SUMMARY OF FINDINGS
Brighton, Colorado September 11 and 12, 2009
“I feel pretty, happy, and . . . I can smile! ”
COMOM Patient
February 2010
TABLE OF CONTENTS
Introduction ...... 2 Patient Population...... 3 Exit Interviews...... 3 COMOM Dental Site and Patients’ Home Location ...... 4 Demographic Characteristics...... 5 Dental Care ...... 7 Dental Insurance ...... 9 Dental Pain ...... 11 Dental Procedures ...... 12 • Overview – Dental Procedures Performed and Donated Fees • Overview – Patients Undergoing Dental Procedures • Radiographic/Diagnostic Imaging • Preventive • Restorative • Endodontics • Periodontics • Prosthodontics • Oral and Maxillofacial Surgery Tobacco Use ...... 21 Further Dental Care...... 24 Oral Health Instruction ...... 24 COMOM Experience for Patients ...... 25 Patient Messages ...... 29 Appendices ...... 30 A: Patient Treatment Form B: Patient Interview Form C: Dental Procedures Performed and Donated Fees D: Contributors E: Volunteers F: Brighton COMOM Images
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INTRODUCTION
Dental care is unaffordable for many individuals. Among these individuals, it is common to find severe decay, infection, and pain. Oral disease is progressive and cumulative, and becomes more complex over time. It can affect the ability to eat, and how a person looks and communicates. Oral health is inseparable from general health, and can affect self-esteem and compromise a person’s ability to work at home, at school, or on the job.
In September 2009, the Colorado Dental Association held a two-day Colorado Mission of Mercy (COMOM) in Brighton, Colorado. Colorado has now joined the growing number of states in which volunteer dentists, dental hygienists, dental assistants, and an array of other volunteers commit their time to provide free oral healthcare services to individuals who otherwise cannot afford care.
Building on experience from the COMOMs held in Alamosa, Colorado in 2007, and in Loveland, Colorado in 2008, the Adams County Regional Park Complex was transformed into a large-scale dental clinic. Patients were treated on a first-come, first-serve basis. They waited their turn to see a dentist for an initial evaluation and to prioritize needed dental services. As dentists and dental hygienists became available, patients were guided to areas of the dental clinic where they underwent preventive, restorative, endodontic, periodontic, prosthodontic, and surgical procedures. Upon completing their dental care, patients were asked to participate in an exit interview. Bilingual volunteers were available throughout the clinic experience to assist Spanish-speaking patients.
As shown in Table 1, the success of the Brighton COMOM was due in large part to the nearly 800 individuals who volunteered their services. (Appendix E displays listing of volunteers.)
Table 1. Brighton COMOM Volunteers Dentists 134 Dental Assistants 115 Dental Hygienists 70
Dental Lab Technicians 30 Dental Billing Coders 18 Dental Equipment Specialists 7
Dental Students 19 Predental Students 17 Dental Assistant Students 40 Dental Hygienist Students 38
Nondental Health Professionals 19 (massage therapists, medical assistants, nurses, paramedics, pharmacists, pharmacy techs)
Community Workers 285
TOTAL 792
The intent of this report is to provide a summary of the demographic, dental health, and clinical characteristics of patients attending the Brighton COMOM event, and to also delineate their perspectives of the clinic experience. This information can serve as a framework for informing future planning of COMOM events.
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PATIENT POPULATION*
During the COMOM two-day event in Brighton, 1,291 patients, documented via treatment forms, were seen by dental healthcare professionals; 1,235 underwent evaluation and treatment, and 56 underwent evaluation only. (Appendix A displays the treatment form.)
The reasons given by patients for undergoing only evaluation, and not going onto treatment, are shown in Table 2.
Table 2. Reasons for Patients Choosing Not to Undergo Dental Treatment Not feeling well Family member needing to be taken home Unable to wait (e.g., needing to go to work) No treatment needed (e.g., young children) Too afraid Refusal of treatment
EXIT INTERVIEWS*
Of 1,235 patients undergoing treatment at COMOM, 1,174 participated in exit interviews; a 95 percent response rate.
The interview was comprised of 25 questions, asking patients about their pain status and the time frame of their most recent dental care, insurance status, demographic factors, and about their COMOM experience including whether they received oral health education. Bilingual volunteers conducted exit interviews with Spanish speaking patients. (Appendix B displays the exit interview questionnaire.)
*Throughout the report, findings will be displayed with a denominator (N=X,XXX). The denominator will vary. It will represent the number of patients with data available related to the particular issue being examined.
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COMOM DENTAL SITE AND PATIENTS’ HOME LOCATION
The Brighton COMOM was held in Adams County. Most patients attending the 2009 COMOM lived in close proximity to the dental clinic with 324 patients living in Adams County, and 306 living in neighboring Denver County (Figure 1).
The distance traveled from home to the COMOM event ranged from 3 to 643 miles (average 29 miles), with 51 percent of patients traveling 20 miles or less.
The vast majority of patients (97 percent) lived in communities classified as urban with only three percent living in communities classified as rural.*
Figure 1. Patients’ Colorado County of Residence (N=1,282)
Sedgwick Logan Weld Larimer Moffat Jackson Phillips Routt Morgan
Grand Boulder Yuma Rio Blanco Broomfield Washington Gilpin Denver Adams Eagle Clear Arapahoe Garfield Summit Creek Jefferson
Elbert Kit Carson Pitkin Douglas Lake Park Mesa Delta El Paso Cheyenne Chaffee Teller Lincoln Gunnison
Fremont Kiowa Montrose Crowley Ouray Pueblo San Miguel Saguache Custer Hinsdale Bent Prowers Otero Dolores San Juan Mineral Huerfano Alamosa Rio Grande Montezuma Las Animas Baca La Plata Costilla Archuleta Conejos
Adams (324) Boulder (31) Logan (6) Fremont (2) Denver (306) El Paso (16) Morgan (5) Pueblo (2) Broomfield (14) Delta (3) Cheyenne (1) Douglas (14) Garfield (3) Park (1) Arapahoe (182) Los Animas (10) Alamosa (2) Phillips (1) Larimer (143) Weld (122) Jefferson (90)
(An additional three patients were identified as residing outside of Colorado: Kansas=1, Missouri=1, Wyoming=1; one other patient had an unknown address.)
* Rural-Urban Commuting Area (RUCA) codes were used to classify rural and urban areas. (For further information see
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DEMOGRAPHIC CHARACTERISTICS
GENDER
Of the 1,224 patients undergoing treatment with gender data available, 56 percent were female and 44 percent were male.
AGE
The average age of treated patients was 35 years with a range of 2 through 88 years. As displayed in Figure 2, the age group of 21 through 30 years had the highest percentage of patients attending the COMOM event.
Figure 2. Treated Patients by Age (N=1,225)
30% 25% 22% 312 20% 275 17% 14% 210
169 11%
10% 12 9 5% 4% 2% 56 <1% 52 19 3 0% <10 11-20 21-30 31-40 41-50 51-60 61-70 71-80 81-90 Age in Years
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ETHNICITY /RACE
Of the 1,139 treated patients with ethnicity/race data, most were of Hispanic origin (50 percent) or were White non-Hispanic (40 percent) – (Figure 3).
Figure 3. Treated Patients by Ethnicity/Race (N=1,139)
American Indian or Alaska Native 17 1%
Asian 21 2%
Black or African American 53 5%
Hispanic or Latino 575 50%
Native Hawaiian or Other Pacific Islander 2 <1%
White Non-Hispanic 453 40%
Multi-Racial 16 1%
0% 20% 40%
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DENTAL CARE
Dental health is an important part of a person’s overall health. As a general recommendation, individuals should be seen by a dental health professional every six months. Regular visits allow a dentist to find early signs of decay and disease, and treat problems at a manageable stage.
Of treated patients, only 14 percent saw a dentist within six months of the COMOM event. On average, the last time patients saw a dentist was 4.0 years (range one week through 40 years), with five percent of patients never seeing a dentist. (Figure 4).
Only six percent of these patients had their teeth cleaned within six months. On average, the last time patients had their teeth cleaned was 5.1 years prior to COMOM (range one week through 40 years), with nine percent of patients never seeing a dental hygienist for care.
Figure 4. Treated Patients – Receipt of Dental Care
Last time saw dentist (N=1,087)
Six m onths or less 156 14% More than six months 931 81% Never 63 5%
Last time teeth cleaned (N=1,133)
Six m onths or less 69 6%
More than six months 962 85%
Never 102 9% 0% 20% 40% 60% 80%
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REASONS FOR NOT SEEKING DENTAL CARE
As displayed in Figure 5, patients indicated that that the two major reasons for not seeing a dentist were not being able to afford dental care (82 percent) and not having dental insurance (71 percent).
