VOL. 86 NO. 2 www.cdaonline.org SPRING 2007 Are You Ready to Start a

FREE! New Practice? Earn 5 CE Credits! Or want to improve your existing one?

Dear CDA Member: The Colorado Dental Association and Banc of America Practice Solutions invite you to attend a seminar on Friday, May 18, at the CDA office, 3690 S. Yosemite St., #100, Denver, CO 80237. The seminar is from 9:00 am to 2:00 pm, with lunch provided. Take advantage of free advice from a CPA, attorney, practice financing representative, insurance specialist, computer software/hardware specialist, dental equipment representative, architect, construction specialist, practice management consultant and more! These professionals specialize in servicing dental practices and will provide budgeting resources. When starting a new practice, or wanting to improve an existing practice, it is important to obtain professional advice from individuals and companies that have the expertise to assist you with your decision making. This seminar is intended to provide you with information on running a dental business. Please RSVP by Friday, May 4, 303-996-2843 or [email protected], and join many of your colleagues for this helpful seminar. Get your answers to these questions and many more! How do I go about arranging financing for my practice Do I really need an employee manual for a small without tying up my personal lines of credit? How can practice? What questions are illegal to ask in an I arrange patient financing so I get paid right away? interview? Is it better to be a sole proprietor, limited liability How do I conduct a demographic study of my practice company, C Corp, S Corp., etc. for income tax site? How do I establish a marketing plan and budget purposes, and how do I reduce potential liability to for my practice? personal assets? Should I buy an existing practice or start a new What type of insurance is required to open a practice? practice? Should I outsource my payroll?

RSVP: 303-996-2843 or 800-343-3010 or [email protected] CDA, 3690 S. Yosemite St., Denver, CO 80237 The CDA is an ADA CERP recognized provider. CDA Editorial Board Editor-in-Chief Joseph C. Tomlinson, D.M.D. Director of Communications, Managing Editor Molly M. Osberg CDA EXECUTIVE COMMITTEE Dr. Rhett Murray President Dr. Jeanne Salcetti President-Elect Dr. Jeffery Hurst Vice President Dr. Pasco Scarpella Treasurer Dr. Dave Lurye Secretary Dr. John Hanck Immediate Past President Dr. Kevin Sessa Speaker of the House Gary Cummins Executive Director BOARD OF TRUSTEES Dr. Robert Morrow Arkansas Valley 719/324-5251, fax 719/324-5621 Dr. Gerald Savory Boulder/ Broomfield County 303/530-4145, fax 303/530-9620 Dr. Cal Utke Colorado Springs 719/593-8701, fax 719/593-9258 Dr. Rob Yardumian Intermountain 719/687-9011, fax 719/687-3919 Dr. Tom Pixley Larimer County 970/221-5115, fax 970/221-5136 Dr. Ken Peters MDDS 303/791-2570, fax 303/683-4198 Dr. J. Scott Hadley Northeastern 970/521-7267, fax 970/521-7203 Dr. Brian West San Juan Basin 970/259-5600, fax 970/247-2820 Dr. Stephen Schiffer San Luis Valley 719/589-4946, fax 719/589-4949 Dr. R.J. Schultz Southeastern 719/542-0036, fax 719/544-6777 Dr. Robert Benke Weld County 970/356-2120, fax 970/356-1013 Dr. David Nock Western 970/242-4433, fax 970/256-7671 Cynthia Packard, RDH ADT Liason 719/324-5251, fax 719/324-5621

USPS 661730 ISSN 0010-1559 Journal of the Colorado Dental Association (ISSN 0010-1559) is published quarterly by the Colorado Dental Association, 3690 S. Yosemite St., Ste. 100, Denver, CO 80237-1808. Annual subscription rates: CDA members included in dues; Non-members US – $35; Other countries–$45. Periodical postage paid at Denver, Colorado, and additional offices. Single copy is $10 in the USA. POSTMASTER: Send address changes to: Journal of the Colorado Dental Association, 3690 S. Yosemite St., Ste. 100, Denver, CO 80237-1808. Articles for publication, correspondence, and advertising should be addressed to: Managing Editor, Journal of the Colorado Dental Association, 3690 S. Yosemite St., Ste. 100, Denver CO 80237- 1808. 303/740-6900 or 800/343-3010. The Journal reserves the right to reject any advertising and, as a matter of policy, does not accept advertising of any product classified by the American Dental Association Council on Dental Therapeutics as unacceptable. Advertisements: For advertising rates and specifications call 303/740-6900 or 800/343-3010. Contributions: Neither the Editors nor the Colorado Dental Association are in any way responsible for the articles or views of contributors published on these pages. The Journal of the Colorado Dental Association is a peer-reviewed publication. ©2007 Colorado Dental Association. All Rights Reserved. Supporting Colorado’s Fee-For-Service Dentisits Since 1974

Practice

Transitions Paul D. Sletten ➣ Practice Sales ➣ Adding An Associate ➣ Partnerships/Mergers ➣ Life and Practice Planning ➣ Retirement Planning ➣ Transition Coaching The Sletten Group, Inc. Office: 303-699-0990 Fax: 303-699-4863 Email: [email protected] Journal OF THE COLORADO DENTAL ASSOCIATION Vol. 86, No. 2 www.cdaonline.org Spring 2007

CONTENTS

6 “If You Have a Good 18 give kids a smile! Idea, Share it With Your Photo Essay Colleagues.” By Joseph Tomlinson, D.M.D. 19 Despite Gloomy Weather, Colorado 8 There is Nothing That Dentists Shine the Dentist Can Do, By Molly Osberg, Associate Executive Director About Our Cover: Which the Patient Cannot Undo Amanda Moore, from By James C. Grant, D.D.S. 20 Thank You Volunteers! Maranatha Christian Center 22 Media Spotlight in Arvada, Colo., won the 10 Mission of Mercy – My Experience 2007 CDA Coloring Contest. By John Hanck, D.D.S 23 Some Bite, Some 3,715 entries were submitted Benefit – A Look at this year, setting a record for 11 Relationship Questions: Recent Tax Law the annual contest. Please The Glue to Create Changes see the May issue of the Powerful Doctor-Patient By Mimi N. Hackley, C.F.P. Colorado Dentistry newsletter Bonds By Janet Steward and Lawrence 25 Spring Cleaning for for the full story and other Steward, M.B.A. Your Practice – winners. Collecting Unpaid 13 The Importance of Balances Documentation and Use By Lori Lepar, Quantum of Progressive Discipline Healthcare Services By Stacy Jensen 27 Classifieds 14 A Simple Technique for Opening the Vertical Dimension of Occlusion as an Aid in Solving Challenging Restorative Problems

PRINTED ON RECYCLED PAPER By Joseph C. Tomlinson, D.M.D.

Publication Member of the American Association of Dental Editors

VOL. 86, NO. 2 Journal of the Colorado Dental Association 5 ■ EDITOR IN CHIEF “If You Have a Good Idea, Share it With Your Colleagues.” (Quote by Dr. Gordon Christensen, ADA Annual Session in Orlando, Fla.) By Joseph Tomlinson, D.M.D.

“You should write a paper on My next question to him was “had he ever seen anything published on this hen I this and have it published.” concept?” It was important to me that heard the -Dr. Irwin Becker, CDA Annual Session in W Telluride, Colo. something be published on this topic as words spoken by Dr. another one of my patients insisted Christensen as his Prior to Dr. Christensen’s statement, I that I teach this concept to other opening comments had attended a lecture by Dr. Irwin dentists as it had made such a before an all-day Becker, of the Pankey Institute, at the dramatic improvement in her condi- Dr. Joseph seminar at the 2004 2003 CDA Annual Session in Telluride. tion and her life. What I had Tomlinson is a ADA Annual Session One of his sub-topics dealt with increas- accomplished for this patient was to General in Orlando, I knew he ing Vertical Dimension of Occlusion create the right amount of interocclusal Practitioner in was speaking to me. (VDO). During a question and comments space to allow me to properly restore her Fort Collins, In fact, I was already period at the conclusion of his presenta- badly chipped and worn anterior teeth, Colo. scheduled to present tion, I explained to him that I had been enhancing her smile. Her upper and lower a program to the Larimer County Dental using the technique described in my incisors had been in an edge-to-edge Society about a concept and technique I accompanying paper for years, and I position for years and there was simply no had developed following a discovery I wondered what he thought of the room to add restorative material until made over 25 years earlier while trying to technique. He told me “it was a great after this “bite opening” technique was solve an unusual occlusal and orthog- idea,” and added that he and others were performed. In addition to enhancing her nathic problem for a patient who was very experimenting with such a concept at the smile, an unexpected benefit occurred dear to me, my own mother. In addition, I Pankey Institute for the previous two very soon after I altered her vertical had nearly completed a paper on the years. They were using it as a means to dimension of occlusion (even before I had concept, which had been accepted for temporarily establish an appropriate a chance to restore the incisors) – her jaw publication pending a few revisions. vertical dimension for patients before muscle spasm dysfunction, which had completing more permanent treatment. been troubling her for years, had a complete spontaneous resolution. In order for me to accept this patient’s charge to teach this concept, I believe it is essential that it be supported by published Career Opportunities papers including a discussion of the technique, results, findings and any Available untoward outcomes. Dr. Becker’s answer to my question in the preceding paragraph was, “no, nothing has ever been published on my concept, but it should be.” He then added, “you should write a paper on this and have it published.” Through e-mail DR. MARK A. BIRNER / 303-691-0680 correspondence, Dr. Becker provided me with suggestions on completing the paper

6 ■ Journal of the Colorado Dental Association SPRING 2007 for publication. Thanks to his charge, and Dr. Bill Iversen of Fort Collins and Dr. after waiting a reasonable amount of time Mark Stasi of Denver, have expressed for untoward outcomes to surface, if there support for the fundamentals of this should be any, I am now ready to publish technique and an interest in utilizing it to my paper in this Journal. simplify some of the issues they face in The article that accompanies this their everyday orthodontic practices. Both column, “A Simple Technique for have recommended I publish a paper on Opening the Vertical Dimension of this concept and technique. Occlusion as an Aid in Solving Please read the accompanying article Challenging Restorative Problems,” is and, if you would like to know more about one that I feel passionate about. I used the concept and its applications, contact Power Point to present this concept to a me. I would be happy to spend an hour group of about 50 dentists at the Larimer with any group or study club, teaching and County Dental Society in October 2004. discussing this concept by way of the same The response has been overwhelmingly Power Point presentation shown to positive. A few general practitioners have members of the Larimer County Dental indicated to me that they have used the Society. I also plan to follow the paper technique a few times since learning published in this issue of the Journal with about it. They have reported that it subsequent papers showing examples of allowed them to better solve some patients already treated with this technique, challenging problems that could not have and to discuss various other conditions that been so easily solved without the aid of could reasonably be corrected or improved this technique. Two orthodontist friends, with this concept. ■

VOL. 86, NO. 2 Journal of the Colorado Dental Association 7 ■ GUEST COLUMNIST There is Nothing That the Dentist Can Do,Which the Patient Cannot Undo

By James C. Grant, D.D.S.

