based on our findings, we can conclude that surfaces mimicking porous, dentin-like surface topography is the best for DPSC differentiation and, in the future, bone regeneration.

The mercury containment unit captures 100% of the mercury. The containment system does not require any maintenance from the dental office. It is truly a hands off system. As dentists we often speak to our patients about having routine examinations. We do so in part to minimize a patients’ dental issue. The best time to treat the small lesion that we find on a radiograph is now. As we often tell our patients, “It will never be less costly or invasive then it is right now”. Decay never gets smaller. The same can be said with your cesspools.

Our method represents a novel, rapid, and cost-effective approach for creating different surface topographies to study DPSC behavior. CLSM, SEM, EDX, and RT-PCR results clearly elucidate the effect of surface topography on DPSCs, which is a crucial factor in controlling stem cell fate. In the future, we hope to apply these porous surfaces onto scaffolds, which are three dimensional structures that are integrated into the body to promote tissue regeneration by acting as a growth platform for cells. These scaffolds would be created by using a medical-grade 3D printer to construct their basic framework and reproduce our optimized surface topographies. Our research supports the creation of porous scaffolds, and its implications are promising in the field of regenerative medicine.

If you would like more information please contact me at [email protected]. {Ed. note: The opinions and statements of the author do not necessarily reflect those of the Suffolk County Dental Society.}

{Alice Wu is currently a senior at Half Hollow Hills High School West in Dix Hills. She and her partners finished fifth in the Siemens Competition in Math, Science & Technology team category. The team was mentored by Stony Brook University's Miriam Rafailovich, distinguished professor of materials science & engineering; Marcia Simon, professor and director for graduate studies at the School of Dental Medicine's Department of Oral Biology and Pathology; and Adriana Pinkas-Sarafova, Garcia Summer Program coordinator in the department of Materials Science and Chemical Engineering.}

OBITUARY Dr. Richard Weledniger passed away on November 14, 2016 at the age of 70. Dr. Weledniger graduated from NYU Dental School in 1972 and completed his residency at Westchester County Medical Center in 1973. He maintained a general practice in Melville for many years.

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DENTAL PRACTICE

SCOTT R. FIRESTONE, DDS

Infection Control in the Dental Office… 'There's an app for that'® The Center for Disease Control and prevention (CDC) has developed a mobile application, CDC Dental Check, that helps dentists monitor their infection control practices in their offices. Developed directly from the CDC publication Infection Prevention Checklist for Dental Settings, Basic Expectations for Safe Care, the application helps the dental practice monitor compliance with administrative policies and clinical practice infection prevention and control procedures and also engage in direct observation of personnel and patient-care practices.

the 2003 comprehensive Guidelines for Infection Control in Dental Health-Care Settings. It added infection prevention program administrative measures, infection prevention education and training, respiratory hygiene and cough etiquette, updated safe injection practices, and administrative measures for instrument processing. At this time, the application is only available in the iTunes App Store. An inquiry to the CDC elicited no response as to when and if the application will be available for Windows or Android operating systems. For those practices without access to apple applications, the previously mentioned CDC publications, especially Infection Prevention Checklist for Dental Settings, Basic Expectations for Safe Care would be a good substitute for the application.

Key features include checking Yes/No to acknowledge compliance with a list of administrative policies or observed practices, a summary of basic infection prevention principles and recommendations for dental health care settings, ability to export results for records management and provides links to full guidelines and source documents that users can reference for more detailed background and recommendations In October 2016 the CDC published Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. This publication supplements

{Dr. Firestone is the Chair of the NYSDA Council on Dental Practice.}

NEW MEMBERS We welcome the following new members elected in December 2016, February and March 2017: Jessica Henner, DDS (Transfer from NCDS) SUNY SB 2011; Northport VA 2012 228 E Main St E Islip, NY 11730 General Dentistry

Matthew Miller, DDS (Transfer from NY County) NYU 2012; NYU 2016 175 Main St Setauket, NY 11733 Orthodontics

Michael Wakily, DDS (Transfer from Seventh) Univ of the Pacific 2007 228 E Main St E Islip, NY 11730 General Dentistry

Natasha Kapoor, DDS Virginia 2010; Univ of Detroit Mercy 2015 23 Southdown Rd Huntington, NY 11743 Periodontics

Thomas Patrie, DDS SUNY SB 2005; SUNY SB 2007 42 Terry Rd Smithtown, NY 11787 General Dentistry

Steven Xerri, DDS Univ at Buffalo 2010 100 S Jersey Ave Ste #24 E Setauket, NY 11733 General Dentistry

Michael Maiorino, DDS (Transfer from NC) NYU 2001; NYU 2002; St Charles 2003 560 E Jericho Tpke Huntington Station, NY 11746 General Dentistry

Victoria Shack, DDS (Transfer from QCDS) NYU 2012; NY Hospital Queens 2013 3 Medical Dr Ste D Pt Jeff Sta, NY 11776 General Dentistry

Christiaan Zietsman, DDS SUNY SB 2013; Eastman 2016 30 Landing Ave Smithtown, NY 11787 Prosthodontics

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GIVE KIDS A SMILE

Some of the dedicated SCDS members who volunteered their time: from left: Drs. Nick Vittoria, Jimmy Kilimitzoglou, Scott Firestone, Frank Kestler, John Damaskos, Marty Dominger

Congressman Lee Zeldin stopped by to offer his support and acknowledge our service to the community.