Figure 5. Treated Patients – Major Reasons for Not Seeking Dental Care (N=1,093)
Cannot afford to pay 899 82%
No dental insurance 778 71%
Afraid / Don't like 53 5% receiving dental care
Too busy 42 4%
Didn't think I needed to go 31 3%
0% 20% 40% 60% 80%
* Patients were able to provide more than one reason for not seeing a dentist, consequently percentages total more than 100%.
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DENTAL INSURANCE
Access to dental care is difficult for many individuals, and lack of dental insurance is a factor. As displayed in Figure 6, the vast majority of patients who were treated at COMOM did not have dental insurance (96 percent).
On average, patients with dental insurance saw a dentist 2.6 years prior to the Brighton COMOM; those patients without dental insurance saw a dentist 4.0 years prior. (Figure 7)
On average, patients with dental insurance saw a dental hygienist to have their teeth cleaned 3.3 years prior to the COMOM event; those patients without dental insurance saw a dental hygienist 5.4 years prior.
Figure 6. Treated Patients – Dental Insurance Status (N=1,240)
No insurance 980 96%
Insurance through job 28 3%
13 1% Insurance through family/partner
Insurance self purchased 4 <1%
0% 20% 40% 60% 80% 100%
Figure 7. Treated Patients – Average Time since Last Dental Visit and Dental Insurance Status
TO DENTIST TO DENTAL HYGIENIST 7
6 5.4
5 4.2 N=867 4 3.3 N=952 3 2.6 N=42
Time in Years N=43 2 1 0 No Insurance No Insurance Insurance Insurance
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MEDICAID AND CHP+
Medicaid and the Child Health Plan Plus (CHP+) programs provide limited dental coverage. Of COMOM patients age 18 years and younger, 17 percent were covered by these programs. With patients 19 years and older, 8 percent were covered. (Figure 8)
Figure 8. Treated Patients – Medicaid/CHP+ Coverage
18 YRS AND YOUNGER 19 YRS AND OLDER N=171 N=1,054
20%
9% 10% 8% 8%
16 13 84
0% Medicaid CHP+ Medicaid
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DENTAL PAIN
Of 1,224 treated patients, 53 percent indicated that they were in pain prior to coming to the COMOM dental clinic (Figure 9).
On average, patients were in pain for 16 months with a range of one day through 25 years. Of the 521 patients with pain duration data, 74 percent of the patients were in pain for more than a month.
Figure 9. Treated Patients – Dental Pain
N=1,224
60% 53% 50% 47% N= 521
40% 1 month 653 or less More 571 26% 30% than 1 month (133) 20% 74%
10% (388)
0% Not in Pain In Pain Duration of Pain
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DENTAL PROCEDURES
OVERVIEW – DENTAL PROCEDURES PERFORMED AND DONATED FEES
As detailed in Appendix C and summarized in Table 3, dentists and dental hygienists performed 6,663 coded dental procedures at the Brighton COMOM event, providing $1,001,267 in documented donated fees.*
Given 1,291 patients were provided with either evaluation only or evaluation and treatment, the donated fees amounted to $776 per patient.
Of the 6,663 dental procedures performed, the highest numbers were those related to evaluation (36 percent), restorative (21 percent), and surgical (20 percent) – (Figure 10).
Table 3. Dental Procedures Performed and Donated Fees TREATMENT PROCEDURES NUMBER OF DONATED CATEGORIES PROCEDURES FEES Evaluation Oral exams, cancer screening 2,396 $ 155,226 Imaging Intraoral-periapical, bitewing, panoramic films 358 27,388 Preventive Prophylaxis, topical fluoride, sealants 760 45,928 Restorative Fillings, prefabricated crowns 1,392 308,067 Endodontic Pulpotomies, root canal therapies 80 57,026 Periodontic Debridements, gingivectomy/ gingivoplasty 212 39,585 Prosthodontic Interim partial dentures, denture repair 116 62,108 Surgical Extractions, alveoloplasties 1,348 305,757 Miscellaneous Occlusion adjustment 1 182 TOTALS 6,663 $1,001,267
Figure 10. Distribution of Dental Procedures (N=6,663)
Surgical 20% Restorative 21%
Preventive 11%
Evaluation Imaging (5%) 36% Periodontic (3%) Prosthodontic (2%) Endodontic(1%) (1%)
* Source: American Dental Association, Survey Center. 2009 Survey of Dental Fees . 2009. (COMOM assigned dental fees in relation to Colorado practice and market considerations, and used as reference the fees of surveyed general practitioners in the mountain range at the 90 th percentile.)
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OVERVIEW – PATIENTS UNDERGOING DENTAL PROCEDURES
Of the 1,291 patients who were seen by dental health professionals, all (100 percent) received a comprehensive oral examination. The 1,105 patients who were 15 years or older also underwent an oral cancer screening. (At COMOM events, the youngest patients who used tobacco products were 15 years old.)
Of the 1,235 patients who went on to undergo treatment, 46 percent received restorative services, 40 percent received surgical services, and 34 percent received preventive services (Figure 10).
Approaches to providing dental care are often dependent on patient age. In order to provide background information for future COMOMs, the following sections delineate the cross-section of treatment services provided in relation to patient age groups.
Figure 10. Patients Undergoing Dental Procedures
100% 100%
N=1,235 1,291 80%
60%
46% 40%
40% 34% 570
24% 496 426 17% 20% 291
211 8% 5% 101 0% 65
Imaging Surgical Evaluation Preventive Endodontic Periodontic Restorative
Prosthodontic
Note: Patients underwent multiple procedures across dental treatment categories; consequently percentages total more than 100%.
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RADIOGRAPHIC /D IAGNOSTIC IMAGING
Dentists performed 358 procedures coded as radiographic/diagnostic imaging, providing $27,388 in donated dental services (Appendix C).
Patients underwent intraoral-periapical, bitewing, and panoramic imaging.*
Of the 1,235 patients undergoing dental treatment, 291 (24 percent) were provided with imaging services.
Of these 291 patients, an average of 1.2 procedures per patient was performed (range 1-7).
Figure 11 shows the percentage of patients by age group who underwent imaging procedures. The age groups of 21 through 30 years and 51 through 60 years had the highest percentage of patients (32 percent); the age group of 10 years or younger had the lowest percentage of patients (7 percent). The variation across age groups was statistically significantly (p=0.002).
Figure 11. Patients Undergoing Imaging Procedures by Age Group
60%
40% 32% 32%
101 23% 22% 41 25% 24% 312 129 19% 13 291 20% 16% 61 5 52 1,235 275 39 22
27 210 7% 169
4 56 0% <10 11-20 21-30 31-40 41-50 51-60 61-70 71-90 All Age in Years
Notes: 1) The numerator represents the number of patients undergoing imaging procedures; the denominator represents the number of patients in the age group. 2) Only three patients were in the 81 through 90 age group; these patient data were combined with that of the previous age group creating a 71 through 90 age group.
* Dental Procedure Codes: D0220, D230, D0272, D0330.
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PREVENTIVE
Dental hygienists performed 760 procedures coded as preventive, providing $45,928 in donated dental services (Appendix C).
Patients underwent prophylaxis, topical fluoride, and sealant treatments.*
Of the 1,235 patients undergoing dental treatment, 426 (34 percent) were provided with preventive services.
Of these 426 patients, an average of 1.8 procedures per patient was performed (range 1-18).
Figure 12 shows the percentage of patients by age group undergoing preventive procedures. The age group of 10 years or younger had the highest percentage of patients (82 percent); the age group 71 through 90 years had the lowest percentages (18 percent). The variation across age groups was statistically significant (p<0.001).
Figure 12. Patients Undergoing Preventive Procedures by Age Group
82% 80% 46 56
59% 60%
99 169
40% 32% 35% 34%
28% 26% 18 426 99 23% 52 1,235 312 76 18% 20% 275 54 210 30 129 4 22
0% <10 11-20 21-30 31-40 41-50 51-60 61-70 71-90 All
Age in Years
Notes: 1) The numerator represents the number of patients undergoing preventive procedures; the denominator represents the number of patients in the age group. 2) Only three patients were in the 81 through 90 age group; these patient data were combined with that of the previous age group creating a 71 through 90 age group.
* Dental Procedure Codes: D1110, D1120, D1203, D1204, D1351.
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RESTORATIVE
Dentists performed 1,392 procedures coded as restorative, providing $308,067 in donated dental services (Appendix C).
Patients were provided with amalgam fillings, resin-based composite fillings, sedative fillings, and prefabricated stainless steel crowns.*
Of the 1,235 patients undergoing dental treatment, 570 (46 percent) were provided with restorative services.
Of these 570 patients, an average of 2.4 procedures per patient was performed (range 1-13).
Figure 13 shows the percentage of patients by age group undergoing restorative procedures. The age group of 31 through 40 years had the highest percentage of patients (53 percent); the age group of 10 years and younger had the lowest percentage (34 percent). The variation across age groups did not statistically differ.