caramelized, hot, cold, ordered to your perception is, “at least I’m exercising and temperature, oversized to today’s Super helping my body, so now I need to replace his statement Size mega drink is readily available. The the lost fluids.” Unfortunately, we have the has never rang T calories with accompanying weight and same problem with exposure to sugar for truer than today. For medical problems are an issue unto itself; extended periods of time, except now we the past 31 years, I however, my concern is the way it is add in acids. One bottle (almost 17 oz.) of have practiced clinical ingested. My experience is this: in the fitness water has only 25 calories, which dentistry. I am now morning, on the way to work, people doesn’t seem too bad, but along with the observing some very Dr. James purchase one of these enormous and sucrose syrup and high fructose corn syrup, disturbing trends and Grant is a expensive drinks — say a 16 oz. caramel we now have citric acid, ascorbic acid and habits related to society General latte with whipped cream — and plan on phosphoric acid (a lesser percentage of the that are here to stay. Practitioner in sitting at their desks and sipping it from blue gel we etch teeth with). Even some Patients who have been Colorado morning to lunch. It costs too much to not bottled water with 0 calories has at least in my practice for years drink it all, and they need the caffeine and two of the mentioned acids added to them. Springs, Colo. and have exhibited sugar buzz. So for hours they are bathing Again, it’s the patient’s perception of these consistently good oral hygiene habits, their teeth, root surfaces and restoration exercise-related drinks that worries me, regular prophylaxis and exams, are now margins in sugar. The outcome is obvious. not to mention the effects they have on presenting with gross recurrent decay on What isn’t so obvious is the patient’s their teeth. multiple teeth, and decay on previously perspective as to this daily ritual being a non-restored teeth. It is not an isolated Which brings us to diet drinks: One of source of tooth decay. Will these trendy case or some anomaly, rather a disturbing my patients likes to argue with me (ok, coffee shops go away as some fad? Will frequency and commonality. I have had he’s a lawyer and likes to argue with people go back to plain black coffee and long conversations filled with probing anybody) because he drinks (as he is sugar substitute? Or at least if they drink questions regarding the habits and willing to testify to) diet soda, and only the flavored, syrupy coffee over say a 15 nutrition of these intelligent, long-term diet soda. He finally admitted, thanks to minute period, will they then rush to the patients to see if I could discern a his wife, that this means multiple sodas bathroom to brush and floss the sugary diagnosis. The following are my clinical daily, but nevertheless only diet. The residue off their teeth? I’m not too observations and conclusions from the amount of erosion around margins of optimistic. answers that these patients informed me restorations, class V areas, and the as to the etiology. The answer comes in at I do see patients who don’t drink coffee general destruction of his teeth, was least five parts and has developed as a at all, perhaps substituting a healthier remarkable. So, here is an intelligent man social trend or blight that I feel is here to alternative, and some of them have the who thinks he is causing no harm to his stay, and dentists will need to deal with same problem with recurrent decay and teeth by drinking a diet soda, when in fact this trend from now on. periodontal lesions not previously seen. he is doing everything possible to erode Another possible contributing factor are all the organic tooth structures, and cause Within walking distance from my office the latest hip sport drinks, which replace irreversible damage to restorations, are seven (no kidding) coffee shops – electrolytes and hydration lost during necessitating early replacement. some the trendy specialty cafés, others the exercise. Again, we have a pleasant drink quick stop type, but all still serving the One of the more recent drinks to come that is “good for us,” and is to be con- new definition of coffee. The extensive out is the “energy drink.” I see this in the sumed over a long period of time: before, menu of sugared, creamed, foamed, younger patient. The chemistry of these is during and after exercise. The patient flavored, syrupy, whipped creamed, pretty simple – they are loaded with

8 ■ Journal of the Colorado Dental Association SPRING 2007 caffeine and sugar. These patients are no person or class status is immune from sometimes already a challenge nutrition- this blight on society. ally, and with so many of these products At times I am discouraged with defeat available, coupled with pressures from of how we, as dentists, can combat this peers and high demands on performance, relentless attack on our tight margins and I think we’ll continue to see more of this well-placed, contoured restorations, by deleterious affect in the future. patients who knowingly or unknowingly The last trend I have identified is inflict this abuse on themselves and their without a doubt the worst, and unfortu- teeth. These are the patients who trust us, BUILDING. RELATIONSHIPS. nately, I have seen some cases this past but put an unrealistic expectation on the • Honesty year. The diagnosis of “meth mouth” is a longevity of the outcome. It has to be a • Communication hard one, as it is shocking for me to think renewed partnership, a symbiotic • Attention to Detail one of my patients who has never shown relationship where we both do our part • Personal Service signs in the past, can now be diagnosed and help counteract the slick advertising • Absolute Satisfaction with all the symptoms. The ingredients in with information and truth. We can do the methamphetamine that are so damaging diagnosis and inform the patient of the are muriatic acid, sulfuric acid, red side effects of these hidden habits and phosphorous and lye, to name a few. actions, resulting in dire consequences if Along with xerostomia, tooth decay, poor not altered or eliminated entirely. As a oral health, cracked teeth and gum dentist, I will continue to do my best in disease, it is shocking to think anyone treating and combating the new trends, would voluntarily do something to his/her but frankly I am not hopeful for most of www.mendelandcompany.com body such as this, but lately it seems that these patterns to be altered. ■ 1165 S. Pennsylvania St. Suite 204 • Denver 303-698-5628

VOL. 86, NO. 2 Journal of the Colorado Dental Association 9 ■ VOLUNTEERISM Mission of Mercy – My Experience By John Hanck, D.D.S.

Due to the nature of the event, and to alleviate the pain that many of ou have no doubt heard a the patients were suffering from, buzz recently about COMOM Y the motto of the day was, “If in – the Colorado Mission of Mercy – a doubt, take it out.” Almost all large-scale, multi-chair dental clinic necessary treatment was completed that will travel around the state at the event – we didn’t want to annually to underserved areas. As part leave the local area dentists with large of the CDA team that scouted out whether COMOM registration is open online numbers of problem teeth needing follow- a Mission of Mercy (MOM) event would be at www.cdaonline.org. Please sign- up care. a good fit for Colorado, I can tell you that up to be a part of this inaugural event without a doubt you will not know what During the evenings, KMOM provided in Colorado. Dental and non-dental you’re missing until you participate in a us with dinner, music, dancing and MOM. It is an opportunity that provides an volunteers are welcome! camaraderie, as well as an enthusiasti- enormous amount of oral health care to cally announced report of the day’s people who don’t have access to dental donated services and the treatment goals operative dentistry, oral surgery, pediatric treatment but desperately need help. It has for the next day. The two and a half day dentistry, hygiene, radiology, endodontics, been an opportunity that has warmed my KMOM in Pittsburgh treated 2,761 pharmacy and a prosthetic lab. There was heart and has made me proud to be a patients, delivering $981,500 worth of food provided for the patients and staff, dentist. dental care. and traffic and crowd control by the I first learned about MOM when Dr. Bob National Guard. There was a health It was a wonderful feeling to be part of Morrow of Walsh, Colo. informed the CDA history station run by nurses, entertain- a “bigger than life” event. The expressions Board of Trustees of the event in 2002. He ment for children, post-treatment of gratitude from the patients were heart had participated in the Kansas Mission of interviews for patients, and paramedics felt and continuous throughout the Mercy (KMOM) and was eager to establish available in case of emergency. Just weekend. The hug quotient was also very a MOM event in Colorado. The Board watching the set-up of this grandiose high with many tears of appreciation. It asked Dr. Morrow to invite Dr. Jeff Stasch, event generated excitement to start was a life-changing event for me and of Kansas, to attend a Board meeting to treating patients the next day. many others. tell the trustees more about MOM. I Patients started coming to the parking lot The pride I felt in my profession was remember being very impressed by the at 3 a.m. – they knew it was a first come, indescribable. To have the opportunity to amount of dental care that was delivered first served event. As the crowd grew, the be part of a large philanthropic event that and the amount of need that existed in National Guard directed cars to the proper is open to the entire dental team was the small area of Kansas where the MOM parking lots and maintained order while beyond gratifying. events had been held. patients waited in line for the doors to I hope that all of you will join the In 2004, CDA staff members Lu Anne open. We started seeing patients in triage at COMOM in Alamosa, Colo. on Oct. 19-20, Garvin and Molly Osberg, as well as Dr. 6 a.m. Once screened, the patients would 2007. The first COMOM will take place at Pasco Scarpella, Dr. Bob Morrow and I go to the anesthesia station and then to Adams State College. The CDA is also went to the KMOM in Pittsburg, Kan. to operative, where I was assigned, or to seeking monetary donations. If every CDA volunteer at and observe a MOM in another treatment area. We treated patients member donated just $100, we could cover action. We saw the transformation of a using portable dental stations, complete the cost of this COMOM and purchase college gymnasium into a working dental with sterile water and suction. equipment for COMOMs in the future care center, complete with triage, The amount of dental care that was (checks should be made payable to the CDA anesthesia, central supply, sterilization, needed, primarily by adults, was shocking. Charity and Educational Fund, Inc.). ■

10 ■ Journal of the Colorado Dental Association SPRING 2007 PRACTICE MANAGEMENT Relationship Questions:The Glue to Create Powerful Doctor-Patient Bonds By Janet Steward and Lawrence Steward, M.B.A.

QUESTION: I feel very comfortable with patients do, but most want more. They are questions typically asked of new my clinical skills but my staff keeps want relationships with professionals they patients, such as “are your teeth sensitive hinting that they think I could do better know and trust. to hot or cold?” Most dental practices do a relating with patients. How can I improve? Many corporations and business very respectable job asking transactional ANSWER: Your current approach to researchers have spent hundreds of questions. While essential, be aware that patient relationships is common among thousands of dollars, and years of their they do not create patient bonds. dentists, but it may be placing too much time, studying the question of how their While transactional questions don’t emphasis on increasing patients’ dental businesses can improve relationships with build patient relationships, the second IQ while underestimating the power of their customers. category of questions are the powerful treating patients as unique individuals. The simple response, in spite of all that tools that spark patient-doctor bonds. The “problem” with the common research, time, money, and volumes of Relationship questions are patient approach is it assumes that patients are reports and articles, can be condensed centered and designed to get to know the coming to your practice because they just into two concepts: (1) ask questions that patient as a person. Good relationship want their teeth fixed. Naturally, some engage and (2) listen to the answers. questions can’t be answered with a simple yes or no because they’re designed to In fact, the art of engage the patient in conversations about asking questions is themselves. clearly the most powerful tool in Unless you ask, it’s unlikely you’ll learn creating personal and the fact a patient has just received a new professional relation- promotion at work, has written a book, ships. Of course, it does has a new baby, or is a new grandparent. little good to ask Sure, patients want a great dentist, but to questions if you don’t them that means a dentist who is good listen to the answers, clinically AND who understands and cares so it’s obvious the two about them. go hand in hand. Successful dentists want to know more There are two types about their patients, but very often, while of questions that are doing so, amazing things happen that important in dentistry: benefit their practices as well. For transactional and example, by asking an older patient about relationship builders. his life, the dentist may learn this patient The transactional has a huge extended family and their question is used to gain current family dentist is retiring at the end basic but important of the month. The time it took to get to clinical information. know the patriarch of the family may These seek specific benefit the dentist with three-dozen new responses and often patients in the future (without a cent can be answered with spent on external marketing)! yes, no, or a single word/phrase. These GLUE continued on page 12