Thank you to all the volunteers who made the day a success: SCDS members, dental students from Stony Brook SDM, dental residents from St. Charles Hospital, dental hygiene students from Farmingdale, dental assisting students from BOCES and other family and friends!

Approximately 100 volunteers treated over 300 children during our 2017 Give Kids a Smile event which was held at the Long Island Aquarium in Riverhead for the sixth year. Representatives from Fidelis Care were present to educate the families of these children regarding dental insurance coverage that they might be eligible to receive. Hopefully, all of these children without dental homes will now be able to receive the ongoing care they need to keep themselves healthy. We could not continue to offer these programs with sponsorship to offset our costs. This year, we were fortunate to have two individuals go out of their way to raise substantial funds for GKAS. Nicole Kaloustian, RDH and Victoria Lane (wife of SCDS Past President Dr. Kerry Lane) sponsored "Miles for Smiles", a spin class, which raised thousands of dollars. In addition, we received financial support from Fidelis Care, Bank of America Practice Solutions, the Mattituck Lions Club, the Riverhead Rotary, and numerous individuals. Every year, we receive dental supplies from Henry Schein and Colgate and portable dental units and additional supplies from our friends at the Stony Brook School of Dental Medicine. Finally, thanks go out to the members of the Sunrise HiRailers, who set up a large model train display to entertain the children, in memory of our past Executive Officer, Dr. Mike Gulotta. Thank you to everyone who donated their time, money and expertise to help the children of Suffolk County!!

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MEMBER COMMENTARY

ROBERT P. IOVINO, DDS, MA (Philosophy)

Revising the American Dental Association Principles of Ethics and Code of Professional Conduct Adding “Respect for Human Dignity” as the sixth principle of dental ethics to accommodate advances in genetic science

The new era of genetics in dental education, practice, and

Other authors also have pointed to the pressing need for ethical guidelines concerning genetic testing in dentistry. In the journal 5 Oral Diseases, Eng and colleagues identified the need for “ethical, legal, clinical, and educational initiatives... to responsibly incorporate genomic information into the practice of dentistry.” Also, in an Ethics in Biology, Engineering & Medicine article funded by the National Institutes of Health titled “Need for an Ethical Framework for Testing for Systemic Diseases in Dental 6 Clinics,” Silveira and Chattopadhyay noted that “testing for systemic diseases in dental clinics is a potentially attractive avenue for oral health professionals” given the potential genetic and other systemic testing methods have “to increase professional reach, expand practice, and improve financial returns.” Silveira and Chattopadhyay6 resist giving more specific advice; rather, they pose 9 ethical questions that concern genetic testing in a dental practice that they believe “must be addressed before such activities are adopted.”

research has arrived. In the wake of the October 2015 “first of its 1 kind” American Dental Association (ADA) conference on genetics in dentistry, there is little doubt that ADA ethical guidelines concerning genetic testing, research, and possible therapy are now required. Our colleagues at the American Medical Association (AMA) have wrestled with the challenging moral issues inherent in genetic-based medicine, and their ethical code reflects it. Accordingly, a timely evaluation of the 2 AMA’s 600-plus-page code of ethics is in order. (Note: Fundamental editorial and policy decisions account for the AMA ethical code’s voluminous size. The guide within the AMA Code of Medical Ethics [AMA Code] notes “attorneys, judges, and scholars in medical ethics have looked to the Principles and 2 Opinions for legal advocacy and decision making in health care.” In light of this, the AMA Code’s annotations “are designed to provide a research and reference tool for practitioners, scholars, 2 jurists, and others.” In contrast, the ADA Principles of Ethics and 3 Code of Professional Conduct [ADA Code], designed primarily to serve as an easy-to-use guide for practitioners, is a slim 22 pages.)

Our current ADA Code: its versatility and limitations. The immediate origin of the current principle-based format of our ADA Code can be traced back to 1994. (Note: The origin of our pluralistic principle-based ethical method can be traced further back to the work of the Oxford University intuitionist W.D. Ross and the 18th century Scottish “common sense” ethics of Thomas 7,8 Reid. ) Maintaining that previous versions of the ADA Code 9 failed in their 3-fold task “to educate, to regulate, and to inspire,” the ADA Council on Ethics, Bylaws and Judicial Affairs embarked on a 2-year project during which it significantly revised the ADA Code. The council’s efforts culminated in October 1996 when the ADA House of Delegates passed Resolution 59H, and the ADA 9 Code assumed its familiar “easier to use” 5-principle format.