Figure 13. Patients Undergoing Restorative Procedures by Age Group
60%
53%
49% 45% 46% 46%
147 102 42% 144 40% 570 76 275 210 40% 312 36% 1,235 34% 169 22 71 52 129 8 19 22 56
20%
0%
<10 11-20 21-30 31-40 41-50 51-60 61-70 71-90 All Age in Years
Notes: 1) The numerator represents the number of patients undergoing restorative procedures; the denominator represents the number of patients in the age group. 2) Only three patients were in the 81 through 90 age group; these patient data were combined with that of the previous age group creating a 71 through 90 age group.
* Dental Procedure Codes: D2140, D2150, D2160, D2161, D2330, D2331, D2332, D2335, D2391, D2392, D2393, D2394, D2920, D2930, D2931, D2940, D2950, D2954. -16-
ENDODONTICS
Dentists performed 80 procedures coded as endodontic, providing $57,026 in donated dental services (Appendix C).
Patients underwent pulpotomies and root canal therapies.*
Of the 1,235 patients undergoing dental treatment, 65 (5 percent) were provided with endodontic services.
Of these 65 patients, an average of 1.2 procedures per patient was performed (range 1-4).
Figure 14 shows the percentage of patients by age group undergoing endodontic procedures. The age group of 31 through 40 years had the highest percentage of patients (8 percent); the age groups of 41 through 50 years and 51 through 60 years had the lowest percentage (3 percent). The variation across age groups was not statistically significant.
Figure 14. Patients Undergoing Endodontic Procedures by Age Group
60%
40%
20%
8% 6% 6% 4% 4% 3% 3% 5% 5%
2 7 18 23 7 4 3 1 65 0% 56 169 312 275 210 12 9 52 22 1,235
<10 11-20 21-30 31-40 41-50 51-60 61-70 71-90 All
Age in Years
Notes: 1) The numerator represents the number of patients undergoing endodontic procedures; the denominator represents the number of patients in the age group. 2) Only three patients were in the 81 through 90 age group; these patient data were combined with that of the previous age group creating a 71 through 90 age group.
* Dental Procedure Codes: D3220, D3310, D3320, D3330.
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PERIODONTICS
Dentists and dental hygienists performed 212 procedures coded as periodontic, providing $39,585 in donated dental services (Appendix C).
One patient underwent a gingivectomy/gingivoplasty, and a series of patients underwent full mouth debridements.*
Of the 1,235 patients undergoing dental treatment, 211 (17 percent) were provided with periodontic services.
Of these 211 patients, except for one case, one procedure per patient was performed.
Figure 15 shows the percentage of patients by age group undergoing periodontic procedures. The age group of 31 through 40 years had the highest percentage of patients (17 percent); the age group of 10 years and younger had no patients. The variation across age groups was statistically significant (p=0.002).
Figure 15. Patients Undergoing Periodontic Procedures by Age Group
60%
40%
24% 23% 23%
65 48 20% 17% 5 17% 14% 275 210 16% 22 11% 20 9 211 45 129 52 1,235 19 312 169 0% 0%
<10 11-20 21-30 31-40 41-50 51-60 61-70 71-90 All Age in Years
Notes: 1) The numerator represents the number of patients undergoing periodontic procedures; the denominator represents the number of patients in the age group. 2) Only three patients were in the 81 through 90 age group; these patient data were combined with that of the previous age group creating a 71 through 90 age group.
* Dental Procedure Codes: D4211, D4355.
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PROSTHODONTICS
Dentists performed 116 procedures coded as prosthodontic, providing $62,108 in donated dental services (Appendix C).
Patients were provided with interim partial dentures and denture repair.*
Of the 1,235 patients undergoing dental treatment, 101 (8 percent) were provided with prosthodontic services.
Of these 101 patients, an average of 1.1 procedures per patient was performed (range 1-2).
Figure 16 shows the percentage of patients by age group undergoing prosthodontic procedures. The age groups of 41 through 50 years and 51 through 60 years had the highest percentages of patients (17 percent); the age groups of 10 years and younger and 11 through 20 years had the lowest percentage (0 and 2 percent respectively). The variation across age groups was statistically significant (p<0.001).
Figure 16. Patients Undergoing Prosthodontic Procedures by Age Group
60%
40%
20% 17% 17%
12% 35 9 9% 2% 4% 5% 210 52 8%
101 0% 3 13 15 15 2 169 312 275 1,235 0% 129 22 <10 11-20 21-30 31-40 41-50 51-60 61-70 71-90 All Age in Years
Notes: 1) The numerator represents the number of patients undergoing prosthodontic procedures; the denominator represents the number of patients in the age group. 2) Only three patients were in the 81 through 90 age group; these patient data were combined with that of the previous age group creating a 71 through 90 age group.
* Dental Procedure Codes: D5650, D5730, D5820, D5821.
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ORAL AND MAXILLOFACIAL SURGERY
Dentists performed 1,348 procedures coded as oral surgery, providing $305,757 in donated dental services (Appendix C).
Patients underwent tooth extractions and procedures related to tooth removal.*
Of the 1,235 patients undergoing dental treatment, 496 (40 percent) were underwent surgical services.
Of these 496 patients, an average of 2.7 procedures per patient was performed (range 1-26).
Figure 17 shows the percentage of patients by age group undergoing surgical procedures. The age group of 51 through 60 years had the highest percentages of patients (50 percent); the age group of 10 years and younger had the lowest percentage (20 percent). The variation across age groups was statistically significant (p=0.003).
Figure 17. Patients Undergoing Surgical Procedures by Age Group
60% 58%
30 50% 52 46% 45% 64 45% 39% 129 40% 40% 139 96 10 107 496 312 210 22 275 1,235
23% 20%
20% 39 11 169 56
0% <10 11-20 21-30 31-40 41-50 51-60 61-70 71-90 All Age in Years
Notes: 1) The numerator represents the number of patients undergoing surgical procedures; the denominator represents the number of patients in the age group. 2) Only three patients were in the 81 through 90 age group; these patient data were combined with that of the previous age group creating a 71 through 90 age group.
* Dental Procedure Codes: D7111, D7140, D7210, D7220, D7230, D7240, D7241, D7250, D7310, D7997.
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TOBACCO USE
Tobacco use is a risk factor in the development and progression of gum disease, and the chemicals in tobacco slow down the healing process and make treatment of gum disease less successful. Individuals who use tobacco products are more likely to develop oral cancer, and have high rates of tooth decay, tooth loss, gum recession and bone loss.
PATIENT TOBACCO USE BY AGE
At the COMOM event, the youngest treated patient who used tobacco products was 15 years old. Of the 1,105 patients receiving treatment who were 15 years or older, 31 percent indicated that they currently were using tobacco.
As shown in Figure 18, the age group of 21 through 30 years had the highest percentage of patients using tobacco products (42 percent); the age group of 71 through 90 years had no patients. The variation across age groups was statistically significant (p<0.001).
Figure 18. Patients Using Tobacco Products by Age Group (N=1,105)
42%
40% 132 312 28% 30% 29% 31%
343 24% 64 31 76 1,105 210 129 275 20% 25 17% 105
9 52
0% 0%
15-20 21-30 31-40 41-50 51-60 61-70 71-90 All
Age in Years
Notes: 1) The numerator represents the number of patients who were using tobacco products at the time of the 2009 COMOM event; the denominator represents the number of patients in the age group. 2) Only three patients were in the 81 through 90 age group; these patient data were combined with that of the previous age group creating a 71 through 90 age group.
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PATIENT TOBACCO USE IN RELATION TO PAIN
Data were available on both tobacco use and pain status for 1,104 treated patients age 15 years or older (Figure 19).
In addition to the 343 patients who indicated that they were using tobacco at the time of 2009 COMOM event, 134 patients indicated that they used tobacco in the past.
Findings indicate a statistically significant variation in pain status dependent on tobacco use (p=0.001).
Of patients who were using tobacco products at the time of the clinic, 69 percent were in pain prior to coming to COMOM. Of patients who used tobacco products in the past, 57 percent were in pain. Of the patients not using tobacco products, 50 percent were in pain.
Figure 19. Treated Patients Age ≥≥≥15 – Pain Status and Tobacco Use (N=1,104)
69%
57% 60% 235 343 50% 77 40% 134 315 627
20%
0% Tobacco Currently Tobacco Used in No Tobacco Use Used Past
Note: The numerator represents the number of patients who were in pain; the denominator represents the number of patients who use or do not use tobacco products.
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PATIENT TOBACCO USE IN RELATION TO ORAL SURGERY
Data were available on both tobacco use and surgical procedures performed for 1,105 treated patients age 15 years or older (Figure 20). These surgical procedures were largely tooth extractions.
In addition to the 343 patients who indicated that they were using tobacco at the time of 2009 COMOM event, 134 patients indicated that they used tobacco in the past.