VOL. 86, NO. 2 Journal of the Colorado Dental Association 11 ■ do in my practice is spend a little time manipulation or other tricks just to sell GLUE continued from page 11 with you as a patient just so I can get to something: they are genuinely interested. Once the dentist has established a know you better. So what’s happening in Despite their simplicity, relationship personal relationship, it’s appropriate to your life?” Further questions then seem questions provide dramatic returns by move on to such issues as clinical history natural and are based on patients’ creating lasting bonds with patients as real and experience, goals for dental health, and responses. people who like to create relationships. ■ any current financial concerns they might When these questions are skillfully used have. (Remember, nearly everyone feels and the doctor uses active listening skills, Janet and Lawrence Steward are speakers, broke today, but most feel optimistic about a transformation is taking place within consultants and authors. Their book, their ability to afford important purchases at patients. Suddenly, instead of being asked What Do Dentists Really Want? is available some time in the future.) Even when through www.Amazon.com or for passive information, they are being patients have huge financial obstacles for www.theManageDentPros.Com. Janet engaged. Somewhere inside the patient’s treatment acceptance today, establishing a Steward, president of Quantum Leap brain, the message is sinking in: “this bond with them ensures that, when they’re Dental Consulting, can be reached at doctor really cares enough about me to ready, they’ll come to you. 970/207-0776. find out about my life and what’s impor- So what questions seem to get the best tant to me, my family and friends.” Do you have a practice management results? The best approaches are well question you’d like answered in this There is a time tested and true analogy rehearsed but very conversational and quarterly column? Submit your questions that patients won’t care about what you natural. For example, one doctor might to [email protected] or 3690 S. have to say until they know you care start the conversation with a new patient Yosemite St., #100, Denver, CO 80237. about them. Through the use of active by saying something similar to this after listening skills, doctors are not using introductions: “One of the things I like to

12 ■ Journal of the Colorado Dental Association SPRING 2007 PRACTICE The Importance of Documentation and Use of Progressive Discipline By Stacy Jensen

QUESTION: One of my hygienists is for an employee to allege that they “didn’t improve their performance, it is important constantly late, uses foul language on the know the policy.” that you revisit the issue when the time has job, and has a terrible attitude in general. If there is a breach or a suspected elapsed. If the behavior or offenses When I called my HR company to tell breach of company policy, a thorough continue, and you have appropriately them that I wanted to fire her, they told investigation should be conducted. documented the lack of improvement, your me that I should give her a written Employers need to be relatively certain grounds for terminating the employee are warning instead. about what’s really going on in order to more likely to be substantiated, helping I thought that Colorado was an at-will address the situation. If the problem is you to potentially avoid an unemployment state. Why can’t I just terminate her? clear-cut (i.e. tardiness) the situation claim or discrimination suit. ANSWER: Colorado is an employment- requires little investigation. If an employee It is critical to maintain equitable at-will state, as are most other states in is being accused of some type of negative treatment in your disciplinary process. If the nation. Although you can terminate behavior by another co-worker, however, it you treat all employees equally, each any employee who does not have a is important to seek both sides of the story. employee’s personnel file will reflect your written contract with your practice, in When you are certain that a breach in disciplinary action consistency. Though many instances it is not always advisable. company policy has occurred, the next each disciplinary problem is unique, civil rights investigators and plaintiffs’ There are several reasons why employ- step is to determine the severity of the offense. A first-time offense should call for attorneys will not just accept your “word” ers are advised against terminating an that you do not discriminate. Despite a employee when there is an absence of less of a formal intervention than a repeat offense. If the employee has committed an state’s “at-will” policy, adhering to a documentation or progressive discipline. consistent disciplinary procedure will The threat of complaints such as wrongful illegal act you will most certainly impose more serious discipline. protect you in the unfortunate event that discharge, discrimination, and a host of employment must be terminated. other legal battles are reason enough to Written documentation officially make sure that your practice adheres to a recognizes that a problem exists and strict and uniform discipline policy. Used should be prepared after meeting with the Stacy Jensen is a Communication properly, progressive discipline gives staff member (if there is any uncertainty Strategist for Terra Firma, a locally owned and operated Professional Employer managers the tools they need to make about the alleged offense). When a Organization (PEO) in Denver, Colo. Terra fair, consistent, and legally defensible manager presents the disciplinary action Firma is a CDA Medallion Plan Partner disciplinary decisions. Because it’s based form to the employee, it is important that and provides small to mid-sized employ- on communication and collaboration, true it is signed by both the manager and the ers with a full scope of human resources progressive discipline also helps employ- employee. The form should indicate the services, safety and risk management, ees improve, which is the ultimate goal of details of the occurrence as well as the employee benefits administration, and any disciplinary system. required employee action. Maintaining regulatory compliance consulting. Contact The first step is to ensure that your clear and accurate documentation at [email protected] for information. company policies are legal and up-to- every step of the disciplinary process is date. Every employee should receive and crucial in the final stages of progressive Do you have a human resources acknowledge receipt of your employee discipline when termination of the staff question to be answered in this quarterly handbook prior to commencing their first member is probable. column? Submit your questions to day of employment. Keep a copy of the When appropriate, establish a timeline [email protected] or 3690 S. Yosemite acknowledgement of receipt in their for the corrective employee action. If you St., #100, Denver, CO 80237. employee file. This makes it more difficult give an employee a certain time frame to

VOL. 86, NO. 2 Journal of the Colorado Dental Association 13 ■ DENTAL TECHNIQUE A Simple Technique for Opening the Vertical Dimension of Occlusion as an Aid in Solving Challenging Restorative Problems

By Joseph C. Tomlinson, D.M.D.

A Dental Technique Paper space is needed, or if the patient doesn’t tolerate this amount of opening. While I Abstract: The technique presented in haven’t tried using a two-step or one-step this paper allows general dentists and product for this procedure, manufacturers specialists to more effectively treat a wide of those products indicate that they bond variety of conditions in a simpler and far as well as a three-step technique. more affordable manner, bringing better For many patients, the four lower dentistry to more patients than ever premolars are selected for this procedure before. The technique itself is very simple. (Figure 1). For others, the four upper It consists of applying a composite build- premolars are selected; and for some, the up to the occlusal surfaces and cusps of Figure 1: Four lower premolars have been buildup is divided between upper and two or more teeth on each side of the built up two to three millimeters with lower premolars. In some cases the mouth. The teeth I recommend selecting composite. Photo was taken more than procedure may involve using one or two for this procedure are the four lower two years after procedure was initially molars, especially if the cusps are heavily premolars. However, variations of the performed. worn or cupped out, or show signs of technique are acceptable, and are wear, utilizing the technique presented in excessive wear and would benefit from discussed later in this paper. this paper can facilitate achieving a being restored to their original unworn Introduction: Many times during the positive solution for both the patient and shape and contour. This is particularly course of a typical week in the dental the dentist. helpful when some of the premolars are office, we are faced with a situation where Technique: This can be performed with crowned or otherwise unavailable for this the patient’s teeth are heavily worn, either any type of durable, tooth-colored purpose. Regardless of whether the teeth in the molars and premolars, or the upper composite material. I prefer to use a selected are in the lower arch, the upper and lower anteriors, or both. If the teeth three-step (etch, prime, bond and arch, or a mix of upper and lower arches, have not passively erupted to compensate composite) technique using Kerr Opti- what matters most is that there are at for that wear, we may be faced with a bond. More specifically, I etch the enamel, least two teeth on each side of the difficult challenge in restoring any one of rinse and dry, prime and dry, bond and mouth, resulting in occlusal contact on the teeth, especially if the patient needs cure, reapply bonding, and then apply a at least four teeth in each arch. This is crowns but can’t afford full-mouth composite buildup to the cusps and to prevent overloading any one tooth with reconstruction, or can’t afford more than occlusal surfaces of at least two teeth on an excess of occlusal stress and possibly one or two crowns at a time over the each side of the mouth to a height of two damaging it. course of a year. In such cases, gaining an to three millimeters. I overbuild the teeth Another important factor in deciding extra two to three millimeters of inter- slightly so that, as the bite is checked and which teeth to bond is the effect created occlusal space can make a huge adjusted for balance, and polished for on the esthetic transitions from the difference in allowing us to accomplish smoothness and comfort, the end result is anterior teeth to the built-up premolars something that will be durable over time a total height increase of two to three and/or molars. In other words, this and acceptable in function and appear- millimeters. This can be reduced if less procedure should be planned to provide ance. In these situations of excessive

14 ■ Journal of the Colorado Dental Association SPRING 2007 patient must be educated as to why their restoration of difficult and challenging condition causes concern, and how conditions such as an edge-to-edge utilizing this technique could help solve anterior bite, which has resulted in these difficult and challeng?ing problems. excessive wear and chipping of the upper In addition, the patient should be shown and/or lower anterior teeth (Figure 3). It is how the treatment will help to improve impossible to restore teeth in this the long-term prognosis for the subse- condition to a normal incisal-gingival quent restorative treatment. This will length without opening the VDO, or make the patient’s investment in his or undertaking a major treatment alternative. Figure 2: Side view of build-up on teeth her teeth more predictable, both initially #20 and #21 reveals harmony in appear- Common treatment alternatives to and in the long-term. ance with nearby teeth. create inter-incisal space, to permit teeth The patient must also understand that in this condition to be restored, are the best esthetic enhancement (Figure 2), this procedure will not harm the teeth by orthodontic realignment, surgical rather than creating a cosmetic problem. applying this material, nor will it cause repositioning of the lower jaw, or surgical repositioning of the upper anterior Obviously, it is important to avoid them to need crowns or other treatment segment of teeth and the alveolar process. creating any new problems, such as they didn’t already need. The molars, All three alternatives are costly and abnormal lateral shifting of the bite, which which are initially left out of contact after constitute a major undertaking, something could lead to stress or strain on one or the composite is applied to the premolars, that many patients will refuse to consider. both TM joints, or an uneven function of tend to passively erupt into contact over a the muscles of mastication, resulting in period of four to six months. For some Traditionally, opening of the VDO fatigue and muscle spasm, or to cause a patients, passive eruption of the molars usually means placing crowns on most of hypersensitive tooth. To minimize does not occur. In those cases, the molars the teeth (full mouth reconstruction), an problems with the bite, the modified teeth will need to be restored with onlays, area generally reserved for prosthodon- on both sides of the mouth must contact crowns or composite build-ups, or tists, or others with special advanced at the same instant when the teeth are repositioned orthodontically to establish training. In addition, such treatment is closed together. In addition, the patient normal occlusal function. This potential limited to a select few patients who have must be able to move the lower jaw and need for crowns, even on otherwise substantial financial resources. teeth freely from side to side and forward healthy molars, should be discussed in and back. If new occlusal contacts turn advance with the patient. out to be heavier on one side than on the Patients must be informed that the bite other, or if a “slide” is created, or if will feel strange for the first week or two, muscle tightness occurs, or if any possibly as long as a few months, and they soreness develops in the joints or in the will have difficulty eating some foods. In teeth, appropriate adjustments must be addition, they may find their speech made until those problems are corrected. affected slightly, at least initially, until the Urge the patient to call the office for anterior teeth are restored, or realigned, if minor reshaping (or major reshaping if orthodontic treatment was planned. necessary) if contact problems are In addition to educating the patient, a noticed, and for relief of any soreness that trust level must be established with the Figure 3: Black lines across the upper and may have developed in the teeth, muscles patient before this procedure is per- lower incisors depict the pre-treatment or joints. It has been my experience that formed. It is best to offer this service only level of wear of these teeth. Upper and most patients undergoing this procedure to patients you have known awhile, lower incisors were edge-to-edge prior to opening VDO, leaving no space to add have reported being able to relax more, people who already trust your skills and restorative material to develop a normal breaking up their patterns or habits of clinical judgment. chronic clenching or grinding. This is shape and contour. Photo was taken more than one year after procedure was borne out by the fact that they rarely wear Discussion and Application: This performed. down or chip off the composite material. technique allows the opening of the Vertical Dimension of Occlusion (VDO) in Educating the patient is a big part of a simple, straightforward manner. It has a this technique. This should always variety of applications across several precede performing the procedure. The disciplines. One such application is the TECHNIQUE continued on page 16