3

My simple thesis is that the ADA Code can remain principle based, elegant, and short; however, the addition of a sixth ADA principle of ethics is now required. Arguably, the addition of the principle of respect for human dignity will help serve better to provide the foundation of a dentist’s professional obligations in a new era of genetics in dental research, education, and practice. (Note: This commentary presupposes a familiarity with the 3 3 current ADA Code. The current ADA Code has 3 sections: the principles of ethics, code of professional conduct, and advisory opinions.)

Dr. Robert Rosen, chair of the council in 1996, explained that the “implied” ethical guidelines within previous editions of the ADA 9 Code now were enunciated clearly. In addition, the organization of the Code was streamlined around the 5 principles by “organizing the various sections of the code of conduct under the 9 principle that best serves as their foundation.” Understanding that the 5 principles “form the basis of a dentist’s professional 9 obligations,” Rosen explained that the newly enumerated principles “provide guidelines to the user who can’t find a specific 9 code section to cover a given fact situation.” The content of this last sentence is worth reappraising carefully. Essentially, in this sentence, Rosen succinctly outlined why the ADA Code could successfully be brief; an exhaustive list of rules and advisory opinions, as seen contained in the voluminous AMA Code, is unnecessary.

GENETIC DENTISTRY AND WHAT THE AMERICAN DENTAL ASSOCIATION PRINCIPLES OF ETHICS AND CODE OF PROFESSIONAL CONDUCT NEEDS TO OFFER The problem. The recognition of the need for ethical guidelines concerning genetics in dental practice is not new. Gettig and 4 Hart’s goal in their 2003 Journal of Dental Education article was “to foster awareness within the dental community of the ethical and social issues emerging from the availability of genetic information.” Their article highlighted the ethical, legal, and social concerns regarding issues of confidentiality, discrimination, informed consent, risk communication, and professional and continued education as they regard the use of genetic information in the practice of dentistry. Predicting that “dental care in the future will rely increasingly upon genetic testing” as a means to identify a patient’s disease risk and susceptibility, 4 Gettig and Hart point to the incongruity that “no professional dental society has offered recommendations or guidelines for genetic testing.” Noting how medical care was being transformed from “a reactive clinical approach to a proactive paradigm,” they cautioned against underestimating the future effect of genetics in dental practice.

It is worth noting that the identification of 4 of the 5 principles contained in the 1996 revision of the ADA Code (beneficence, nonmaleficence, autonomy, and justice) can be connected to the scholarship of Beauchamp and Childress and the profound effect of their “four principles” approach to health care ethics. (continued on page 24)

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(continued from page 23)

of subsections related to genetics include ethical issues regarding third-party access to genetic information, genetic testing and counseling, genetic testing of children, and research in gene therapy and genetic engineering. In addition, AMA Code opinions cover numerous related topics, ranging from ethical issues concerning research on stem cells and cloning to the use of genetic information in forensics relating to the criminal justice 2 system.

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(Note: Beauchamp and Childress’ 1979 Principles of Biomedical Ethics is considered a foundational document in the field of bioethics. Bioethicist Bruce Jennings maintains that Beauchamp and Childress’ politically astute decision to introduce the prima facie principle of respect for autonomy within their “four principles” method, together with the prima facie principles of nonmaleficence, beneficence, and justice, did much to further the 11 successful development of the field of bioethics. ) To be precise, the ADA adopted a version of Beauchamp and Childress’ 4 ethical principles; the ADA subtly modified Beauchamp and Childress’ principle “respect for autonomy” into “patient autonomy.” The fifth ADA principle is veracity. The principle of veracity’s incorporation into the ADA’s professional ethical code was a reflection of social change at the time. The ADA then had a heightened concern regarding dentists once again advertising given changes in Federal Trade Commission guidelines.

Similar concerns regarding genetic science and testing now loom large on the ADA’s horizon. A dental program already has been proposed regarding the use of the interleukin-1 genetic test to stratify patients according to their susceptibility to developing 16 periodontitis. The reassuring fact that the ADA principle of patient autonomy appears to be capable of providing adequate guidelines in the case of interleukin-1 gene testing must not invite our complacency. (Note: The purpose here is not to weigh in on 17 the scientific validity of the interleukin-1 genetic test. ) Arguably, what is required is the identification of a guiding principle under which the ADA Code rules and advisory opinions, applicable to both the standard and the more stringent ethical challenges inherent in gene-based research and clinical dental practice, can be organized.