Findings indicate a statistically significant variation in surgical status dependent on tobacco use (p=0.001).
Of patients who were using tobacco products at the time of the clinic, 54 percent underwent surgical procedures. Of patients who used tobacco products in the past, 46 percent underwent surgical procedures. Of the patients not using tobacco products, 36 percent underwent surgical procedures.
Figure 20. Treated Patients Age ≥≥≥15 – Surgical Status and Tobacco Use (N=1,105)
60% 54% 46% 186 343 36% 40% 62 134 226 628 20%
0% Tobacco Currently Tobacco Used in No Tobacco Use Used Past
Note: The numerator represents the number of patients who underwent surgical procedures; the denominator represents the number of patients who use or do not use tobacco products.
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FURTHER DENTAL CARE
Of patients being treated, 64 percent indicated that they did not have a place to go for dental care, and 45 percent where told by COMOM dental health professionals that they were in need of further dental care (Figure 21).
Figure 21. Treated Patients – Further Dental Care
64%
60%
520 45% 1,160 40% 741 1,156 20%
0% Don't Have Dental Clinic Need Further Dental Care
Note: The numerator represents the number of patients who either don’t have a dental clinic or need further dental care; denominator represents the number of patients who have dental care data.
ORAL HEALTH INSTRUCTION
Eighty-seven percent of those treated at COMOM received oral health instruction, and in particular, were shown the optimal way to brush their teeth. Seventy-four percent of patients were given written information about what to do for their teeth following dental clinic (Figure 22).
Figure 22. Treated Patients – Dental Education
87% 74% 80% 1,017 60% 1,172 854 1,152 40%
20%
0% Received Oral Health Given Written Information Instruction
Note: The numerator represents the number of patients who either were shown how to clean their teeth or given written information; denominator represents the number of patients who have oral health instruction data.
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COMOM EXPERIENCE
ATTENDANCE AT MISSION OF MERCY EVENTS
A series of 42 individuals were patients at previous Mission of Mercy events – 40 attended the COMOM in Loveland, Colorado, one attended the event in Alamosa, Colorado, and one attended a Kansas Mission of Mercy.
HOW PATIENTS HEARD ABOUT THE DENTAL CLINIC
Patients learned about COMOM from several sources (Figure 23). A large number of patients heard about the clinic via media sources with many patients speaking of television news broadcasts (42 percent); another large contingent learned from friends and family (41 percent).
Several patients also indicated that they became aware of COMOM via the internet, schools, social service and workforce entities. Some found out through physician and dental offices, hospitals, churches, and flyers available at restaurants and businesses within the Brighton community.
Figure 23. Treated Patients – Learning About COMOM (N=1,160)
60%
42% 41% 40% 489 477
20% 7% 5% 5%
76 57 54 0% Media Friend/ Internet School Social Fam ily Services
Note: Patients were able to provide more than one response.
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SATISFACTION WITH CLINIC
Patients being treated at COMOM were overwhelmingly satisfied with 93 percent of them indicating that they were very happy about their clinic experience (Figure 24).
Figure 24. Treated Patients – Satisfaction with Clinic (N=1,159)
Very happy 1,073 93%
A little happy 65 6%
Neither happy nor 14 1% unhappy
A little unhappy 4 <1%
Very unhappy 3 <1%
0% 20% 40% 60% 80% 100%
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PATIENT PERSPECTIVES OF COMOM
Table 4 highlights the comments that patients provided about what was most helpful about the COMOM event.
Table 4. Patient Comments on COMOM – Most Helpful Aspects of Program
DENTAL CARE RECEIVED PAIN RELIEF • Ability to see “real” dentists. • Having my painful teeth removed, and two very nice dentists who were careful and caring. • The screening guy pulling together all the • You took the pain away. treatment that needed to be done. • Dentist checking in triage. He was awesome. • Getting my molars out. No more headaches. Everyone was so nice. • Pulling tooth relieved a ton of pressure. • The dentists being very nice and on top of what they were doing. EXPLAINING CARE • Able to get cavities filled. Would have lost teeth. • Dentists and dental hygienists being very • Able to get a root canal. knowledgeable with good attitudes. • Extraction of a troubled tooth! • Dentist was knowledgeable, and took her time. • Fixing chipped tooth. • Getting teeth cleaned. • Every step of the way, there was someone explaining what was going on and what to expect • Leaving with a healthy mouth. next. • Saving my mouth! • Dentists were very personal, professional, and answered all questions. PATIENT SELF -IMAGE • Dentist provided explanations, and answered the • Front tooth filled and crack repaired. Thrilled with questions I had. new look. • Dentist went out of his way with follow-up • Everything feels better to have a front tooth! instruction. • Getting my front teeth fixed. I can smile again. • Really good job. Helpful, explained treatment. • Elated. I can smile at my son with teeth. • Wonderful, very kind, not rude, explained • I now have some teeth, and I’m no longer everything. ashamed to open my mouth. • Liked the dentist; he was informative. • Everyone was great! I can smile and not be embarrassed. • Getting information about other work needed, and where to go to get it. • Now I feel confident. • I feel pretty, happy, and . . . I can smile! PATIENTS COMFORTABLE WITH DENTAL CARE • Good project! God bless everyone here. I don’t like RESPECTFULNESS receiving dental care but comfortable today! • No one harassed me about not taking care of my teeth. • Very informative. Very nice. Dentists made me feel very comfortable and I wasn’t scared. • Everyone was extremely kind and respectful. They • The caring and compassion of the dentists didn’t treat me like I was just trying to get because I was scared. something for free. • Doctors and assistants treated me with respect, • Dentist didn’t hurt me. not as an indigent. • They all did a good job. Did not feel any pain.
• Grateful that they took HIV clients for dental work.
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Table 4. Patient Comments on COMOM – Most Helpful Aspects of Program (continued)
COMPASSION VOLUNTEERS • Dentist was excellent, actually cared. • Nice, helpful people while I was waiting in line. • Hygienist very helpful. Enjoyable experience. • Kindness and perkiness of the volunteers. • Everybody caring about my well being, and being • Staff being extremely friendly. very patient. • All the wonderful smiles. • I witnessed much compassion from everyone. • Fixing everything with a smile. • They were really polite and enjoyed what they • Very friendly. They gave a lot of confidence to were doing. the patients • Helpful people with great attitudes. • Organized and took time with the patient. ORAL HEALTH INSTRUCTION • Made sure everyone was comfortable. • Teaching me how to clean my teeth, and • Volunteers were great in directing patients. complimenting my smile. • People were kind, generous, understanding, and • The hygienist doing the cleaning really took her very organized. time and gave me good pointers. • Everybody. People were very nice . . . and they • Tips for brushing and flossing. listened! • Learned not to brush in a circular motion. • Everybody’s helpfulness. I could easily find staff • Informed me of gum disease. when I had a question. • Everyone cordial, helpful, willing to answer • Now I can teach my children how to clean their questions. teeth better. • The learning for her and her children. FAMILIES /C HILDREN • Being able to get help, and to ask questions. • Families being able to go through clinic together, Being encouraged to go back to the dentist. and having everyone getting what they needed. • I learned I need to go to the dentist. • They got my whole family in. • Family atmosphere. • Balloonist, clowns for the kids. COST • Kids taken care of. • Just having a program to help people who don’t • Daycare. have any money for the services.
• Giving people an opportunity who can’t afford CLINIC ENVIRONMENT care. • Blankets given out in the middle of the night. • Being able to get the services because I couldn’t • Cared about all the patients’ needs – food, water, afford to get it done otherwise. balloons, etc. • Having the work done that I can’t afford. • Offering the water and the food was great! • Providing blankets, liquids, snacks. • Knowing I could get the help I needed without it • Hospitality, food, entertainment. Organization. costing me. Blankets were great. • Great service. Good food. • I don’t work, so it was helpful financially. • It was offered on a Saturday. • Blessing for those without dental insurance. They took good care of us. • Great thing for people who can’t afford TRANSLATORS insurance! • They had Spanish translators to help me. • People spoke my language (Spanish) • Free services for anyone that came • They treated me very well and had Spanish speakers.
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PATIENT MESSAGES
Patients were very thankful for the services they received, and for the individuals who helped them. (Table 5 highlights a sampling of patient messages left for COMOM volunteers.) As the volunteers conducting the exit interviews would attest, the written words of the patients do not embody the intensity of the appreciation and gratitude that they expressed.