VOL. 86, NO. 2 Journal of the Colorado Dental Association 15 ■ should decide that he/she doesn’t find TECHNIQUE continued from page 15 this change to be acceptable or tolerable. For many patients, after a period of four Another application of this technique to six weeks, passive eruptive movement for opening the vertical dimension is to by the molars will have begun to occur, create inter-occlusal space in the poste- making it less possible to fully reverse this rior regions, making it easier to place procedure. Since passive tooth eruption is crowns on teeth with short clinical height, a desired result for many of the patients, or on teeth with heavily worn chewing this should be viewed as a positive effect surfaces. Teeth in that condition have (benefit). However, if it is desired to utilize inadequate inter-occlusal space available the inter-occlusal space for achieving an Figure 4: Blue marks on occlusal surfaces for a normal thickness of material. In adequate thickness of material for new of this patient’s molars confirm they have crowns that are planned, it is best not to addition, the risk of pulpal exposure is passively erupted into occlusal contact high and retention can be a problem due over time. The gold crown was made wait much longer than six weeks to to the shortness of the walls retaining the prior to opening of the VDO. The two commence with the crown treatment, or crown. By opening the vertical dimension molars on the right have been crowned the space created may be lost due to the of occlusion, it is possible to restore the since this photo was taken. passive molar eruption (Figure 4). If it is molars with minimal to no occlusal desired to prevent passive molar eruption, reduction during crown preparation. The I have been reluctant to recommend this can be accomplished by applying space gained from opening the vertical this procedure for patients with known composite to the occlusal surfaces of dimension allows us to achieve an TMJ signs or symptoms. However, I did those teeth within a few days or weeks of adequate thickness of material on the recommend it to one of my TMJ patients initiating treatment, if it hasn’t been done occlusal aspect of the crown and avoid for several reasons. First, I thought it might in the beginning. exposure of pulp horns lying close actually help reduce her muscle spasm Of all the patients I have treated with beneath the heavily worn surface. In problems. Secondly, we agreed that if, at this technique, which includes about 25 addition, the retentive walls will be minimum, it didn’t make her TMJ muscle during the past 10 years, a few in the five shortened much less than they otherwise problems worse, her other malocclusion years prior to that, and the very first one would be, resulting in far better retention conditions would greatly benefit from this over 25 year ago, none have requested of the crown. procedure. To the delight and amazement reversing this procedure. None have of both of us, it actually provided almost More importantly, some of the molars wanted to end the quest to achieve the immediate, profound, and permanent relief and premolars may not be as heavily goal that was established. None have ever from chronic muscle symptoms and worn, and will not require crowns at all, expressed dissatisfaction with the overall spasms thought to be TMJ related. especially if passive eruption is allowed to outcome. In fact, all have been pleased occur, as it often does in these cases. For Benefits: The greatest benefit of this that it has corrected a long-standing those teeth that need to be crowned, this technique is to gain space inter-occlusally problem. can be staged over time so that patients and inter-incisally for obvious reasons History: The genesis of this concept who need assistance from their dental already discussed. Another benefit of this came about while evaluating and treating insurance plans, or who simply need to technique is to be able to test a patient’s an unusual anterior cross-bite condition pay for the treatment over time, can end tolerance and adaptability to an increased that my mother had developed early in my up with an outstanding result. For those vertical dimension of occlusion before dental career. I determined that this patients in need of full mouth reconstruc- commencing with more involved restora- patient needed to see an orthodontist to tion, and who have committed to paying tive treatment. A reasonable time period correct this, or else have her lower for it, this technique can serve to test the for most patients to decide if they are incisors extracted and replaced with a patient’s tolerance for the new position of going to find this new position agreeable removable partial denture. Neither option the mandible before commencing with the and either comfortable or at least was acceptable to her, and she challenged major reconstruction procedures. This tolerable, is three to five weeks after the me to think of a better solution. The only testing of the opening of vertical dimen- composite buildups are completed. idea I could think of was one based on sion may uncover previously unknown No tooth preparation is required for this certain principles I had learned during sub-clinical TMJ issues. technique, making it completely reversible. orthodontic classes taught by Dr. William This is important in case the patient Proffit, professor of orthodontics and

16 ■ Journal of the Colorado Dental Association SPRING 2007 department chair, when I was a student at outcomes. Most of the patients treated with The second major advantage is that, for the University of Kentucky. I decided that this technique continue to see me for patients with otherwise healthy posterior a temporary bite opening procedure using regular cleaning and check-up visits. If teeth (not otherwise in need of crowns), a composite material fixed to the lower there is any dissatisfaction, and this is rare, the potential for passive molar eruption is premolar teeth might be a solution. It was it is that the composite material is wearing high. When it occurs, it eliminates the at least worth a try. What started out as a down, and they need a little supplemental need to restore them while correcting temporary bite opening for my mother, to treatment to re-establish the vertical problems in the anterior part of the help in the correction of her late onset dimension again. Most patients, however, mouth, greatly reducing the costs for anterior cross-bite, evolved into a do not lose the vertical dimension gained these patients compared to the cost of full permanent and stable new Class I bite as it becomes stabilized by the molars that mouth reconstruction. ■ relationship for her, without the help of have passively erupted into occlusion, or orthodontic treatment. The results were have been restored with crowns. References: 1. Becker, I.; Lecture in Telluride Colorado, so astounding and unexpected, that it Summary: The chief advantage of this 2003, and personal correspondence, 2004. took me awhile to comprehend just what technique is to create an adequate we had accomplished so serendipitously. amount of space between the upper and 2. Abrahamsen, T.C., ADA lecture, 2004 - Gradually, I gained confidence that I could lower anterior and posterior teeth so Etiology, Diagnosis and Treatment of the incorporate this concept into my treat- those that are most in need of restoration Worn Dentition. ment protocol for other patients with may be properly restored, achieving more 3. Moskowitz, M.E., ADA lecture, 2004 - worn dentition problems without causing ideal proportions for cosmetic and Complex Dentistry Made Simple. them harm. I began to offer it to more and functional results, as well as greater 4. Christensen, G.J., ADA lecture, 2004 - New more of my patients with heavily worn durability. In many cases, only a few teeth Clinical Concepts in Dentistry. dentitions, especially those with heavily will need to be crowned, rather than all 5. Tomlinson, J.C., lecture, 2004 - Utilizing worn incisors. It has also been used for the teeth in the mouth. While full mouth Opening of Vertical Dimension to Aid in other conditions, such as flared upper reconstruction will still be necessary for Solving Challenging Restorative Problems. incisors, and even for sagging faces that I some patients, this technique will greatly determined were the result of a loss of assist in the transition, both functionally 6. Proffit, W., lectures and text, 1967-71 - vertical dimension of occlusion. and financially. Principles of Orthodontics. Untoward outcomes or results: So far 7. Stuart, C.E., lectures and text on occlusion, as I know, there have been no untoward 1976.

VOL. 86, NO. 2 Journal of the Colorado Dental Association 17 ■ give kids a smile!

Dr. Eric VanZytveld sneaks a CU School of Dentistry Dean Dr. Denise In the waiting room, patients take toothbrush to a happy GKAS patient. Kassebaum (left), CU student Kristin turns working at their brushing skills. Jones, Dr. Randy Kluender and Dr. Rodger Miller take a break to pose for a photo.

Husband, wife team Dr. Richard Sathre and Janette Sathre treat a Dr. Troy Fox (right) and CU student patient at CU. Sung Cho work together at GKAS.

Just a few of the CU staff members who Dr. Tom Pixley gives instructions to his Dr. Cynthia Sheeks (left) and her make GKAS such a success: Nancy patient and her dad. dental assistant at the CU School of Jamehgar, Sonia Perez, Fabian Walker, Dentistry. Theda Goodgain Williams, Debbie Norwood and Ruth Wilson.

18 ■ Journal of the Colorado Dental Association SPRING 2007 VOLUNTEERISM Despite Gloomy Weather, Colorado Dentists Shine By Molly Osberg, Associate Executive Director

gave school presentations and conducted community center screenings. Save the Date: Give Kids a In Colorado: Smile Day, Feb. 1, 2008 • 1,480 children were given free dental treatment. politan Denver Dental Society staff, • 3,500 students were educated about the Colorado Springs Dental Society staff and importance of good oral health. key organizers across the state. Thank you Dr. Randy Kluender, Dr. Bob • $441,298 was donated in dental Murphy, Fabian Walker, Michelle services. Cunningham, Sharyn Markus and • 34 statewide media stories were Marcie Feinglas. Additional appreciation broadcast and published, bringing goes out to the Region II Migrant Educa- awareness to Colorado’s access-to-care tion Program for closing their office to issues and how dental professionals are provide translating services in private his February marked the fifth year trying to help. offices and clinics. Thank you to Leslie of Colorado’s Give Kids a Smile Impressive numbers weren’t the only Bennett, Karina Bonilla, Joy Castillo, T Joe Archuleta and Marie Guinet. program. In just five short years, Give Kids marks of success from Give Kids a Smile a Smile has established a huge following Day. In fact, the ADA News sent a reporter As in past years, Doug and Pat James, of dental teams willing to donate their to cover the Give Kids a Smile event at the with the Broomfield Photography Studio, time to serve children from low-income CU School of Dentistry this year. Colorado Inc., generously donated their time and families in desperate need of care. was highlighted in the Feb. 19 issue of talent to taking professional photos of the Feb. 2 was not only this year’s Give ADA News on page 21. Give Kids a Smile event. Their dedication Kids a Smile day, but also one of the Thank you to those of you who to this cause is again greatly appreciated. coldest days of the season for Colorado as volunteered for Give Kids a Smile Day. Give Kids a Smile Day was fortunate to temperatures dipped 18 degrees below You are responsible for a great success have follow-up care provided by the zero in some parts of the state. The frigid story in Colorado and for improving the Colorado Foundation of Dentistry for temperatures and icy roads had an impact lives of the children you helped. Your the Handicapped Disadvantaged Youth on patient flow and transportation, but it dedication and continued support of this Program. Over 100 children were referred didn’t affect the generosity of over 800 program truly makes a difference and the to the Foundation for additional treatment. dentists and dental team members who Colorado Dental Association is proud to Lastly, Give Kids a Smile Day owes a were determined to honor the nationwide have so many members committed to great deal of appreciation to national movement to help kids. In fact, despite the Colorado’s communities and the oral sponsors: Colgate, Sullivan-Schein Dental conditions and several “no-show” health of children. We also appreciate the and Dexis Digital X-ray Systems. patients, Colorado dental professionals completed surveys that have been sent treated more children and donated more back to the CDA. This information will be For information about the 2008 event or dental treatment than ever before. put to good use to enhance Give Kids a if you would like to share your feedback from the 2007 event, please call the CDA This year, 258 dentists registered, Smile in the future. Thank you for sharing at 303/740-6900 or 800/343-3010. We’d setting a record for Colorado. Dental your thoughts with us. love to hear from you! ■ volunteers in Colorado treated patients in In addition to the dental volunteers, this their private offices, volunteered in clinics, day was not possible without the Metro-

VOL. 86, NO. 2 Journal of the Colorado Dental Association 19 ■ GKAS Thank You Volunteers!