Although not explicitly acknowledged in the ADA Code, the way we actually now mostly do and teach dental ethics is tied directly to Beauchamp and Childress’ 4-principles method. In light of this de facto relationship, it is prudent to be cognizant that none of Beauchamp and Childress’ 4 principles, nor the fifth principle of veracity, apparently were envisioned, selected, or designed intentionally to impose limits on the future direction and potential scope of medical research, practice, and therapy. (DeGrazia and 12 Beauchamp, commenting in a chapter on the philosophy of ethical principles and common morality, once noted, “Arguably, medicine should be viewed as an evolving set of practices with no intrinsic limits to the possibility for change.”) Arguably, from its inception, this approach represented a somewhat questionable policy; now, given remarkable advances in genetic science, this open-ended approach is dangerously inadequate. (In accord with the Pulitzer Prize–winning physician, author, and cancer researcher, Siddhartha Mukherjee, I use the adverb dangerously 13 13 “with full cognizance.” Mukherjee states that his book The Gene “is the story of the birth, growth, and future of one of the most powerful and dangerous ideas in the history of science: the ‘gene,’ the fundamental unit of heredity, and the basic unit of all p9] 13 biological information.”[ Mukherjee on the very same page poses the key ethical questions, “And what if we learned to change the genetic code intentionally? If such technologies were available, who would control them, and who would ensure their safety? Who would be the masters, and who the victims, of this [p9] technology?” ) With the National Institutes of Health actively considering authorizing and funding embryonic research to 14 develop human-animal organisms, or chimeras, and the very real prospect of human germline genetic engineering and bravenew-world “enhancement” therapies, a sixth ADA ethical principle now is required. The new principle must be equipped to serve as the foundation of guidelines, sensible limits and rules, and even, when necessary, taboos on questionable gene-based scientific research projects and clinical protocols.

The human genetic code contains the building blocks of life; when snipped and placed anonymously in the laboratory or the clinic, should not the replicable message in human DNA continue to retain a moral status or dignity equivalent in many ways to the intrinsic dignity of the unidentified person from whom the genes were derived? Respect for patient autonomy and justice here can 18 vanish in the laboratory. The genetic message uniquely configured in each of us is common to us all and connects those living to all past and future human generations. Just who is being hurt or helped when researchers manipulate genetic material on the laboratory bench can be equally puzzling. Genetic research projects designed to benefit the few, hypothetically, may result in potential harm to many. Such ethical concerns beg the following questions: In the age of genetics in dental research, education, and practice, would not the ADA Code benefit from the addition of another ethical principle? Should that sixth ethical principle be 19 respect for human dignity? (Not to be confused with the principle of “respect for persons” contained within the Belmont 20 Report, along with the principles of “beneficence” and “justice,” framing ethical responsibilities in conducting applied research on humans. In the Belmont Report, respect for people aligns with 21 the concept of informed consent. ) Although arguably the most compelling reason to incorporate respect for human dignity now as the sixth principle within the ADA Code is its usefulness in ethical matters pertaining to genetic science, the principle has value in many other areas of application. For example, the normative content contained within the principle of respect for human dignity can be used to help delineate a dentist’s obligation and the correct course of ethical action to take in matters concerning access to needed oral health care; interpersonal dentist, patient, staff member, and community relationships; digital records and communication; and even emerging 22 technologies such as nanotechnology and artificial 23 intelligence.

TURNING TO THE AMERICAN MEDICAL ASSOCIATION CODE OF MEDICAL ETHICS FOR POSSIBLE INSIGHT The AMA on its website notes how “advances in genetics have the potential to revolutionize how physicians diagnose and treat 15 illness.” Undoubtedly, such large-scale change is accompanied by ethical challenges. The AMA has responded proactively to this dilemma by incorporating multiple guidelines relating to genetic medicine into its ethical code. In accord with common sense, the AMA Code is structured on 9 broad-based ethical principles. Chapters 2, 4, and 7 in the 2016 revised AMA Code of Medical Ethics, respectively, titled “Opinions on Consent, Communication & Decision Making,” “Opinions on Genetics & Reproductive Medicine,” and “Opinions on Research & Innovation,” contain more than 8 subsections concerning genetic medicine. Headings

Undoubtedly, some will disagree. For example, philosopher Ruth Malkin maintains, “Dignity is a useless concept. It means no 24 more than respect for persons or their autonomy.” However, such an understanding of the principle of respect for human dignity is mistaken. There is a key difference between respect for a person’s autonomy and respect for human dignity. This difference is illustrated best in the following example: In bioethics, 11 the principle of autonomy is applicable to the decision-making capacity of the genetic researcher, clinician, and research participant; the principle of respect for human (continued on page 26)

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MEMBER COMMENTARY

AL BERGER, DDS

Cesspool Problem with Amalgam Separator

For those of us that remember the original 60 Minutes, it has been said that a bad day is when you go to work and Mike Wallace is at your front door. Well Mike Wallace was not at my front door in February 2016, but it was a horrible day for me and could be a very damaging day for any dentist especially those who practice in Suffolk County. He asked if I had sewers and I told him, “not in my area. We have cesspools.” He told me that I have a problem, but he had a solution for me. Since I am a member of NY State Dental Society I am entitled to a free initial consultation with an environmental attorney and a 10% discount off their fees. I do not believe that many dentists practicing on Long Island can afford such an attorney.

In February 2016, I received an e-mail from my landlord informing me that mercury was found in the cesspool. My practice is located in Oakdale and other than the landlord, who is not a dentist, I am the only tenant. I am a general dentist in a solo practice. Since the time I purchased the practice in1994 from a general dentist, I have never placed an amalgam filling. I have removed many amalgam fillings since I first picked up my high speed handpiece in1994.

The relationship between my landlord and me rapidly deteriorated as the various testing companies came up with test scores that did not make sense. I was given the name of a highly respected remediation company.