Table 5. Messages to COMOM Volunteers
• Appreciated the respect everyone showed me. I liked • Thanks! I can think about my appearance again. their work and they treated me great. • Thank you all. Now I can get dentures and smile again. • Bless everyone here for their act of service and I haven’t smiled in years. their sense of humor, and that they are able to • Thank you for taking care of those who can’t afford think of someone other than themselves. care. Best experience I’ve ever had with a dentist! • Can’t thank you enough. You were wonderful. I felt • Thank you very much! I appreciate it! Some days I more at home than being at a dentist. can’t afford TP let alone dental care! • Continue to do these events. They are very helpful • Thank you! What you do is very appreciated by the especially to us that are uninsured. We are very people who need it the most. grateful. Thank you so much! • Thank you so much. You’ve changed my life. • Dentist was the best dentist I’ve ever had. Dentist that numbed me up was great too! • Thank you very much for your time and the free dental treatment. It has allowed people without • Exceptional people who gladly took time away from money to get the dental work done. their own lives and businesses to do this. • Thank you so much. This means a lot to so many • Grateful for your time and sacrifice away from your people including me. families. • Thank you very much. Keep up the good work. A lot of • I appreciated the fact that there are people that care people need this service. enough to help people without insurance. • Thank you very much for your volunteered time. It was • I really appreciate your time and service. You saved the most wonderful services anyone can provide! me a lot of money. • The attention was great. Thank you for thinking of us. • It’s great you do these events because dental care is expensive. Thank you and I hope you do another mission. • The programs I know about are just for kids. I received good help, and it’s very nice of you provide free • I was in need of care, and was grateful for the services services. Thanks a lot. that were provided. • The dentist and the hygienist were wonderful. I’m very • I wish everyone the best. You were a blessing to me. I grateful. Thank you for giving my smile back. have no words to say thanks. I would like to help with this event in the future. • The past 15 years of pain have now become part of my past. I’m grateful for all you have done. • Keep doing this for people who can’t afford dental care. • Very good job. Dentist was funny, nice. I wish I had a • Many thanks for giving to those in the community dentist like that. who need it. • Very grateful. I have no job, no money. Did great work. • My appreciation for the time, dedication and service. I’m totally grateful to all dentists, hygienists, and the • Very thankful for me and the community. Would love to friendly volunteers. volunteer next time. • Never experienced anything like this! Another year, I’d • Very nice. Very professional. Thanks for taking your like to volunteer. time with us. • On a scale of 1-10 You’re a 45!! • Very professional. Was more than I expected. Thanks to the volunteers. • People who are low income appreciate the dentists coming out and doing this. • Very thankful for your willingness to help people who need it. • So impressed. Thank you for a job well done. Volunteers had hearts of gold. • Wow. This was a Godsend. People were so great . . . dentists, dental assistants, etc. Thank you for the food. • Thanks a lot for all the services you provided. It was an My smile is forever. awesome event. • You are doing a wonderful job and providing a • Thanks again to both dentists. Happy to be able to service that is greatly needed. show teeth again. Worth the wait overnight. • You were incredible. From primary exam all the way. • Thanks for giving all your time. I couldn’t ask for more than what I’ve been given today.
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APPENDICES
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APPENDIX A 2009 BRIGHTON COMOM PATIENT TREATMENT FORM
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Code Number: ______
COLORADO MISSION OF MERCY – EXIT INTERVIEW
We would like to ask you a set of questions to help us evaluate how well this Mission of Mercy is serving the community. The information will be kept confidential and will not be used to identify you personally.
THE FIRST QUESTIONS ARE ABOUT YOUR DENTAL CARE . . . 1a. Before coming to this clinic, did you have dental pain? Yes No (Skip to 2) 1b. If yes, about how long have you been in pain? ______Years ______Months ______Days
2. Did someone at the clinic provide you with oral hygiene instruction? Yes No
3. Were you given written information about what to do for your teeth after today’s clinic? Yes No
4. Were you told that you needed further dental treatment beyond that provided during COMOM? (for example, cavity filled, root canal, dental cleaning) Yes No
5. Do you have a place to go for dental care after today? Yes No
6. Are you covered by Medicaid? Yes No
7. Are you covered by CHP+? (only children age 18 and under and pregnant women age 19 and over) Yes No
8. Aside from Medicaid or CHP+, what dental insurance do you have to help pay for dental care? (mark one ) No dental insurance Dental insurance through a family member or partner Dental insurance through my job Dental insurance I purchase myself Other (please describe): ______
9. When was the last time you had your teeth cleaned? ______Years ______Months ______Days Never I have full dentures
10. When was the last time you saw a dentist? ______Years ______Months ______Days Never
11. If you have not been to a dentist in six months or more, what is the primary reason for not getting dental care? (mark one ) What would be another reason for not getting care? (mark one )
Primary Secondary Reasons I cannot afford to pay I do not have dental insurance I have dental insurance, but copay or deductible is too high for me to pay Attempted to go to a dental clinic, but it would not accept the insurance I use Attempted to go to a dental clinic, but it would not accept payment based on my ability to pay Attempted to go to a dental clinic, but it was not accepting new patients Attempted to go to a dental clinic, but it refused to see me. Describe: ______ There is no dental clinic near my home I lack transportation to a dental clinic I didn’t think I needed to go I had a dental appointment but didn’t keep it I’m too busy I do not like receiving dental care Other (describe): ______
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THE NEXT QUESTIONS ARE ABOUT YOU . . .
12. What is your age? ______Age in years
13. Gender? Male Female
14. Are you of Hispanic or Latino origin? Yes No
15. Which one or more of the following would you say describes your race? (mark all that apply) American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
16. Where do you live?
______Town/City State ZIP Code
THE FOLLOWING QUESTIONS ARE ABOUT YOUR MISSION OF MERCY EXPERIENCE . . .
17. Have you been treated at a Mission of Mercy event before this one? Yes No (If yes, where? ______)
18. How did you hear about this Clinic? (mark all that apply) Friend/family member School Church Medical Clinic Social Services Media: Newspaper / TV / Radio: ______ Other: (Please describe): ______
19. Today’s dental clinic is on: Friday Saturday
20. I entered the line outside the clinic building on : Thursday Friday Saturday
21. At (time): ______:______ am pm
22. How happy were you with the services you received? Very unhappy A little unhappy Neither unhappy nor happy A little happy Very happy
23. What suggestions do you have for improving the Colorado Mission of Mercy?
24. What about the program was most helpful?
