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January 2016 Periodontics and Oral-Systemic Relationships Atypical Presentation of Zoster Leadership Trajectories of U.S. Dentists JournaCALIFORNIA DENTAL ASSOCIATION You are not a sales goal. You are a dentist deserving of an insurance company relentless in its pursuit to keep you protected. At least that’s how we see it at The Dentists Insurance Company, TDIC. Take our Risk Management program. Be it seminars, online resources or our Advice Line, we’re in your corner every day. With TDIC, you are not a sales goal or a statistic. You are a dentist. Protecting dentists. It’s all we do.® 800.733.0633 | tdicsolutions.com | CA Insurance Lic. #0652783 Jan. 2016 CDA JOURNAL, VOL 44, Nº1 DEPARTMENTS 5 The Editor/My Microbiome and Me 7 Impressions 49 RM Matters/Top Seven Data Breach Considerations 55 Regulatory Compliance/HIPAA Security Rule Technical Safeguards 59 Periscope 64 Tech Trends 65 Dr. Bob/Protest Now 7 FEATURES 17 UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications and Consent This paper presents a systematic review, clinical indications, clinical protocol and consent procedure to guide application for caries arrest treatment using silver diamine fluoride. Jeremy A. Horst, DDS, PhD; Hellene Ellenikiotis, DDS; and Peter M. Milgrom, DDS 29 Periodontics and Oral-Systemic Relationships: Diabetes It has been proposed that periodontal disease is a risk factor for systemic diseases. This paper explores its relationship to diabetes. Alison Glascoe, DDS, MS; Ronald Brown, DDS, MS; Grace Robinson, DDS; and Kassahun Hailu, DDS 35 Atypical Presentation of Zoster Mimicking Headache and Temporomandibular Disorder: A Case Report This article reports on a case of trigeminal herpes zoster, which presented as sudden onset headache and acute temporomandibular pain in the prodromal phase. Mohammad Reza Zarei, DDS, MSc, and Goli Chamani, DDS, MSc 39 A National Survey of Positional Leadership Trajectories of U.S. Dentists This paper extends the nascent work in understanding leadership among dentists. David Chambers, EdM, MBA, PhD JANUARY 2016 3 CDA JOURNAL, VOL 44, Nº1 Volume 44, Number 1 JournaCALIFORNIA DENTAL ASSOCIATION January 2016 CDA Classifieds. Free postings. published by the Editorial Upcoming Topics Letters to the Editor California Kerry K. Carney, DDS, CDE February/Oral Cancer www.editorialmanager. EDITOR-IN-CHIEF Priceless results. Dental Association March/Integrated Health com/jcaldentassoc 1201 K St., 14th Floor [email protected] Systems Sacramento, CA 95814 Ruchi K. Sahota, DDS, CDE April/Changing Landscape Subscriptions 800.232.7645 ASSOCIATE EDITOR of Practice Subscriptions are available cda.org only to active members of Brian K. Shue, DDS, CDE Advertising the Association. The CDA Offi cers ASSOCIATE EDITOR Doug Brown subscription rate is $18 and ADVERTISING SALES Kenneth G. Wallis, DDS is included in membership PRESIDENT Andrea LaMattina [email protected] dues. Nonmembers can PUBLICATIONS SPECIALIST [email protected] 916.554.7312 view the publication online at cda.org/journal. Blake Ellington Clelan G. Ehrler, DDS Permission and PRESIDENT-ELECT TECH TRENDS EDITOR Manage your subscription [email protected] Reprints online: go to cda.org, log in Courtney Grant Andrea LaMattina and update any changes to COMMUNICATIONS Natasha A. Lee, DDS PUBLICATIONS SPECIALIST your mailing information. VICE PRESIDENT SPECIALIST [email protected] Email questions or other [email protected] 916.554.5950 changes to membership@ Jack F. Conley, DDS cda.org. EDITOR EMERITUS R. Del Brunner, DDS Manuscript SECRETARY Submissions [email protected] Robert E. Horseman, DDS HUMORIST EMERITUS www.editorialmanager. Kevin M. Keating, DDS, MS com/jcaldentassoc TREASURER Production [email protected] CDA classifiedsclassifieds workwork harder to Val B. Mina SENIOR GRAPHIC DESIGNER Stay Connected cda.org/journal bbringring you resuresults.lts. SeSellinglling a practice Craig S. Yarborough, DDS, MBA or a piece ooff equipment? Now you SPEAKER OF THE HOUSE Randi Taylor SENIOR GRAPHIC DESIGNER [email protected] can include photos to help buyers Walter G. Weber, DDS Celina Miranda Go Digital cda.org/apps see the potential. IMMEDIATE PAST PRESIDENT GRAPHIC DESIGNER Look for this symbol, noting additional video [email protected] content in the ePub version of the Journal. And if you’re hiring, candidates anywhere can apply right from Management Peter A. DuBois the site. Looking for a job? You can EXECUTIVE DIRECTOR Journal of the California Dental Association (ISSN 1043–2256) is published monthly by the post that, too. And the best part— Jennifer George California Dental Association, 1201 K St., 14th Floor, Sacramento, CA 95814, 916.554.5950. it’s free to all CDA members. CHIEF MARKETING OFFICER Periodicals postage paid at Sacramento, Calif. Postmaster: Send address changes to Journal of the California Dental Association, P.O. Box 13749, Sacramento, CA 95853. Cathy Mudge The California Dental Association holds the copyright for all articles and artwork published All of these features are designed to VICE PRESIDENT herein. The Journal of the California Dental Association is published under the supervision of PUBLIC AFFAIRS help you get the results you need, CDA’s editorial staff . Neither the editorial staff , the editor, nor the association are responsible for any expression of opinion or statement of fact, all of which are published solely on the authority faster than ever. Check it out for Alicia Malaby of the author whose name is indicated. The association reserves the right to illustrate, reduce, COMMUNICATIONS revise or reject any manuscript submitted. Articles are considered for publication on condition yourself at cda.org/classifieds. DIRECTOR that they are contributed solely to the Journal. Copyright 2016 by the California Dental Association. All rights reserved. 