The building that I am located in was sold to my present landlord in 2002. He insisted that the cesspool be checked for any contamination before he would finalize the purchase. The seller of the building is the same dentist from whom I purchased the practice. The cesspool was found to be contaminated with mercury and the sale of the building was on hold until this matter was rectified. The seller had the cesspool finally replaced and the soil cleaned and tested. The cost back then was $60,000.00.

This company was immensely helpful to me in my hour of despair. They asked for all the reports and tests that had been done previously. After he reviewing them they pointed out inconsistencies and inaccuracies. The company explained to me in terms that I could understand the type of testing that was needed to be done to accurately depict the level of contamination that existed in our cesspool. I conferred with my landlord and agreed to move forward with this particular company.

Everything at this point was neat and clean and the purchase of the building was finalized and completed. In 2004 the landlord had the cesspool rechecked and again it was found to be clean. In 2006, while attending a dental lecture it was mentioned that amalgam separators would be required to be placed by dental practices on their evacuation lines. It would not become law for another two years. I had spoken with my landlord about the amalgam separator and he was very much in support of placing it on my lines ASAP. He was willing to absorb half the cost to place it.

It was brought to our attention that the amalgam separator I had installed previously was not preventing mercury from entering the cesspool. We had been warned that even though the cesspools would be cleaned and found in compliance with Suffolk County upon final inspection that the result would only be temporary because mercury will still be getting into the cesspools from the separator and I will have to go through the same process again. This is not want I wanted to hear.

I contracted an amalgam separator company in 2006 to place this device in my practice two years before it was mandated. I was informed that once a year the collecting canister had to be shipped to the company and a new one would be hooked up. In 2012 this company began to provide a written report as to the contents of the returned canister. In the years between 2006 and 2015, there was only one year that the canister was not sent in (2014).

When the remediation company finished the testing they found that the mercury contamination was only four feet deep and the mercury levels were minor. A great weight had been lifted from my shoulders when I read the report which dramatically differed from a previous report which stated that our levels were toxic. Suffolk County accepted their report and their remediation procedure for our cesspools. The final cost was almost $30,000.00.

In March 2016, my landlord spoke with me regarding the cesspool contamination. He mentioned a potential $60,000.00 cost to me. Panic mode set in. I was in denial. I started grabbing at straws.

As I moved forward I did not want to ever have to deal with this nightmare again. Once in a lifetime is still one time too many. I wanted a separating system for my practice with a 100% guarantee that I would not recontaminate the cesspools.

My first straw I grasped was I am a renter and therefore not responsible. I spoke to an attorney who asked to look at my lease and advised me that I am not responsible: Wishful thinking and inaccurate advice. The generator of the mercury is the responsible party.

I had done much research in this area and found only one systemwhich fits this bill. It is called a mercury (Hg) containment system. The waste material in the unit does not communicate with the environment and therefore cannot contaminate an existing cesspool. This is the major advantage the containment system has over a separator. Separators target solids. They are designed to meet an ISO particle standard. The amalgam separators are designed to capture 95% of the solids by weight, not total mercury. Some solid mercury can still get through as well as all of the ionic mercury (mercury dissolved in the water).

My second straw to grasp for was the NY State Dental Society. I had shared my story with a representative of the Dental Society. He asked me if I had a separator on my lines and I told him I did. He responded by saying that I am in compliance with NY State Dental Society. I informed him that I am not in compliance with Suffolk County.

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(continued on page 20 - right column)

dentist’s obligations in specific areas of research, testing, and clinical practice relating to genetic science.

(continued from page 24) dignity, such as the intrinsic dignity that resides in each one of us and the life-giving replicable message in the sequences of our DNA, sets ethical limits that can trump a politician’s, genetic researcher’s, clinician’s, and even the research participant’s exercise of his or her personal autonomy. (In accord with the invaluable prima facie nature of the existing ethical principles, no priority is to be assigned to the principle of respect for human dignity.)

The future list of rules and advisory opinions produced need not be exhaustive. Because, once enumerated as the sixth ADA Code ethical principle, the principle of respect for human dignity will serve, as Robert Rosen noted, to “provide guidelines to the user who can’t find a specific code section to cover a given fact 9 situation.” Practicing dentists, researchers, students, patients, research participants, and the public all stand to benefit from such guidelines.

Such a position must not be misconstrued as reactionary. 13 Mukherjee notes our desire to experiment, create, and use new technologies is itself encoded and selectively perpetuated in our DNA. In turn, this creative gene-driven factor is responsible for evoking both some of our species’ most magnificent and 13 reprehensible qualities. Mukherjee cautions us to recognize the inherent circularity of this logic, and, driven by a skeptical awareness of its possible overreach, to seek additional moral precepts to “protect the weak from the will of the strong, and the ‘mutant’ from being annihilated by the ‘normal.’ ” Such is our nature and the challenge of modulating scientific progress.

http://dx.doi.org/10.1016/j.adaj.2016.09.011 Copyright ª 2016 American Dental Association. All rights reserved. Dr. Iovino is a clinical assistant professor, Department of Oral and Maxillofacial Surgery, and a lecturer, Dental Ethics and Professionalism, College of Dental Medicine, State University of New York at Stony Brook, Stony Brook, NY, and is in private practice in oral and maxillofacial surgery, Southampton, NY. Address correspondence to Dr. Iovino at 351 Meeting House Ln., Southampton, NY 11968, e-mail [email protected]. Disclosure. Dr. Iovino did not report any disclosures.