25. What message would you like us to share with the dentists, dental hygienists, and others who helped with the Clinic?
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APPENDIX C DENTAL PROCEDURES – DONATED FEES – NUMBER OF PATIENTS
PATIENTS – EVALUATION ONLY & EVALUATION AND TREATMENT (N=1,291) ASSIGNED DONATED AVERAGE RANGE CODE DESCRIPTION OF SERVICES FEE # PROC FEES # PTS PROC / PT PROC / PT
CLINICAL ORAL EVALUATION D0150 Comprehensive oral exam $86 1,291 $111,026 1,291 1.0 1 VELscope - cancer screening (Fees calculated for patients age 15 years or older; 15 is the youngest age of patients D0431 attending COMOM who used tobacco products.) $40 1,105 $44,200 1,105 1.0 1
NUMBER OF PROCEDURES & DONATED FEES 2,396 $161,532 PATIENTS UNDERGOING EVALUATION PROCEDURES 1,291 1.9 1-2 ALL PATIENTS 1,291 PERCENTAGE OF ALL PATIENTS UNDERGOING
EVALUATION PROCEDURES 100%
PATIENTS – EVALUATION AND TREATMENT (N=1,235) ASSIGNED DONATED AVERAGE RANGE CODE DESCRIPTION OF SERVICES FEE # PROC FEES # PTS PROC / PT PROC / PT
RADIOGRAPHS / DIAGNOSTIC IMAGING D0220 Intraoral – periapical (first film) $29 91 $2,639 91 1.0 1 D0230 Intraoral – periapical (each additional film) $24 39 $936 29 1.3 1-3 D0272 Bitewings $46 23 $1,058 11 2.1 1-6 D0330 Panoramic film $111 205 $22,755 205 1.0 1 NUMBER OF PROCEDURES & DONATED FEES 358 $27,388 PATIENTS UNDERGOING IMAGING PROCEDURES 291 1.2 1-7 ALL PATIENTS 1,235 PERCENTAGE OF ALL PATIENTS UNDERGOING
IMAGING PROCEDURES 24%
PREVENTIVE D1110 Prophylaxis – adult (12 years or older) $92 247 $22,724 247 1.0 1 D1120 Prophylaxis – child (11 years or younger) $70 57 $3,990 57 1.0 1 D1203 Topical application of fluoride (prophylaxis not included) – $39 46 $1,794 46 1.0 1 child (11 years or younger) D1204 Topical application of fluoride (prophylaxis not included) – $37 260 $9,620 260 1.0 1 adult (12 years or older) D1351 Sealant - per tooth $52 150 $7,800 33 4.5 2-16 NUMBER OF PROCEDURES & DONATED FEES 760 $45,928 PATIENTS UNDERGOING PREVENTIVE PROCEDURES 426 1.8 1-18 ALL PATIENTS 1,235 PERCENTAGE OF ALL PATIENTS UNDERGOING
PREVENTIVE PROCEDURES 34%
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PATIENTS – EVALUATION AND TREATMENT (N=1,235) ASSIGNED DONATED AVERAGE RANGE CODE DESCRIPTION OF SERVICES FEE # PROC FEES # PTS PROC / PT PROC / PT
RESTORATIVE D2140 Amalgam - one surface, primary or permanent $149 169 $25,181 101 1.7 1-6 D2150 Amalgam - two surfaces, primary or permanent $196 143 $28,028 113 1.3 1-3 D2160 Amalgam - three surfaces, primary or permanent $224 58 $12,992 48 1.2 1-3 D2161 Amalgam - four or more surfaces, primary or permanent $290 18 $5,220 14 1.3 1-4
D2330 Resin-based composite - one surface, anterior $171 128 $21,888 82 1.6 1-5 D2331 Resin-based composite - two surfaces, anterior $222 124 $27,528 73 1.7 1-8 D2332 Resin-based composite - three surfaces, anterior $270 90 $24,300 59 1.5 1-6 D2335 Resin-based composite - four or more surfaces or involving incisal angle (anterior) $306 98 $29,988 62 1.6 1-4 D2391 Resin-based composite - one surface, posterior $185 218 $40,330 124 1.8 1-9 D2392 Resin-based composite - two surfaces, posterior $244 167 $40,748 110 1.5 1-8 D2393 Resin-based composite - three surfaces, posterior $300 71 $21,300 62 1.1 1-3 D2394 Resin-based composite - four or more surfaces, posterior $350 46 $16,100 38 1.2 1-2
D2920 Recement crown $105 3 $315 3 1.0 1 D2930 Prefabricated stainless steel crown - primary tooth $275 8 $2,200 5 1.6 1-2 D2931 Prefabricated stainless steel crown - permanent tooth $350 1 $350 1 1.0 1 D2940 Sedative filling $120 15 $1,800 14 1.1 1-2 D2950 Core buildup, including any pins $275 32 $8,000 24 1.3 1-3 D2954 Prefabricated post and core in addition to crown $333 3 $999 2 1.5 1-2 NUMBER OF PROCEDURES & DONATED FEES 1,392 $308,067 PATIENTS UNDERGOING RESTORATIVE PROCEDURES 570 2.4 1-13 ALL PATIENTS 1,235 PERCENTAGE OF ALL PATIENTS UNDERGOING
RESTORATIVE PROCEDURES 46%
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PATIENTS – EVALUATION AND TREATMENT (N=1,235) ASSIGNED DONATED AVERAGE RANGE3 CODE DESCRIPTION OF SERVICES FEE # PROC FEES # PTS PROC / PT PROC / PT
ENDODONTICS D3220 Therapeutic pulpotomy (excluding final restoration) $201 11 $2,211 9 1.2 1-2 D3310 Root canal therapy: Anterior (excluding final restoration) $710 34 $24,140 26 1.3 1-3 D3320 Root canal therapy: Bicuspid (excluding final restoration) $821 25 $20,525 22 1.1 1-3 D3330 Root canal therapy: Molar (excluding final restoration) $1,015 10 $10,150 10 1.0 1 NUMBER OF PROCEDURES & DONATED FEES 80 $57,026 PATIENTS UNDERGOING ENDODONTIC PROCEDURES 65 1.2 1-4 ALL PATIENTS 1,235 PERCENTAGE OF ALL PATIENTS UNDERGOING
ENDODONTIC PROCEDURES 5%
PERIODONTICS D4210 Gingivectomy or gingivoplasty - four or more contiguous teeth or bounded teeth spaces per quadrant $550 1 $550 1 1.0 1 D4355 Full mouth debridement to enable comprehenisve evaluation and diagnosis $185 211 $39,035 211 1.0 1 NUMBER OF PROCEDURES & DONATED FEES 212 $39,585 PATIENTS UNDERGOING PERIODONTIC PROCEDURES 211 1.0 1-2 ALL PATIENTS 1,235 PERCENTAGE OF ALL PATIENTS UNDERGOING
PERIODONTIC PROCEDURES 17%
PROSTHODONTICS D5650 Add tooth to existing partial denture $217 4 $868 3 1.3 1-2 D5730 Reline complete maxillary denture (chairside) $370 2 $740 2 1.0 1 D5820 Interim partial denture (maxillary) $550 76 $41,800 76 1.0 1 D5821 Interim partial denture (mandibular) $550 34 $18,700 34 1.0 1 NUMBER OF PROCEDURES & DONATED FEES 116 $62,108 PATIENTS UNDERGOING PROSTHODONTIC PROCEDURES 101 1.1 1-2 ALL PATIENTS 1,235 PERCENTAGE OF ALL PATIENTS UNDERGOING
PROSTHODONTIC PROCEDURES 8%
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PATIENTS – EVALUATION AND TREATMENT (N=1,235) ASSIGNED DONATED AVERAGE RANGE CODE DESCRIPTION OF SERVICES FEE # PROC FEES # PTS PROC / PT PROC / PT
ORAL AND MAXILLOFACIAL SURGERY D7111 Extraction, coronal remnants - deciduous tooth $150 7 $1,050 6 1.2 1-2 D7140 Extraction, erupted tooth or exposed root (elevation and/or forceps removal) $175 727 $127,225 291 2.5 1-21 D7210 Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth $275 468 $128,700 223 2.1 1-26 D7220 Removal of impacted tooth - soft tissue $300 23 $6,900 18 1.3 1-3 D7230 Removal of impacted tooth - partial bony $353 45 $15,885 31 1.5 1-4 D7240 Removal of impacted tooth - completely bony $430 12 $5,160 8 1.5 1-3 D7241 Removal of impacted tooth - completely bony, with unusual surgical complications $478 4 $1,912 2 2.0 2 D7250 Surgical removal of residual tooth roots (cutting procedure) $307 45 $13,815 26 1.7 1-5 D7310 Alveoloplasty in conjunction with extractions - four or more teeth or tooth spaces, per quadrant $344 14 $4,816 10 1.4 1-3 D7997 Appliance removal (not by dentist who placed appliance), includes removal of archbar $98 3 $294 3 1.0 1 NUMBER OF PROCEDURES & DONATED FEES 1,348 $305,757 PATIENTS UNDERGOING SURGICAL PROCEDURES 496 2.7 1-26 ALL PATIENTS 1,235 PERCENTAGE OF ALL PATIENTS UNDERGOING
SURGICAL PROCEDURES 40%
MISCELLANEOUS D9951 Occlusal adjustment - limited $182 1 $182 1 1.0 1 NUMBER OF PROCEDURES & DONATED FEES 1 $182 PATIENTS UNDERGOING MISCELLANEOUS PROCEDURES 1 1.0 1 ALL PATIENTS 1,235 PERCENTAGE OF ALL PATIENTS UNDERGOING
MISCELLANEOUS PROCEDURES <1%
GRAND TOTAL 6,683 $1,001,267
DONATED FEES PER PATIENT (N=1,291) $776
Source: American Dental Association, Survey Center. 2009 Survey of Dental Fees. 2009. (COMOM assigned dental fees in relation to Colorado practice and market considerations, and used as reference the fees of surveyed general practitioners in the mountain range at the 90th percentile.)
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APPENDIX D
2009 COMOM CONTRIBUTORS
Thank you to the following organizations and individuals who donated funding, supplies, food and services to make COMOM a success!