Danny Abboud Francisco Chacon Andrew Fiscus, DDS John Hening, DDS Rhonda Krause, DDS Victoria Abeyta Jason Chapman John Forney, DDS Michele Hensley James Kuhar, DDS James Abramowitz, DDS Sung Cho Colt Foster Doxiades Hill, DDS Randall Kumm, DDS Stephen Alberston Kevin Christ, DDS Cory Foster, DDS Judy Hill, DDS Karl Kunstadter, DDS Margarita Aleksanyan Harold Christiansen, DDS Stella Fox Tonya Hoffman William Lacey, DDS Ken Allen, DDS Mike Cimino, DDS Lisa Fox, DDS Tamera Holloway Jennifer Land Scott Allen Jaime Claypool Troy Fox, DDS Daniel Holmes, DDS Vivian Langdon Michelle Alm, RDH Mary Commander, RDH Mitchell Friedman, DDS Nicole Holmes, DDS Erin Lauf Jon Anderson, DDS Kathy Cordova, RDH Billie Gallegos Mark House, DDS Erin Lauf, RDH Caroline Bailey Brian Cox, DDS Julia Garcia Benjamin Howard Ryan Leary Michael Bailey, DDS Michael Crossley Katie Gardner Makala Hubbell, DDS Tim Lemke, DDS James Baker, DDS Michael Crowley Jennifer Garza, DDS Crystal Huck Jason Lemon Timothy Bandrowsky, DDS Arnold Cullum, DDS Randy Geoghan, DDS Roger Humphreys, DDS Tony Lere Kristin Barden April Daley Louis Gerken, DDS Francis Hurd, DDS Brett Levin, DDS Debbie Barger Samir Dauahera Leroy Gerry, DDS Joanna Hurd, DDS Joanna Levin, DDS William Barminski, DDS Jill Decker, DDS Taha Ghomi Jeffery Hurst, DDS Dennis Lewis, DDS Angie Barns, RDH Barbara Dennis Michael Gilbert, DDS Nadine Hutchins, DDS Keesha Lewis Nelle Barr, DDS Erica Derby, DDS Shauna Gilmore, DDS Nataliya Ignatieff Ryan Lewis Elizabeth Barr, DDS Toby Derloshon, DDS Dawn Glaspey Jana Ikeda, DDS Mary Liestman Edward Barrett, DDS Stephanie DesEnfants Mylene Glueckert, DDS Michael Israelson, DDS Shiloh Lindsey, DDS George Beilby, DDS William Dickson, DDS Satish Gobichettypalayam Cheryl Ivy, RDH Gene Lodes, DDS Marcus Bellamy, DDS Rena Dill Sabrina Goff Laurie Jacobs Carol Lybrook, DDS Robert Benke, DDS Robert Dillard, DDS Frank Gold, DDS Gail Jennings, RDH Scott Lybrook, DDS James Bennett Mike Diorio, DDS Gregory Gorman, DDS Raquel Jham Jarad Mack Richard Bently Dick Dobbin, DDS Nancy Grant, DDS Jacob Johnson Les Maes, DDS Michael Billingsley, DDS John Dodge, DDS Jerome Greene, DDS Collis Johnson, DDS Kelsey Majors, DDS Matthew Bishop G. Bruce Douglas, DDS Peri Greenstein, DDS Corey Johnson, DDS Shawn Maloy, DDS Kristi Blasingame Gina Dowlati Nickolas Groskopf, DDS Curtis Johnson, DDS Clarisa Mantanona, DDS Landon Blatter, DDS David Drescher, DDS Havens Guenthner, RDH Dave Johnson, DDS David Manwaring, DDS Justin Bley, DDS Dennis Driscoll, DDS Fred Guerra, DDS Michael Johnson, DDS Jean Manzanares Adam Block Sandra Duarte Kimra Hall, DDS Kristin Jones Steven Markowitz, DDS Cindy Brandich, EDDA Cindy Duelly Darby Hammond, DDS Brandt Jones, DDS Sharyn Markus Cindy Bratcher Wanda Dufrene, DDS John Hanck, DDS Dave Jones, DDS Donovan Martin, DDS Luis Bravo, DDS Cecilia Edwards, DDS Tania Hannon, DDS Jeanice Jones, DDS Mario Martinez Marie-Joy Brill Gerlinde Ehni, DDS Russell Hanson, DDS Denese Kalima Robert Martinich, DDS Dallas Brimhall Robert Elliott, DDS Susan Hanson, RDH James Kearney, DDS Tim Masterson, DDS Julie Brown, DDS Geoff Engelhardt, DDS Michael Harris, DDS John Kearney, DDS K. Craig Maughan, DDS Ron Brown, DDS Yanira Espinoza, RDH Mark Harris, DDS Andrew Kelson, DDS Nelly McColley Alicia Brumley Renee Euell Patrick Harrison, DDS Avani Khatri Darby McDermott David Bundy Greg Evans, DDS Stephanie Harrison, RDH Karen Kits Lyndi McDermott, RDH Richard Call, DDS Rebecca Facy, DDS Dayle Hartgerink, DDS Randy Kluender, DDS John McFarland, DDS Clint Callahan, DDS Bob Faucett, DDS Phillip Harwood, DDS Darrel Kneupper, DDS Omid Mehdipour Kerri Camp Marcie Feinglas Darrell Havener, DDS Preston Knight, DDS Jose Mena, DDS Kendal Carlson, DDS Rachel Ferguson Tara Hayes Veneta Koteveska Sherri Meredith Justin Cathers, DDS Marsha Fetzer, RDH Jay Heim, DDS Meghan Kovarik Selina Merkt Richard Cea, DDS Melinda Fimer Suzanne Heller Jeffrey Kramer Sarah Meyer, DDS

20 ■ Journal of the Colorado Dental Association SPRING 2007 Lynne Midgley, DDS Michael Poulos, DDS Thomas Simpson, DDS David Welden, DDS Front Range Community Amanda Miller Eva Poulson, DDS Martha Skelton, DDS Marie Welton, DDS College Dental Assisting Program Karen Miller, DDS Verne Primack, DDS Jenna Slootmaker Sean Whalen, DDS Healthy Smiles Clinic Rodger Miller, DDS Dana Quiller, DDS Alexander Smith, DDS Michael Wiley, DDS High Plains Community Mason Miner, DDS Isaac Quintanar Dianne Smith, DDS Anne Wilson, DDS Health Center Addy Mingus Gail Raether Tracy Smith Michelle Wilson, DDS Kids in Need of Dentistry Bahareh Mirshahi Michael Raizen, DDS Tracy Snyder Richard Wilson, DDS (KIND) Mark Mollner, DDS George Ranta, DDS Allison Solomon, DDS Heidi Winquist, DDS Marillac Dental Clinic James Monk, DDS Jeffrey Ranta, DDS Heather Stamm, DDS Amber Wissing MCPN Altura Plaza Dental Vicki Montez Ryan Raposa, DDS Pamela Steinert Susan Wolcott, DDS Clinic Nicole Moore Virginia Rashad Pamela Steintert Jeffrey Wong, DDS Montrose Community S. Renae Moreschini, DDS Aaron Rasmussen Cindy Sterkel Brad Wood, DDS Dental Clinic Carol Morrow, DDS Doug Reid, DDS Nicole Steward Mark Wood, DDS New Hope Dental Robert Morrow, DDS Greg Reinhold, DDS Heather Still Vicki Wood Services/Inner City Health Center Bob Murphy, DDS Alan Reisman, DDS Gregory Stoll, DDS Terry Young, DDS Northwest Colorado Dental Rhett Murray, DDS Randall Reitz Jeff Stoll, DDS Wayne Zarlengo, DDS Care Melissa Musolf, DDS Maribel Reyes, DDS Reid Stone Ron Zastrow, DDS Peak Vista Community Leo Nassimbene, DDS Mandy Robison, DDS Dale Strietzel, DDS Ryan Zastrow, DDS Health Center James Nelson, DDS Todd Robison, DDS Tara Sutphin, DDS Clinics: Pueblo Community Health Jeff Nelson, DDS Gregg Rogers, DDS Megan Swanzy Colorado Foundation of Center Stephanie Nelson Taylor Ross Pat Sweeney, DDS Dentistry for the Salud Family Health Centers Daniel Neumann, DDS William Roth, DDS Kevin Theroux, DDS Handicapped Southwest Smile Makers Jan Neumann, RDH Marilyn Rowe, DDS Hadley Thurmon, DDS Community College of Sunrise Community Health Denver Dental Hygiene Quynh Nguyen Travis Rust Tamara Tobey, DDS Center Program Hilary Nieberg Baskin, DDS Eric Rysner, DDS Michael Tobler Sunrise Loveland Commu- CU School of Dentistry nity Health Center Kajsa Novembre, DDS David Sabott, DDS Larissa Tolley Dental Aid, Inc. The Children’s Hospital Jacqueline O'Beirne, DDS Jeanne Salcetti, DDS Karen Tomlinson, RDH Dolores County Health U.S.A.F. Peterson Dental Wendy O'Haver, DDS Joseph Salvo, DDS Wendy Towne Association Dental Clinic Clinic Eugene Oja Jr., DDS Mark Sanborn, DDS Thanhvan Tran Kelly O'Neal, DDS Henna Sandhanwalia Michael Transtrum, DDS Michael Onstad, DDS Richard Sathre, DDS Michael Travis, DDS Mark Orr, DDS Karen Savoie, DDS Lori Trembath, DDS Linda Orr, RDH Gerald Savory, DDS Teresa Turan Alex Osak Angela Scapino Celia Turner, DDS MICHAEL L. GILBERT Steven Owen, DDS Pasco Scarpella, DDS Jocelyn Twight ATTORNEY Lisa Pacheco Stephen Schaefer, DDS Lia Urrego Ron Palmer, DDS Nathan Schaffner, DDS Cal Utke, DDS ROMPT ERSONAL ERVICE Scott Pankratz, DDS Michael Scheidt, DDS Scotty VanDusen, P P S Linda Paris Steve Schiffer, DDS DDS “See me before you sign” Alexander Park, DDS Joy Schindler, DDS Keith VanTassle, DDS Eric VanZytveld, DDS Joseph Parsons, DDS Dave Schleicher, DDS DENTAL PRACTICE LAW Janet Pearcey Kristy Schmidt, DDS Ty Vaughn Sheri Pelletier Richard Schroeter, DDS Mary Vigil Purchase and Sale Employment Agreements Gregory Peterson Veronica Schubert Richard Villemonte, Professional Corporation State Board Pro- DDS Tyr Peterson, DDS Caroline Seabury, DDS ceedings Jaylon Waite Bill Pfeifer, DDS Steve Seiler, DDS John Walker, DDS Candace Pfister, DDS Renee Serrano Pamela Walsh, DDS ESTATE PLANNING Dianne Pierson, DDS Kevin Sessa, DDS Philip Walter, DDS Wills Trusts Powers of Attorney Living Wills Jay Pinkner, DDS Sue Sessa John Warner, DDS Lyda Piraquive John Sexton, DDS Erin Watts, DDS Tom Pixley, DDS Brittany Seymour, DDS Priscilla Weber Michael Plous, DDS Cynthia Sheeks, DDS Val Weenig, DDS Sharon Poczatek, DDS Paul Sica, DDS Call: 303-320-4580 Chris Weinman, RDH Myrna Policarpio Myron Sidon, DDS Legal Counsel to the Colorado Dental Association Since 1978

501 S. CHERRY ST., SUITE 610, DENVER, CO 80246

VOL. 86, NO. 2 Journal of the Colorado Dental Association 21 ■ Media Spotlight Give Kids a Smile Day drew media attention from around the state. At least 34 media stories were published and broadcast in Colorado cities.