Accordingly, the ADA needs to expand the number of principles 19 in the ADA Code. The political philosopher Michael Rosen in his monograph Dignity notes, “The basic starting point of Kant’s vision of morality is that we carry within ourselves something of ‘unconditional, incomparable’ value— ‘personhood’ or the ‘dignity of humanity.’ ” Rosen’s philosophical point aligns with the scientific fact that the material of our common humanity is encoded and found in our DNA. It is the ability of the principle of respect for human dignity to highlight the special relationship that exists between the human genetic code and human life that makes the principle ideally suited to serve as the foundation for the fabrication of rules, guidelines, and even taboos limiting the potential excesses unique to the use of genetic science. Might not the addition into the ADA Code of the prima facie duty, responsibility, and ethical principle to respect human dignity, therefore, best serve as the foundation on which to construct professional guidelines, rules of conduct, and advisory opinions now needed in the new era of genetics in dental research, education, and practice?

1. Manchir M. ADA conference to focus on genetics in dentistry. ADANews. Available at: http://www.ada.org/en/publications/ada-news/2015-archive/june/adaconference-to-focus-ongenetics-in-dentistry. Accessed June 9, 2015. 2. Council on Ethical and Judicial Affairs. Code of Medical Ethics of the American Medical Association. American Medical Association; 2016. In press. 3. American Dental Association. American Dental Association principles of ethics and code of professional conduct, with official advisory opinions revised to September 2016. Available at: http://www.ada.org/en/~/media/ ADA/Publications/Files/ADA_Code_of_ Ethics_2016. Accessed October 6, 2016. 4. Gettig E, Hart TC. Genetics in dental practice: social and ethical issues surrounding genetic testing. J Dent Educ. 2003;67(5): 549-562. 5. Eng G, Chen A, Vess T, Ginsburg GS. Genome technologies and personalized dental medicine. Oral Dis. 2012;18(3):223-235. 6. Silveira ML, Chattopadhyay A. Need for an ethical framework for testing for systemic diseases in dental clinics. Ethics Biol Eng Med. 2011; 2(2):115-136. 7. Beauchamp T, Childress J. Principles of Biomedical Ethics. 7th ed. New York, NY: Oxford University Press; 2013:15. 8. Cuneo T. Reid’s ethics. Stanford Encyclopedia of Philosophy. Available at: http://plato.stanford.edu/archives/spr2011/entries/reidethics/. Accessed November 14, 2014. 9. ADA Principles of Ethics, Code of Professional Conduct revamp OK’d by House. ADA News. 1996;27(19):24. 10. Beauchamp TL, Childress JF. Principles of Biomedical Ethics. New York, NY: Oxford University Press; 1979. 11. Autonomy Jennings B. In: Steinbock B, ed. The Oxford Handbook of Bioethics. New York, NY: Oxford University Press; 2009. 12. DeGrazia D, Beauchamp T. Philosophy. In: Sugarman J, Sulmasy DP, eds. Methods in Medical Ethics. Washington, DC: Georgetown University Press; 2001:33. 13. Mukherjee S. The Gene: An Intimate History. New York, NY: Scribner; 2016. 14. National Institutes of Health, Office of Science Policy. Next steps on research using animal embryos containing human cells. Available at: http://osp.od.nih.gov/under-thepoliscope/ 2016/08/next-steps-research-usinganimalembryos-containing-human-cells. Accessed August 10, 2016. 15. AmericanMedical Association. Genetic testing. Available at: http://www.amaassn.org/ ama/pub/physician-resources/medical-science/ genetics-molecularmedicine/related-policytopics/ genetic-testing.page.AccessedJune 29, 2016. 16. Braun TM, Doucette-Stamm L, Duff GW, Kornman KS, Giannobile WV. Counterpoint: risk factors, including genetic information, add value in stratifying patients for optimal preventive dental care. JADA. 2015;146(3):174-178. 17. Diehl S, Kuo F, Hart T. Interleukin 1 genetic tests provide no support for reduction of preventive dental care. JADA. 2015;146(3):164-173. 18. Skloot R. The Immortal Life of Henrietta Lacks. New York, NY: Crown Publishing; 2010. 19. Rosen M. Dignity. Cambridge, MA: Harvard University Press; 2012. 20. Department of Health, Education, and Welfare. The Belmont Report. 1979. Available at: http://www.hhs.gov/ohrp/regulations-andpolicy/belmont-report/. AccessedOctober 6, 2016. 21. Beauchamp T. Standing on Principles. New York, NY: Oxford University Press; 2010:9. 22. Bhardwaj A, Misuriya A, Maroli S, Manjula S, Singh AK. Nanotechnology in dentistry: present and future. J Int Oral Health. 2014;6(1):121-126. 23. Khanna S. Artificial intelligence: contemporary applications and future compass. Int Dent J. 2010;60(4):269-272. 24. Macklin R. Dignity is a useless concept: it means no more than respect for persons or their autonomy. BMJ. 2003;327(7429):1419-1420.