Colorado Dental Association Rely Aid Joseph Catalano DDS Fred Harvey DDS Delta Dental of Colorado Santiagos Kevin Chapman DMD Richard Harvey DDS Platte Valley Medical Center Sierra Radiation Charles Chew DDS Karl Heggland DDS Bank of the West Subway - Brighton Kevin Christ DMD Lloyd Heikes DMD United Power – Operation Round-up Foundation Sunstar Mark Chua DDS Courtney Heinicke DDS Dr. Filipp A Sapienza – Powell Family Charitable Fund Target - Brighton Michael Cimino DDS Dr. Paul Helmstetter of the Greater Saint Louis Community Foundation Tiara Printing Vincent Cleeves DDS James Henry DDS Rosie Wall Community Spirit Grant – ADHA Institute Uhler Dental Supply Larry Coffee DDS Christopher Higuchi DDS for Oral Health United Power Ronald Concialdi DDS John Hildebrandt DDS Hispanic Advisory Council – Brighton School District 27J United Rentals HD Conner DDS Gary Horn DDS ThunderRidge High School – Grizzly Bear Backer Club Valley Bank & Trust Don Cox DDS Scott Horsley DDS Wells Fargo VELscope James Craig DDS Timothy Hubble DMD Adams County Regional Park Complex VFW – Brighton Thomas Croghan DDS Gary Hulse DDS American Red Cross Walmart - Brighton Joseph Dankey DDS Michael Hurtado DDS American Trailer Storage Leasing of Fort Collins Weld County Dental Society Charles Danna DDS Michael Israelson DDS Arbys – Brighton Western Colorado Dental Society Jack Davis DDS James Jack DDS Arkansas Valley Dental Society WISER Walter Davis DDS David Jackson DDS Black Diamond Dental Studio The Worship Center Brock Deal DDS Stephen Jackson DDS Brighton Breakfast Lions Club Wright Group Event Services Jill Decker DDS Terrence Jakubanis DDS Brighton Chamber of Commerce John DiBiaggio DDS David James DDS Brighton Early Rotary Club James Abramowitz DDS Robert DiGiorgio DDS Mark Jankowski DDS Brighton English Seventh-day Adventist Church John Abrams DDS John Dildine DDS Jesse Jenkins DDS Brighton Kiwanis Club Mark Adams DDS Pam Dinkfelt, PhD Leslie Johnson DDS Brighton Local Color Eric Adler DMD Scarlet Disse-Pfeifer DDS Jeffrey Kahl DDS Brighton School District 27J Jack Allen DDS Monica Dobbin DDS Robert Kammer DDS Brighton Standard Blade Richard Anderson DDS Richard Dobbin DDS Anthony Kardelis DDS Bromley Companies Roger Anderson DDS Charles Doolittle DMD Rahim Karmali DDS Buffalo Wild Wings – Brighton Raymond Armstrong DDS G Bruce Douglas DDS James Kearney DDS Chick-fil-A - Brighton Lisa Augustine DDS Bruce Dunn DDS John Kearney DDS Chili's – Brighton William Ayers DDS Matthew Dunn DDS Charles Kelley DDS Coda Coffee Company Steven Bagley DMD Terry Eckles DDS Stephen Kelly, DMD Colorado Springs Dental Society Bruce Baldwin DDS James Eich DMD James Kennedy DDS Colorado Prosthodontic Society John Bassett DDS Richard Elliott DDS Barry Keogh DDS Commerce City Gateway News John Bauman DDS Steve Enea DDS David Kim DDS CSI Colorado George Beilby DDS Steven Eurich DDS Derek Kirkham DDS Dentsply Professional Myra Bender RDH Kevin Evans DDS Donald Kleier DDS Denver Nuggets Robert Benke DDS Angela Evanson DDS Mark Klein DDS Eclipse Engineering Sidney Benner DDS Joel Feinberg DDS Richard Kloehn DDS Empire Portable Restrooms Shane Bergo DDS Neal Fenton DDS Thomas Klumb DDS Gnathodontics Deborah Bhasker DDS Dennis Ferraro DDS Darrel Kneupper DDS Hampton Inn - Brighton John Bishop DDS Ronald Ferrendelli DDS Keith Kohrs DDS Henry Schein Andrew Bland DDS Gary Field DDS Kimberly Kretsch DDS Home Depot - Brighton Jacqueline Blasko DDS Charles Fischer DDS Robert Kron DMD Home Depot - Longmont Gary Blumenschein DDS David Fishman DDS Jennifer Kurth DDS IHOP - Brighton Roger Boltz DDS Roslyn Fleischman Dwaine Kurtz DDS Imprints Wholesale Malcolm Boone DDS Russell Ford DMD William Lacey DMD Johnson and Wales University - College of Culinary Arts Brandi Bottoms DDS John Forney DDS Gregg Lage DDS Kohl's Department Stores - Brighton Paul Bottone DDS Thomas Forti DDS Kenneth Lahr DDS LaBrea Bakery Gary Boudreaux DDS Michael Freimuth DDS Brian Langenfeld DDS La Pantera 92.9 FM James Bradley DDS Nicole Furuta DDS Kye Lee DDS Larimer County Dental Society Gerald Branes DDS Howard Garel DDS Bradley LeValley DDS Lone Star Steakhouse – Brighton Liliane Brantes DDS Randolph Geoghan DDS John Ley DDS Mastercraft Dental Lab Thomas Brewer DDS Louis Gerken DDS Richard Ligon DDS McDonalds – Brighton Terry Brewick DDS Leroy Gerry DDS Shiloh Lindsey, DDS Medical Systems of Denver Cherie Brown DDS Shauna Gilmore DDS Sunshine Lodwick DDS Metropolitan Denver Dental Society Michael Burnham DDS Jessica Goette RDH Eloisa Lovato DDS Montage Graphics William Burns DDS Bradley Goings DDS Teresa Lowery DDS My Cherished Memories Ryan Cable DDS Nicklas Groskopf DDS David Lurye DDS Northern Hills Christian Church Michelle Caldwell DDS Ronald Grout DDS Michael Malivuk DMD Ortega's Vance Carlson DDS Alan Gurman DDS Herbert Mameda DDS Patterson Dental Lisa Carlson-Marks DDS John Hanck DDS J Gregory Mann DDS Platte Valley Ambulance Service Perri Carnes DMD Jarvis Hansford DDS Sharlene Martinson DDS Premier Dental Marc Carpenter DDS Jennifer Hargleroad DDS James Mauer DDS Project Smile Corporation Douglas Carver DDS Katherine Harmon DDS James McCartney DDS Red Bird Farms Bryan Casseday DDS Meredith Harris DDS Lamont McMurtrey DDS Reflections Apparel Wayne Castle DDS David Hartman DDS Guy Mertz DDS
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Kelly Monroe DDS Ken Peters DDS Richard Rozehnal DDS JE Smith DDS Timothy Wachuta DDS Thomas Moran DMD Bruce Peterson DDS Sharon Russell DDS Cindy Snyder John Walker DDS Robert Morrow DMD Jerry Peterson DDS Ellen Sachs DDS Stephen Stein DDS Richard Wallace DDS Jeffrey Moser DDS Justin Petracek DDS Jeanne Salcetti DDS H Scott Stewart DDS John Warner DDS F Robert Murphy DDS William Pfeifer DDS Bryan Savage DDS Michael Stiles DDS Kathryn Warren DDS Ivan Naiman DDS Dianne Pierson DDS Gerald Savory DDS Dale Strietzel DDS Larry Weddle DMD Robert Nassimbene DDS Thomas Pixley DDS Pasco Scarpella DDS Corbett Summers DDS Bradley Weekes DDS Bryan Nelson DDS Michael Plous DDS Michael Scheidt DDS Donald Swartz DDS John Weissman DDS James Nelson DDS Nino Pollaccia DDS Ronald Schmidt DDS Demetrios Syrpes DDS Brian West DDS Jeff Nelson DDS Michael Poulos DMD Charles Schonberger DDS Clara Tao DDS Dan Wherley DDS Roger Nishimura DDS Murray Powell DDS Andrew Schope DDS Glenn Thompson DMD Kenneth Wilson DDS David Nock DDS Robert Powers DDS Darrell Schuler DDS Mark Thurber DDS Philip Wimpee DDS Samuel Novak DDS Patrick Prendergast DDS RJ Schultz DDS Kathy Tomlinson DDS Heidi Winquist DDS Robert Nykaza DDS Nicolas Pruett DDS Timothy Schwartz DDS HK Townsend DDS Jeffrey Wong DDS William Oldershaw DDS Lawrence Purcell DDS Clark Scriven DDS Arlene Tsang DDS Robert Yardumian DMD Dwight Olson DMD Rhett Quist DDS James Setterberg DDS Celia Turner DDS Jeffrey Young DDS Kelly O'Neal DDS William Reardon DDS Roberta Shaklee DDS Michael Unser DDS Wayne Zarlengo DDS Kevin O'Neill DDS Karina Redko DDS Peter Shelley DDS Mark Uremovich DDS Ronald Zastrow DDS Larry O'Neill DMD Paul Regan DMD Paul Sherick DDS Calvin Utke DDS Ryan Zastrow DDS Mark Orr DDS Mark Reinicke DDS Mark Shimoda DMD Peter Vanicek DDS Daniel Zeppelin DDS Thomas Overton DDS Alan Reisman DDS Paul Sica DMD Melissa Venrick DDS Bruce Zimmerman DDS Brandon Owen DDS Bryan Rieker DDS Larry and Brenda Simmons Robert Wilson DDS Ronald Palmer DDS Kristin Robbins DDS Nancy Simons DDS Eric Van Zytveld DDS John Parrish DDS Stephen Robertson DDS Carl Skulski DDS Kenneth Versman DDS Kevin Patterson DDS Edmund Robison DDS Bradley Smith DDS John Volp DDS
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APPENDIX E
2009 COMOM VOLUNTEERS
Thank you to the individuals who volunteered their services and contributed to the success of the Brighton COMOM!