Jan. 9: Glenwood Springs Post Feb. 2: KJCT-TV News 8, Grand Junction, Independent, Give Kids a Smile Day 10PM Jan. 18: The Colorado Springs Gazette, Feb. 2: Moffat County Morning Press, Free Dental Care for Kids Free Dentistry For Kids Jan. 18: Craig Daily Press, Give Kids a Feb. 3: Fort Collins Coloradoan, Filling Smile Event Coming Gaps in Care Jan. 24: Moffat County Morning Press, Feb. 3: Glenwood Springs Post Free Dentistry for Kids Independent, Where Did All the Food Go? Jan. 25: The Business Times of Western Feb. 6: Craig Daily Press, A Smile A Day Colorado, Marillac Clinic to Offer Free Feb. 7: Craig Daily Press, Give Kids a Dental Care for Kids Smile (follow-up coverage) Jan. 25: KTVD-TV Channel 20, Denver, Jan. 31: Fort Morgan Times, Fort Morgan Feb. 8: Durango Herald, Give Kids a 7AM Dentists Giving Free Services Smile Day Makes a Difference for Local Jan. 25: KUSA-TV Channel 9, Denver, Jan. 31: Fountain Valley News, Fountain Children 5AM, 6AM, 4PM, 5PM, 6PM Dentists Give Free Services to Youth on Feb. 8: The Aurora Sentinel, Chomper Jan. 28: The Grand Junction Daily Give Kids a Smile Day Charity Sentinel, Give Kids a Smile Day Jan. 31: Glenwood Springs Post Feb. 19: ADA News, Warm Smiles Beat Jan. 28: Moffat County Morning Press, Independent, Give Kids a Smile Day the Cold in Colorado Free Dentistry for Kids Jan. 31: KOAA-TV Channel 5 and 30, Feb. 25: KYGO 98.5, KJCD 104.3, KQKS Jan. 29: Summit Daily News, Dentists to Colorado Springs/Pueblo, 5AM 107.5, KKFN 950AM, KEPN 1600 AM, Participate in Give Kids a Smile Day Jan. 31: The Wray Gazette, Wray Dental Public Affairs Program Spotlighting Oral Jan. 30: Glenwood Springs Post Office to Give Kids Free Care Friday Health Independent, Give Kids a Smile Day Feb. 1: Fruita Times, Fruita Dentists Mar. 4: KYGO 98.5, KJCD 104.3, KQKS Jan. 30: KOAA-TV Channel 5 and 30, Provide Dental Education to Kids in 107.5, KKFN 950AM, KEPN 1600 AM, Colorado Springs/Pueblo, 5 PM and 10PM February Public Affairs Program Spotlighting Oral Health Jan. 30: Rocky Mountain News, Give Feb. 1: The Grand Junction Daily Kids a Smile Day Sentinel, Give Kids a Smile Day Mar. 11: KYGO 98.5, KJCD 104.3, KQKS 107.5, KKFN 950AM, KEPN 1600 AM, Jan. 31: , Feb. 2: Glenwood Springs Post Commerce City Beacon Public Affairs Program Spotlighting Oral Children Free Dental Care Independent, Give Kids a Smile Day Health Feb. 2: The Grand Junction Daily Sentinel, Give Kids a Smile Day

22 ■ Journal of the Colorado Dental Association SPRING 2007 MONEY MATTERS Some Bite, Some Benefit – A Look at Recent Tax Law Changes By Mimi N. Hackley, C.F.P.

given to a tax-exempt organization own rate, but ordinary or capital gains (excluding private foundations and donor income above $1,700 will be taxed at their he year 2006 brought a flurry of advised funds). By doing this, you can parent’s ordinary or capital gains rate, Ttax law changes that will impact avoid paying income taxes on this respectively. This makes it unlikely that nearly every taxpayer. Some of these distribution and meet most, if not all, of children under age 18 will benefit from changes will save you money, while others your charitable giving goals. the 0% capital gains rate despite their low are just another bite out of your wallet. Long-term capital gains and qualify- incomes. In light of these changes, Here are some changes to consider: ing dividends (generally assets owned alternative college savings ideas are Donations of used clothing or for more than one year) will be taxed at available, which may be more practical. household goods to charity are only a maximum 15% rate for anyone in the Beginning in 2010, conversions of deductible if they are in “good condition.” 25% tax bracket or higher. Taxpayers in traditional IRAs to Roth IRAs will be Many accountants are suggesting having the lowest two tax brackets will have a allowed for those with modified adjusted a garage sale instead or documenting an maximum tax rate of 5% (which will drop gross income (MAGI) above $100,000 (even article’s condition by taking photographs to 0% in 2008). Although these capital for married filing separately). Until 2010, and submitting them along with your tax gains rates were scheduled to expire and Roth conversions are limited to only those return. Another suggestion is to have a revert back to 20% after 2008, they have taxpayers with MAGI below $100,000. representative from the charity sign a been extended for two years until 2010. A Additionally, taxpayers who convert in 2010 statement that the items donated were all good strategy is to make gifts of appreci- have the option of spreading the reportable in good condition. ated assets – within the $12,000 annual income over the following two years. Donations of cash to charity must per recipient gift-tax exclusion – to low Remember, distributions from a Roth IRA are 1 have proof or won’t be deductible. Proof is tax-bracket children or parents so that the tax-free after age 59 /2 and after the account a bank statement, cancelled check or recipient can sell the property in 2008, has been open five years. Furthermore, there receipt from the charity indicating its 2009 and 2010, and take advantage of the are no required minimum distributions while name, date and gift amount. Merely 0% tax. (Beware of the new Kiddie Tax the original Roth IRA owner is still living. A saying that you gave to the collection rules addressed below!) conversion might appeal to someone whose basket at church is no longer sufficient, The Kiddie Tax maximum age has IRAs have a large amount of non-deductible regardless of the amount given. All increased from 14 to 18. This means (after-tax) contributions. ■ amounts must be documented. that any child under age 18 who has more Gift of IRA required minimum than $1,700 (effective in 2007) in Mimi N. Hackley, is a Certified Financial Planner™ at Sharkey, Howes & Javer, Inc., distribution to charity applies only for unearned income will be taxed at the parents top-marginal tax rate. The child a Denver based, fee-only, financial tax years 2006 and 2007, and only if planning and investment management 1 you’re age 70 /2 or older. Up to $100,000 will receive an $850 standard deduction, firm that has worked with many dentists of your required minimum distribution can which offsets some taxable income, and over the years. Visit www.SHWJ.com or be taken directly from your IRA and be will have the next $850 taxed at his/her call 303/639-5100 for more information.

VOL. 86, NO. 2 Journal of the Colorado Dental Association 23 ■

MEMBER BENEFITS Spring Cleaning for Your Practice Collecting Unpaid Balances By Lori Lepar, Quantum Healthcare Services

No charge to send a 10-day pre-collect Quantum Healthcare Services also letter on Quantum Healthcare Services recently enhanced its Client Web Access. very dental practice faces chal- letterhead. If the patient pays the full This program allows authorized users at lenges when attempting to collect E amount in 10 days or less, your practice your practice to access your collection unpaid balances from patients in a timely will receive the full amount of the debt accounts to view patient status, upload manner. Statistically, you will have a with no collection fee. new accounts and customize reports. ■ higher collection success rate if you aggressively seek collection by waiting no Quantum offers CDA members a special longer than 90 days after services have discounted rate for account receivable Quantum was established in 1998 and is headquartered in Lakewood, Colo. been rendered. However, you must also collections (see the boxed fee structure). For more information, please call give consideration to the fact that an 303/984-8300 or 877/984-8300. aggressive policy may make some of your patients leave your practice if sent to collections. Quantum Healthcare Services Fee Structure Some dentists, especially specialists, The Following Fees are Contingency Based seek payment at the time of service. They “No Collection – No Fee” often pay processing fees of 2-5% or more Amount Sent Non-Member CDA Member for credit card transactions, patient To Collections Collection/Legal Fee Collection/Legal Fee financing plans or check guarantee Less than $1,00 33% 25% services. This can be expensive! $1,000 to $2,499 25% 18% Quantum Healthcare Services is a $2,500 to $4,999 20% 15% newly endorsed company of the Colorado $5,000 to $7,499 17.5% 13% Dental Association. Quantum offers some $7,500 to $9,999 15% 11% very unique “hassle free and cost free” $10,000 to $24,999 12% 9% methods that can be effective in collecting $25,000 & over 10% 7% patient payment in a timely manner: No charge to access a national reporting agency for check verification. If the patient’s check declines after verifica- tion, you might then ask for another form of payment such as cash or credit card. No charge for collection of non- sufficient funds (NSF) or account closed checks. Your practice is paid 100% of the face value of the check plus a rebate of either $7.50 or $10 per check to help offset bank charges. The patient is charged a fee of either $20 or $40.

VOL. 86, NO. 2 Journal of the Colorado Dental Association 25 ■ This space reaches more than 3,000 dental professionals. Target your audience.

For advertising rates and information, call Molly Osberg at 303-740-6900 (outside Denver call 800-343-3010).

26 ■ Journal of the Colorado Dental Association SPRING 2007 CLASSIFIED ADS Classified Ads: Journal of the Colorado Dental Association,Vol. 86, No. 2, Spring 2007 issue.