Finally, for confirmation of the principle of respect for human dignity’s usefulness and value in the area of health care, we need simply to turn again to the AMA Code; listed first among the AMA Code’s 9 principles of ethics is the obligation of physicians to provide competent medical care with “respect for human 2 dignity.” SUMMARY The principle of respect for human dignity plays a prominent role within the AMA Code. The principle of respect for human dignity appears capable of both guiding progress and, as needed, firmly checking the excesses possible in the area of dental genetics. Given advances in genetic science, we should strongly consider the following question: Would the insertion of the principle of respect for human dignity into the ADA Code better enable the ADA to appropriately supplement its Code of conduct and issue advisory opinions regarding genetic-based research and practice? The normative content conveyed within the principle of respect for human dignity is useful in highlighting the unique relationship that exists between the dignity of human life and the gene. Accordingly, the evaluative assumptions derived from the application of the principle of respect for human dignity are extremely well suited to providing the ethical foundation of dental professionals’ obligations in areas relating to genetic science. The process of the specification of the principle of respect for human dignity will enable the ADA to make needed additions to the ADA Code and render useful advisory opinions outlining a

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{This article originally appeared in the December 2016 Journal of the American Dental Association. This has been reprinted with permission of the publisher. Dr. Iovino is a member of the Suffolk County Dental Society.}

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THE LAST WORD

thomas j. bonomo, d.d.s.

I Am Too Old To Learn I've owned or leased many cars over the last sixty five years. No, the Model T Ford was not one of them. I took my initial driver's exam in Freeport. I think the examiner broke the world record for the 100 yard dash once I stopped, except for one of my dates who didn't even wait for me to pull over. But that's material for another column. As far as I am concerned, like most Americans, buying a car is one of the most traumatic things we do every few years. Going to the dentist is not much further down the list. To make life easy for me, I decided that I would buy the same model car I had previously leased. No, it's not a Tesla or Porsche. I don't mind being seen in an old man's car. The salesman practically jumped for joy when he saw me. I was offered coffee, tea and water. He showed me all the testimonials to his sales prowess. He said he makes the best deals in dealership. After awhile the negotiations began. I wanted every safety feature that he had to offer. If you saw me drive you would understand. My children suggested a large pickup truck or SUV for my greater safety. Sorry but not my style. We finally set a price agreeable to all. Then I chose a color and was told to return in two days with the rest of the money. The car looked great. The salesman's son was working with his father during his college break. Basically, he showed me how to set the radio and show me all the new features. Everything was different. Nothing was the same as the previous model.

Junior's job was to explain the electronics. Our ages differed by sixty years. I became confused right after he said "hello." A few days later the low tire pressure light came on. I had gotten a nail in one. After it was fixed, my dash board changed. I have been back to the service center so often that I have become good friends with the mechanic. Frankly, I think that there should be a law prohibiting people over a certain age from buying these monsters. Bring back the Model T. It comes in any color as long as you want black. As dentists don't we also speak in jargon? The patient doesn't want to be there. He is afraid of pain, the bill and doesn't understand many dental terms. His eyes glaze over and doesn't comprehend the treatment plan. If possible, I would ask him to bring someone along for the consultation, who can listen and ask questions. I always got better acceptance when I did this. Stay tuned for an update in 2020.

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OFFICERS AND PAST PRESIDENTS Officers of the Society: President: President-Elect: Vice President: Secretary: Treasurer:

Ivan Vazquez, DDS Dimitrios Kilimitzoglou, DDS Martin Dominger, DDS Claudia Mahon-Vazquez, DDS Jeffrey Seiver, DDS

Editors: Thomas Bonomo, DDS Paul Leary, DMD ADA Delegates: 1st : Maria Maranga, DDS (2017) 2nd: Paul Leary, DMD (2017-2018) 3rd: Steven Snyder, DDS (2017-2019) Alternate ADA Delegates: 1st: Dimitrios Kilimitzoglou, DDS 2nd: Kevin Henner, DMD 3rd: Guenter Jonke, DMD NYSDA Trustee: Paul Leary, DMD (2017) Kevin Henner, DMD (2017-2020) NYSDA Delegates: Kevin Henner, DMD (2017) Nick Vittoria, DMD (2017) Jeffrey Seiver, DDS (2017) Chris Salierno, DDS (2017 - 2018) Kerry Lane, DDS (2017-2019) Maria Maranga, DDS (2017-2019) Steven Snyder, DMD (2017-2020) Guenter Jonke, DMD (2017-2020) Alternate NYSDA Delegates: 1st: Ivan Vazquez, DDS 2nd: Dimitrios Kilimitzoglou, DDS 3rd: John Guariglia, DDS 4th: Martin Dominger, DDS 5th: Sharon Pollick, DMD 6th: Claudia Mahon-Vazquez, DDS 7th: Patricia Hanlon, DMD 8th: Anthony Maresca, DDS Committee Chairpersons Access to Care Chemical Dependency: Children’s Dental Health: Dental Benefits Programs: Dent.Hlth, Hlth.Pln.&Hosp.D: Dental Practice: EDPAC representative: Education: Ethics: Governmental Affairs: Membership & Comm: New Dentists: Peer Review & Quality Assur: Professional Liability:

Jeffrey Seiver, DDS Peter Pruden, DDS Howard Schneider,DDS, D. Kilimitzoglou, DDS John Guariglia, DDS Keri Logan, DMD Scott Firestone, DDS Kerry Lane, DDS D. Kilimitzoglou, DDS Nick Vittoria, DMD Sharon Pollick, DMD C Mahon-Vazquez, DDS Brian McCormack, DDS Jeffrey Seiver, DDS Kevin Henner, DMD

Past Presidents 2016- John Guariglia, DDS 2015- Scott Firestone, DDS 2014- Chris Salierno, DDS 2013- Nick Vittoria, DMD 2012- Guenter Jonke, DMD 2011- Maria Maranga, DDS 2010- John Lagner, DMD 2009- Leonard Goldstein, DDS 2008- Jeffrey Seiver, DDS 2007- Kevin Henner, DMD 2006- Paul Leary,DMD 2005- Kerry Lane, DDS 2004- Steven Snyder, DDS 2003- Ian Glaser, DDS 2002- Anthony Maresca, DDS 2001- Stephen Goldstein, DDS 2000- Jeffrey Sherman, DDS 1999- Paul Markowitz, DMD 1998- Tracy Stewart- Flamenbaum, DDS 1997- Eugene Antenucci, DDS 1996- Alan Mazer, DMD 1995- Alan Farber, DDS x1994- Steven Roberts, DDS 1993- Howard Miller, DMD 1992- Thomas Bonomo, DDS 1991- Howard Rodin, DDS 1990- Jay Orlikoff, DDS/ Thomas Bonomo, DDS 1989- John Primavera, DDS 1988- Allen Peyser, DDS x1987- Stephen Gold, DDS x1986- Jack Hanover, DDS 1985- William Katz, DDS 1984- Richard Tesser, DMD 1983- Robert Benton, DDS x1982- Edward Anker, DDS 1981- George Glick, DDS x deceased Board of Directors Lawrence Absatz, DMD William Bast, DMD Alan Berman, DDS Gordon Diehl, DMD Steven Feigelson, DDS Scott Goldstein, DDS Pat Hanlon, DMD Brian McCormack, DDS Radha Munk, DDS Peter Pruden, DDS Howard Schneider, DDS Meena Shah, DDS Craig Smith, DMD

David Amram, DMD Adam Bear, DDS Joseph DiBernardo, DDS Zackary Faber, DDS Christopher First, DMD Joseph Graskemper, DDS Keri Logan, DMD Virginia, Mitchell, DDS Sharon Pollick, DMD John Rose, DDS Laurence Schwartz, DDS Lloyd Simonsen, DDS Marvin Stern, DDS

Executive Director: Paul Markowitz, DMD Executive Assistant: Debbie Wasserman Executive Director Emerita: Jane Meslin

Official publication of the Suffolk County Dental Society 150 Motor Parkway  Suite 105  Hauppauge, NY 11788 (631) 232-1400  Fax (631) 232-1402 email: [email protected]

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THE GREATER LONG ISLAND DENTAL MEETING Defining Dental Excellence

SAVE THE DATES APRIL 25-26, 2017 Hilton Hotel – Melville, NY Featured Speakers Anthony Sclar – “Ultimate Esthetic Implant Course” Clifford Ruddle - “Creating Endodontic Excellence” Gary Alex – “Composites + Adhesive Dentistry + Materials” Mike DiTolla – “Digital Impressions + Technology” Adamo Notarantonio – “Photography” Marc Gottlieb – “Dental Emergencies & Airway Management” Alexandre Molinari – “Reduced Diameter & Short Implants” Anne Koch – “Bioceramics in Endodontics” Robert Schwartz – “Integrating Technology into the Dental Practice” Judy Bendit – RDH – “Silver Diamine Fluoride + Myths and Legends” Shannon Brinker – “Round Table Discussions for the Dental Assistant” + More to Follow Risk Management  Infection Control  CPR Young Dentist Event + Resident and Student Night

PLUS … Alumni Reception  Exhibitor Cocktail Reception Exhibitor Raffles  Door Prizes Table Clinics  Photography Contest

EXHIBITION HALL HOURS – ALWAYS FREE TO ATTEND! Tuesday, April 25th - 5:00 pm to 9:00 pm + Wednesday, April 26th - 10:00 am to 6:00 pm REGISTRATION OPENS JANUARY 1, 2017 www.glidm.org For further details contact our office at (631) 244-0722 or email [email protected] {See CERP and PACE CE Information on page 16}