4 JANUARY 2016 Editor CDA JOURNAL, VOL 44, Nº1 My Microbiome and Me Kerry K. Carney, DDS, CDE y mother likes to remind me that when she was a child, certain things The human microbiome is “the ecological did not exist or had not community of commensal, symbiotic and pathogenic been invented. For my Mmother, this category is very broad and microorganisms that literally share our body space.” encompasses many things common to our world today. For example, it includes computers, plastic wrap, allergies and depression. (Allergies did not exist and ■ Benefi ts them with no detriment ■ The nose (one site sampled). depression had not yet been invented.) to us. ■ The mouth (nine sites sampled: Allergies and depression aside, her ■ Benefi ts both of us. attached gingiva, hard palate, worldview does show us how rapidly our ■ Benefi ts them and is detrimental throat, palatine tonsils, dorsum scientifi c understanding of the world to us. of the tongue, buccal mucosa, has changed. It also allows us to hold These microbes out number the cells in supragingival and subgingival hands with the past and “reach back” our body by 10 to one. If you considered this plaque and saliva). to a world experience very different collection of cells (your human microbiome ■ The skin (four sites sampled). from the one we know now. My mother and the cells that make up your body) as ■ The colon (one site sampled). and her classmates would not have some kind of super organism, then only ■ The urogenital/vagina had access to penicillin. Before its one tenth of that super organism would (three sites sampled).2 mass production in 1945, common be made up of cells from your body. The importance of the mouth childhood infections often resulted in When I fi rst learned that, I thought is clearly refl ected in the number death. Penicillin was a closely guarded I had at last found a satisfactory of sample sites selected. The oral secret that saved the lives of thousands explanation for my weight gain and a sites make up 50-60 percent of of allied forces during World War II.. potentially quick way to lose weight the total microbiome samples. My mother was 8 years old when by divesting myself of those weighty The oral environment is unlike Fleming discovered penicillin in 1928. microorganisms. It was disappointing any of the other sample sites in its The microbiology that my parents to fi nd that though our microbiome out variety of substrates. It has solid surfaces learned in school was not far removed numbers us in cell count, their tiny size (teeth, restorations of various materials, from Florence Nightingale’s miasmic means they account for no more than dentures, orthodontic appliances) theory of contagion. I am amazed by the three pounds per super organism. and shedding surfaces (keratinized chasm of ignorance that separated the The Human Microbiome project was and nonkeratinized mucosa). In simple renderings of bacteria in my high launched in 2008. Following on the heels addition, “saliva contains around school biology classes from the complex of the successful Human Genome Project, 100 million” microorganisms per microbial colonies we studied in dental its goal was to describe by identifying milliliter.2 The identifi cation of all of school. And today, I am fascinated by the and characterizing the community of the microorganisms in the oral sample descriptions of the microbial makeup and microorganisms that are associated is incomplete. Nor has verifi cation of interactions of the human microbiome. with the human body. The ultimate residence been completely established. The human microbiome is goal is to understand how the human Some numbers of the microorganisms “the ecological community of microbiome interacts with the human are transients, just passing through. commensal, symbiotic and pathogenic body in states of health and disease. In dental school, electron microscopy microorganisms that literally share our The human microbiome focused on rendered complex and beautiful the body space.”1 It is that collection of fi ve areas of the body. Male subjects were colonies of microorganisms in oral microorganisms that share our space sampled at a total of 15 sites and females plaque. However, those depictions look and have an association with us that: were sampled at a total of 18 sites.
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