POSITIONS AVAILABLE Associate/Partner: Littleton/Denver, Colo. New, freestanding, state-of-the-art practice on Director: The CU School of Dentistry is busy street. 12 ops., 5,200 sq. ft. X-rays, Practice Sales seeking full-time or part-time faculty member(s) PentaMix, RotoMix, Cavitron, Digital IOC, at the assistant or associate professor level in Dentrix, Panorex, CAESY, Diagnodent. Fee-for- the Department of Applied Dentistry to direct its service. Seek associate to integrate as future Appraisals new mobile dental program providing care to partner. Visit www.transdent.com or call Mercer underserved rural children in Colorado. Transitions, 800/588-0098. Candidates must have extensive experience Associate/Owner: Retirement age doctors treating pediatric patients with advanced wanting to transition in Denver metro and training in pediatric and/or public health surrounding areas (Colorado Springs, Durango dentistry, demonstrated experience in education and other areas). Fee-for-service. High-net and administration and ability to speak income with lots of potential. E-mail Serving Dentists since 1986 Spanish. The position is available immediately. [email protected] or call 877/680-3973. Required D.D.S./D.M.D. degree from an Positions leading to buy-in. CO: accredited U.S. dental school. Salary and Associate: PETER MIRABITO, DDS Colorado Springs, Littleton, Longmont, Denver academic rank commensurate with candidate’s (Spanish speaking), Parker. Temporary Dentist credentials and experience. The University of Available: 20+ years experienced practitioner JED ESPOSITO, MBA Colorado is committed to diversity and equality will work anywhere in Colorado. WY: Casper, in education and employment. The University Members state-of-the-art facility, $1.2M collections, buy- of Colorado at Denver and Health Sciences AMERICAN DENTAL SALES in. Buffalo: Gross $816,000, net $474,000 Center requires background investigations for w/buy-in. Oral Surgery Assoc.: Denver. Precise Dental Practice Brokers & Appraisers employment. http://www.jobsatcu.com. Consultants: Peter Mirabito, D.D.S., Jed Opportunity: Dental partnership available in Esposito, M.B.A., www.dentalsales.com,  THE MOST EXPERIENCED emergency dental clinic in Denver. Limited 303/759-8425. number of partners accepted. You do not need COLORADO BROKER Colorado Springs, Colo. Unique to work there. The value of partner doctors’ Associate: practice seeking an associate. Possible buy-in expertise and management skills advantageous. potential. Four general dentistry operatories, ASSOCIATE RECRUITMENT LLC with benefits of partnership without the  and three prosthetics operatories. Modern risks. All inquiries confidential, office equipped with latest technology. On-site [email protected], 402/740-9235. TRANSITION PLANNING laboratory. 2006 gross production: $1.3M. Fax  Opportunity: If you’re not sure about re-upping resume to 719/213-2249. Include references, with your current lease or want to expand, build experience and education. PRACTICE BUY IN/OUT or start-up in the Littleton area, look me up  I before you commit to something else. I have Considering Bringing in an Associate? have wonderful candidates waiting! Call Susan 2,600 sq. ft. of well-designed, already built-out WIDEST ACCESS TO Spear, practice transition specialist/licensed  space with great street visibility, and I want to broker, Medical Practice Brokers, Inc., 303/973- keep my practice active and growing. Write me QUALIFIED BUYERS 2147 or [email protected]. at [email protected] and see if there’s a deal that’s right for both of us! Associate Buy-In: Cheyenne, Wyo. Three ELLERS ASHED UT operatory practice grossing $820,000, with 45  S C O Associate/Partner: Colorado Springs, Colo. percent overhead. Call Larry Chatterley This beautifully designed, well-established fee- 303/795-8800. for-service general dental practice is an  TAX REDUCTION ON excellent opportunity for a general dentist Associate: Associate needed for our estab- SALE PROCEEDS seeking an associate/partnership opportunity in lished practice located Wheat Ridge/Denver, a unique patient-centered practice. This Colo. Great money for a production oriented premier practice has an excellent reputation in dentist. This is a full-time position. We see  BUYER FINANCING providing comprehensive quality dentistry with adults and children. Please call Todd at 303/940-9755. an emphasis on cosmetic, laser and implant ENTAL UILDING ALES dentistry. Wonderful patients and growth Dentists: Denver, Colo. Perfect Teeth is  D B S opportunity with an exceptional dental team seeking senior dentists in Colorado with a that will welcome you to the community. compensation range of $90,000 to $200,000+. Call for FREE Practice Please reply in confidence with your objectives, Successful private or group experience Curriculum Vitae, and written goals to: The required. Benefit package. Also seeking Value Estimate Sletten Group, Inc., c/o Terri Ness, 7882 S. associate dentists (compensation range $75,000 Argonne St., Centennial, CO 80016. Contact to $95,000). Specialist opportunities also 303/699-0990, fax 303/699-4863 or e-mail available for part- and full-time ortho, endo, 303-759-8425 [email protected]. oral surgery, pedo and perio with exceptional Associate/Partner: High-quality group compensation. Call Dr. Mark Birner at 303/691- 800-307-2537 practice in Aurora is seeking a FT 0680, e-mail at [email protected] or www.dentalsales.com associate/partner. Must have a minimum of visit www.bdms-perfectteeth.com. two years dental experience. Potential for partnership within 12 months. Please e-mail [email protected] your resume to [email protected]. CLASSIFIEDS continued on page 28 [email protected]

VOL. 86, NO. 2 Journal of the Colorado Dental Association 27 ■ for hard-working professionals in a laid-back Practice: Lakewood, Colo. $341,000. Producing CLASSIFIEDS continued from page 27 environment. Please forward your resume to $40,000-$45,000 per month part-time! Newly 866/839-8849. remodeled, five high-tech ops. Susan Spear at Dentists: Attention soon-to-be-graduates! We Full-Time/Part-Time Dentist: Aurora, Colo. 303/973-2147 or [email protected]. have space for two additional dentists in our Large, busy established bilingual practice Practice: Ouray County, Colo. $244,000. Community Health Center in Casper, Wyo. New seeking full/part-time dentist starting in June. Producing $390,000 part-time. Beautiful resort graduates often incur debt for setting up their Lots of endo, crown and bridge, and general town. Susan Spear at 303/973-2147 or first office: buying equipment, software and dentistry. Speaking Spanish a plus but not [email protected]. operatory fixtures, and then also having to be necessary. Opportunity for buy-in. Please fax Practice: Centennial, Colo. $245,000. Start-up concerned with hiring staff. All this while trying resume to 303/367-2776 or e-mail practice ready to move in! Susan Spear at to pay off student loans! There is no overhead [email protected]. Cell: 303/908- 303/973-2147 or [email protected]. involved; we already have an open office with 5155 (after 6 p.m.). Practice: Aurora, Colo. $122,000, priced to sell! trained staff to assist you. Plus, you would Part-time Endodontist: Busy SE Denver Producing $300,000! Four days hygiene, three qualify for our entire benefit package! Please practice seeks endodontist part-time. Please days restorative. Susan Spear at 303/973-2147 send your CV/resume and letter of interest to: contact Dr. John Pfalzgraf at Cherry Hills Dental or [email protected]. Beth Eveland, CEO, 1522 E. A St., Casper, WY, Associates, 303/757-8446. 82601, or fax 307/235-6202. To Sell or Buy a Practice in Colorado: Call Front Desk: Aurora, Colo. Need experienced Susan Spear, practice transition specialist/ Dentists: Dental One is opening new offices in front desk team member. Must be bilingual, licensed broker, Medical Practice Brokers, Inc., the upscale suburbs of Denver. Dental One is possess basic computer skills, and be able to 303/973-2147 or [email protected]. unique in that each office has an individual handle appointments and patient issues in name. Our latest office to open is Cherokee Practice: Pueblo, Colo. Well-run family practice Spanish and English. Please fax resume to in a professional building. Four plumbed ops. Trail Dental Care in Aurora. All our offices have 303/367-2776 or e-mail top of the line equipment, digital X-rays and 1,566 sq. ft. Normal operative, surgical, implant [email protected]. Cell: 303/908 5155 equipment. No capitation or PPO insurance. intra-oral cameras. We are 100% FFS with (after 6 p.m.). some PPO plans. We offer competitive salaries, Looking to transition ownership over to the benefits and equity buy-in opportunities. To PRACTICES/OFFICE new dentist. Visit www.TransDent.com or call learn more about working for Dental One, SPACE FOR SALE/LEASE Mercer Transitions at 800/588-0098. please call Rich Nicely at 972/755-0836. Practice: Southern Colorado pediatric dental Practice: North/central Boulder general Full-Time/Part-Time Dentists: Dentists practice for sale or looking for associate/ buy- practice with six chairs. Very modern. Average needed for unique, fee-for-service, for-profit, in. Excellent opportunity with competitive age of dental equipment is two years. Can dental clinic in northern Colorado Springs. salary. Southern Colorado has numerous accommodate two dentists. Gross income Since we are open seven days per week, outdoor activities. Very busy practice with $950,000. Call 303/499-7133 or 303/579-9729. including holidays, we have openings for a full- dentistry limited to children and young adults. time “anchor” dentist, as well as part-time. Practice: West Aurora, Colo. Near Kennedy Hospital based dentistry is also practiced. Applicants must be comfortable with molar Golf Course! Act now at $134,000. Susan Spear General dentistry with an emphasis in treating endo and oral surgery. Excellent compensation at 303/973-2147 or [email protected]. children also considered. We are seeking caring, motivated individuals with excellent skills including sensitivity of the diverse socioeconomic and ethnic backgrounds of our patients. Please fax or e-mail resume to [email protected] or 719/253-7761. Practice: Boulder, Colo. Practice at the foot of the Rockies in the beautiful, exciting city of Boulder – where recreational, educational and lifestyle opportunities abound. Well-established, highly successful, high-income oral surgery office offering a partnership leading to a progressive buy-out and complete ownership. Owner will assist in the transition. Modern, highly computer- ized, no managed care. Emphasis on dentoalveolar, implants, bone grafting, pathology, some orthognathics and trauma with full scope opportunities. Ideal candidate will be honest, caring, and have excellent people and surgical skills. Please send objectives and CV to: The Sletten Group, Inc., 7882 S. Argonne St., Centennial, CO, 80016. Contact 303/699-0990, fax 303/699-4863 or e-mail [email protected]. Practice: Fort Morgan, Colo. Enjoy fishing and boating in the Colorado Eastern Plains. General practice. $200,000 gross with great potential. Practice and stand alone building for sale, $300,000. Contact Dr. Robert B. Deloian at Professional Transition Strategies, 303/814-9541. Practice: Greeley/Loveland, Colo. Must see two office, modern growing orthodontic practice. $650,000 gross. Seller can stay to introduce. $458,000. Contact Dr. Robert B. Deloian at Professional Transition Strategies, 303/814-9541. Practice: Westcliffe, Colo. Beautiful small town community, 75 miles south of Colorado Springs. Three operatories, $160,000 collections for 2006, two days a month. For inquiries, call Tom Abood, 303/793-3200.

28 ■ Journal of the Colorado Dental Association SPRING 2007 Practice: Durango, Colo. Unbelievable buy-in Practice: Evergreen, Colo. Grossing $423,000 Office Space: Boulder: 2,000 sq. ft. space opportunity! Earn $125,000 first yr., guaranteed and netting $195,000. Call Larry Chatterley at share dental office for lease. Ken Caryl: 1,550 increase, full ownership, sweat equity. 303/795-8800. sq. ft., four ops., newly finished dental office for Established GP, five ops., practice collected Practice: Southwestern CO in Durango/Cortez lease. Southeast Denver: 1,490 sq. ft., three $1.2+ million. Buyer will receive majority of area. Grossing $240,000. Call Larry Chatterley ops., partially equipped dental office with some profit from growth. Practice mgt. and seller at 303/795-8800. charts for sale $60,000. Littleton: 1,542 sq. ft., assist. Prof. Practice Advisors, 800/863-9373, Seller/Buyer Services: If you would like more four ops., dental office for lease. Castle Rock: www.practiceadvisors.com. information on how to buy, sell or associate in Five op. dental office for lease. Precise Practice: Longmont, Colo. Grossing over a practice, please check our Web site, www.ctc- Consultants: Peter Mirabito, D.D.S., Jed $700,000 and netting $350,000, fee-for- associates.com or call CTC Associates at Esposito, M.B.A., www.dentalsales.com, service patient base. Call Larry Chatterley at 303/795-8800. 303/759-8425. 303/795-8800. Practices: 1. Lakewood, Colo. Great west-side Space Sharing: Denver, Colo. Share expenses Practice: Centennial, Colo. Grossing over location with three ops. Collecting $650,000 a – why pay for everything yourself? Seeking $600,000 with four ops. Priced at $225,000 year. Profit of approximately $300,000. general dentist/specialist wanting to share For details, please call Larry Chatterley at Motivated seller. 2. Centennial, Colo. Four ops. practice costs without the burden of going solo 303/795-8800. of new equipment. Collecting $35,000 per on expenses. Office totally re-equipped three Practice: SE Denver, Colo. Grossing $272,000 month, owner financing. For more information years ago. Four operatories, each with with two ops. (can expand to three). Call Larry on these and other listings, call Professional computer, intra-oral camera, DVD, CD, satellite Chatterley at 303/795-8800. Marketing and Appraisal, 800/632-7155. radio and TV. Digital x-ray, Pan-X, Caesy, Luma bleaching, portable Diagnodent, Harvey, Statim, Practice: Cherry Creek area, Colo. Grossing Practices: CO: Aurora, Boulder, Colorado & Hydrim washer. Software schedules, bills, $590,000 with three ops. 61 percent overhead. Springs, Crested Butte, Denver, Cherry Creek, processes insurance for multiple providers. Please call Larry Chatterley at 303/795-8800. Downtown Denver, Dillon, Fort Collins, Denver Private office, consult room, and reception Practice: South Colorado Springs, Colo. Five Tech Center, Dillon/Silverthorne, Glenwood room with large flat screen educational ops., new equipment with digital X-rays and Springs, Eagle, Littleton, Lakewood, Loveland, program. Contact Dr. Pavlik, 719/592-0878 or grossing $477,000. Call Larry Chatterley at Western Mountain Resort, Central CO, Southern [email protected]. CO, Steamboat Springs, Pueblo, Rifle, South- 303/795-8800. Office Space: Boulder general practice offering Practice: Fort Collins, Colo. Grossing $240,000 west CO, Edwards, Winter Park. AZ: Arrowhead, Bullhead City, Prescott, Mesa, Phoenix, cosmetic services, high-tech equipment. Great with three ops. Call Larry Chatterley at location with high visibility. Open to share 303/795-8800. Flagstaff, Yuma. NE: Scottsbluff. SD: Sturgis- Spearfish. WY: Casper (state-of-the-art facility, space with dentist or specialist. Please call Practice: Small town southern Colorado. $1.2M collections, buy-in), Buffalo (gross 303/449-1119 or fax 303/449-1914. Grossing $343,000, 51 percent overhead, busy $816,000, net $474,000). Specialties: oral Office Space: Loveland, Colo. New construc- practice, facility and equipment look great. Call surgery in Denver; pediatric in Colorado Springs tion, class “A” space; L.E.E.D. Certified: Larry Chatterley at 303/795-8800. and Arvada. Precise Consultants: Peter Mirabito, 1,500-8,000 sq. ft. Available May 2007, Call Dr. Practice: Delta, Colo. Acquire the building and D.D.S., Jed Esposito, M.B.A., Ted Mioduski, 960/663-1000. the practice for $220,000. Call Larry Chatterley www.dentalsales.com, 303/759-8425. at 303/795-8800. CLASSIFIEDS continued on page 30

VOL. 86, NO. 2 Journal of the Colorado Dental Association 29 ■ CLASSIFIED ADS

Office Space: Lakewood, Colo. Dental office Temporary Coverage: We have more jobs CLASSIFIEDS continued from page 29 space for lease at 2290 Kipling St. Building has than we have dentists! Just name your flat daily eight other dental practices. 1,000 sq. ft., three fee. Paid weekly. Bread and butter procedures ops. plus office, lab and x-ray. Owner will assist only. Maternity, disability, personal leaves. Fee- Office Space: SW Colorado Springs, Colo. with cost of tenant finish. Call Jack Maxfield, for-service practices, not mills. We can’t call Excellent location near Broadmoor-Skyway 303/919-0813. you until you first call us. No strings or area. Open concept with dental chairs, Panorex Office Space: Office for lease or lease/pur- obligation. So say hello. Doctors per Diem, Inc., and cabinets that can be purchased. Beautiful chase. Up to 4,800 sq. ft. ready to build-out in 800/600-0963. Temporary placement (locums) view of mountains. Professionally designed. brand new building with dramatic views of the since 1997. Ask us the secret to working out of Great for GP or specialist. 2,500 sq. ft. Call Dr. Front Range. Access growing patient popula- state occasionally or on demand, in state. E- Gary Stiehl, 719/636-3015. tions in northeastern Colorado Springs and mail: [email protected] or visit Office Space: Space is available for lease with expand your practice from this ideal location http://www.doctorsperdiem.com. option to buy in fast growing Conifer/Aspen adjacent to Endodontic Specialists. Competitive On-Call Services: I need occasional call park area. Owner converting approximately lease rates with generous tenant finish coverage two-to-three times per year. Do you? 2,000 sq. ft. of building into dental facilities. allowance or lease-purchase as condo. Call General dentist in south Denver area wishes to Construction estimated completion date is May Jane Peck, 719/599-3210 or Tom Binnings, share occasional on-call with other area 15, 2007. If purchase is preferred, an additional 719/471-0000. dentists. Please call 303/733-8885. $2,700 per month income available in addition Office Space: Aurora, Colo. Professional Temporary Dentist Available: Why close to the dental space utilized. For details, call dental office space consisting of 1,234 sq. ft. your office for lack of vacation, pregnancy, or Paul Tillotson, 303/526-1277. will be available for lease on July 1, 2007. It is disability coverage? I am semi-retired, quality Office Space: Erie, Colo. New construction currently partitioned, plumbed and wired for oriented, GP dentist that owned a successful, dental arts building in the heart of the new Erie three dental operatories. The dental suite is in fee-only, solo practice. Willing to cover your Commons. Generous tenant improvement excellent condition, and in a wonderful location office on short-term basis anywhere in allowance. Seeking pediatric practice, general and beautiful building. Great visibility and easy Colorado. Terms negotiable. 970/547-1440. practice or other specialists to join the building access near a highly residential area. Ideal Looking To Hire A Trained Dental Assis- group. Contact Dr. Steven Markowitz at location for a general dentist, orthodontist, tant? We have dental assistants graduating [email protected] or 303/444-6680. pedodontist, prosthodontist, periodontist or every three months in the Denver/Boulder, Office Space: Fort Collins, Colo. Commercial endodontist. Call Dr. James Trompeter at Colorado Springs and Grand Junction areas. To land: Very desirable Harmony Corridor location 303/688-3838. hire or to host a 32-hour externship, please call near South College Avenue. Highly visible SERVICES/ANNOUNCEMENTS/MISC. the Colorado School of Dental Assisting at across from busy mall. Initial work-up/layout 866/880-3030. and architecture is city approved for dental For Sale: Dental Art Collectables by Charles Service: Concerned Colorado Dentists (CCD) is office. 4,400 sq. ft. Building plans with eight Fazziano, world-renowned 3-D artist. Three a subcommittee of the Colorado Dental operatory office can also be included. Private matched-number DX three-layer editions w/all Association. We are in existence to help financing possible. Contact Warner Brothers cartoon characters. Beautiful, colleagues, staff and/or families who think they [email protected] or 970/988-6655. entertaining art for your office. Seller retired – may have a problem with substance abuse. If Office Space: Build/Relocate/Remodel: Call us will sell below market value as package. you think you or someone you know may have or visit www.fcbidenver.com for free office 303/425-0114. a problem, please call Dr. Brett Kessler at locator assistance. Foothills Commercial For Sale: Belmont X-ray, doctors stool, Rinn 720/989-7960 (day or night). All inquiries are Builders, the future is now! 303/755-5711 x306. chairside developer, Sterident sterilizer, lead kept confidential. Office Space: Fountain, Colo. Close to aprons, Whaledent Biosonic cavitron, assorted Practice, Equipment and Real Estate Colorado Springs. One of the fastest growing stainless impression trays, assorted hand and Financing: We provide financing for the areas in Colorado. 25-year dental office surgical instruments, intraligamental and purchase of new/existing practices. Equipment location, available in October. Dr. Stephen regular injection syringes, amalgam, X-ray financing and real estate. We can assist you Seiler, 719/576-4247. viewer, laboratory high-speed lathe, Leeson with your entire banking relationship. Please model trimmer, buffalo vibrator, Hanau Office Spaces: Plug and Play #1: Finished call Tyson Bullard at 303/473-2310 or articulator and pink boxing wax. Most items are dental suite, south DTC. Three-to-five ops., two [email protected]. less than three years old, reasonably priced. offices, lab, reception, admin. #2: Finished Delivery: Let Crystal Courier Service take care Please call Dr. Richard Collar at 970/921-6474 dental or oral surgery space, County Line Road of your delivery needs! From Ft. Collins to or 505/536-3641. and south Holly Street. Four ops., office, Pueblo, we deliver SAME DAY. Call 303/534- reception, two restrooms, recovery room, two For Sale: Three Pelton-Crane Chairman chairs 2306 or visit us on the Web at labs. Great location, excellent value. Contact and 1 ADEC chair, several matched and mis- www.crystalcourierservice.com. Bob, 303/713-1588. matched stools, all good condition. VISICOM Office Technology: Moving? Starting up? inter-office messaging system; Mada Jet XL Office Space: Two months free rent! 2,500 sq. Sharing costs or office space? Looking to save “painless” injector; Jelenco burn out furnace; ft. dental space, already plumbed and ready to money? NetQ iServices is the quickest, easiest, Ellman 90 FFP electro surgery unit; electro go. Building totally renovated in 2005. By new most reliable way to get your office technology, surgery manual and video film (new, never streets of Southglenn redevelopment. Average phones and e-mail done. Let the pioneers in opened); lab pans; computer CPUs with XL HH income, $98,000. 303/726-2093. revolutionizing these services and their support, Professional; Alginator; NewImage Intraoral show you how to save thousands of dollars Office Space: First floor office with five camera, printer, monitor, mobile cabinet; operatory suites located in central Greeley. All while eliminating the headache and expense. Dr./Asst. carts and more! Needs? Contact Call Tom at 303/908-7221 to schedule a free plumbing, nitrous lines, computer lines and [email protected], 970-988-6655. cabinetry are in place, along with sterilization assessment. For Sale: Antique oak dental cabinet, room and lab space. Call 970/356-5151. Attorneys: Representing dentists/dental excellent condition, 39"x44"x19", 24 drawers, practices: Practice start-ups, purchase/sale of Office Space: Operatories to rent. One to two glass pulls. Contact 303/601-4750. fully equipped operatories in lovely tech center practices, associate agreements, employment Practice Management Software: PerfectByte: office. Call Dr. Kevin Evans, 303/796-8668. law, and contracts. Hourly and flat fee billing Comprehensive/user friendly/affordable, $695- arrangements. Responsive. Please contact Ryan Office Space: Dental office condo for sale near $1,295. Billing, scheduling, recall module, Howell at 303/957-3795 or University and County Line in Centennial. 2,028 charting, image storage, customizable [email protected]. This is an sq. ft. Leaseholds in place. Great location! documents and more. Free trial! advertisement. 303/881-1263. www.perfectbyte.net, 877/767-7007.

30 ■ Journal of the Colorado Dental Association SPRING 2007