Sara Abbott Dan Benson Tami Choe RDH Nicole Eberle DDS, MS Arlene Gonzales Cecily Abeyta Bruce Bergstrom Justin Christenson Darlene Edwards Belinda Gonzales Arica Abrames DDS Cheryl Bergstrom RDH Angelique Christianson EDDA Mark Ehrhardt DDS Elizabeth Goodnow Pritee Adhikari Ronald Berquist DDS Tori Cimiano Michael Elevich Jennifer Goodrum Jana Aldrich Jennifer Berrong Shana Clapp Albert Eng DDS, MS Harold Gordon Jackie Alexander Kim Berry RDH Christina Clements Geoff Engelhardt DDS Bonnie Gower Mike Alexander Kelly Beyrouty John Clemons Adan Enrique Connie Gower Travis Alexander Josephine Bicknell Shane Clyde Joshua Erickson DDS, MSD Mallory Graham CDA Naomi Alford Elizabeth Blakeley Carolyn Cobb Tina Erickson Monta Greenfield Ammie Allen Joe Blankenship Bill "Stretch" Coleman Joan Eskens RDH, MS, MHA Bruce Greenstein DMD Leslie Allen RDH Jessica Bograd Jeanette Coleman Danna Esquibel RDH Kelly Greenwood Adam Almeida DDS Gwen Bohlender Kristie Coleman Ariany Estrada Sheri Griego Ramiro Alvarado Julia Boratenski DDS Sarah Coleman Greg Evans DDS Franciso Guillen William Ames DDS Dana Borini Julie Collett Tom Evans DDS Profirio Guillen Carl Anderson Gary Boudreaux DDS Kay Collins Rochelle Evitt Kyle Guerin Carol Anderson Lori Boudreaux Andrew Comerci Cara Fagnant Alisha Guerrero Gladys Anderson John Bozis Diana Conigliaro Dick Fatout Stacey Haarman Julie Anderson PharmD Charis Bozung Lisa Connelly Jennifer Fawaz RDH Jerry Hafford Kate Anderson Megan Bradbury Marisol Contreras Marielle Feilinger Scott Hallbriter Steve Anderson DDS Rebecca Bradford Cara Cooper RDH Darlene Feinberg Willie Hammond Mariella Andreo Jenna Braun RDH Delith Corral Joel Feinberg DDS John Hanck DDS Carolyn Anello RDH Corliss Brecht Martha Cosby Nicole Ferrara DDS Nancy Hanck Heather Angers RDH Tracy Bremen Jarred Cottam DDS, MD Tavita Ferrer Jamie Hardy Robert Antiel DDS Pam Brockhaus Britton Cottrell Dennis Fetzer Tiko Hardy Dustin Apple Cassandra Broeker RDH Miranda Cottrell Julie Fiorenzi Chelsea Harris RDH Helen Aragon Julie Brown DDS Julie Cowles Eunice Flores Nicole Harris Vicki Arnold Michele Brown Meghan Crow RDH Daniel Foley DDS Ashleigh Harrison DDS Sharla Aronson DDS Shannon Brown Sherri Crutchfield Ashley Foos Stephanie Harrison RDH Aimee Arroyo M. Laura Brumfield Arnold Cullum DDS Dana Forbes EDDA Tracie Harrison Marcus Artis Charles Brunette Michelle Cunningham Gwen Forbes David Hartman DDS Trevon Askew Lisel Brutlag Easton Cyrus Robert Fossell Raeann Hawley Pam Atherton RDH Cassandra Bryant Matthew D'Addario DDS, MD Cassi Foster Danielle Hayes Herman Axelrod Greg Buchholz CMT Tabitha Dafni Cory Foster DDS Thomas Hebda DDS Gulala Aziz Claudia Buckley Susan Dale Brian Fox Charlie Hebeler Dr PH Sahar Babak Charles Burge Cathy Dalpes Kathleen Fox RDH Xue Xiao Hedensten Charlene Baca Cassie Burgett Sheri Danieli RDH James Franckum DDS Rose Anne Heisser Ana Baeza Nichole Burke EDDA Kayana Daniels Jacqueline Frank Ryan Helber Dustin Baio Michael Burnham DDS Charles Danna DDS Jennifer Franks Jodi Henderson Gabriel Bakhtiyaryan Cheryl Burrows Tonya Danna EDDA Sarah Frawley CDA Andrew Hendreschke Linda Ballard RDH Andrea Buxton Eric Dayhuff Amy Frazey RDH Greg Herman Alicia Banuelos Michael Byczynski Pat Dayhuff Shira Freeman CDA Martie Herman Jan Barker Mayra Cabrera Sandra Dean Cathy French Kizzie Hernandez Nelly Barreto DMD Kolleen Callo Jan DeBell CDA Maria Freyta Dave Herrera Mercedes Barrientos Claudia Calus RDH Brittany Debus CDA Laura Fuller Kimberly Herrera Pam Bartholomay Rocio Campana Ruth DeCrescentis Alex Gaebler Diane Herrick Rebecca Barton Peter Carlesimo DDS Martha DelaCabada Kendra Gagich Jonathan Herrman Benjamin Bass Ann Carlson RDH Jill DelRoss Rhiannon Gallegos Megan Heston Karla Bass Dartanian Carlson Hugo DeLuna Katherine Galm DDS Jessica Hetcko DDS Cornelius Bates Kendal Carlson DMD Nena DelVillar Logan Gapp Kristin Heylmun Jaclynn Bates Alisa Carmosino EDDA Barbara Dennis Alta Garcia Thomas Hickman DDS Jennifer Bates Jeanne Carnes RDH Jan Dennis Amy Garito RDH Kirsten Hoffman Emily Batson DDS John Carr Toby Derloshon DDS Becky Garrison RDH Jim Holland Amanda Baxter John Carroll Christina Despot RDH Lu Anne Garvin Kate Holligan Don Baxter Rebecca Castillo Robert DiGiorgio DDS Jennifer Garza Jolene Holzfaster Jonette Baxter Tanya Castle Pam Dinkfelt PhD Steve Gaskin Mark Hood Jennifer Bay EDDA Richard Cea DDS Linda Divido Jennifer Geiselhofer RDH Tanara Hooper Ernesto Becerra Tina Ceretto Kristen Dlugos Kasie George Greg Horner Martina Becerra Jesus Cervantes Carrie Dodds Doree Gerken Inna Horvath RDH Kate Beckham John Chase Jeffrey Dombrowski DDS, MD Gage Gerken James Houser Paul Beer DDS Citlali Chavez Sandy Dorcey John Gerken Amy Houston George Beilby DDS Mike Chavez Candice Dow John Gerken Jr Cassandra Hughs EDDA Michael Bemski Raquel Chavez Cara Downey RDH Kenneth Gieger DDS Donald Hull DDS Sabrina Bendiff Tina Chavez Delma Duncan Josey Giessinger RDH Deb Humann RDH Robert Benke DDS Chelsea Chiovitti Amy Dunlap Doug Glaser Latisha Hummel Brenton Bennett DDS Meghan Chiovitti Keegan Dunson Jennifer Goddard RDH Tina Hunt Laura Bennett RDH Nicholas Chiovitti DDS Michelle Duran Antoinette Gomez Richard Hurd DDS Mike Bennett RDH Steve Choe Molly Earls Javier Gomez Jeffery Hurst DDS -40-
Luann Husmann Joe Lehey Ursula Monterosa Traci Parchman RDH Edward Rosenfeld DMD, MS Pamela Ichiyasu Sandra Leonard Vicky Montez EDDA Alexander Park DDS Linda Roth Jamie Irwin DDS Linsey Liestman Heather Moorcroft Janelle Passalaqua RDH Meredith Roth Bruce Iverson DDS Mari Liestman Dustin Moore Jenife Patrick Ashley Roush Sara Anne Iverson Sid Ligon DDS Jeanne Moore Devrie Patterson Jessi Rowland James Jack DDS Shawna Lind Jordan Moore Janet Patterson Carrie Roybal Felicia Jackson Shiloh Lindsey DDS Mindy Moore Mark Patterson RDH Patricia Ruiz Christine Jacobucci M. Tyron Link Scott Moore Jake Patton Jamie Ryan Pam James Donna Lobb Mark Moores Margaret Patton Linda Ryan Christine Jantzen RDH Matthew Loeppke Sheree Moraga-Gonzales Roy Patton David Sabott DDS Sheri Jaramillo Natasha Long Carmen Morales Linda Paul Adam Saeks DDS Peggy Jarrett Ana Loya Rosalee Morales Zeb Peak Grace Saffy Sarah Jenkner Larry Lubar DDS Judy Morgan Julie Pelz Patrick Sailas Rossana Jeri-Mata EDDA David Lurye DDS Vernon Morgan DDS Justin Pelz Cynthia Salazar Nyla Johansen Kristin Majkowski Tamara Morris Yolanda Pena Bob Salcetti Denise Johnson Kelsey Majors DDS Bob Morrow DMD James Penta Tracy Sales Grant Johnson Sally Majors Carol Morrow DDS Patty Penta Larry Salmen Michael Johnson Esmeralda Maldonade RDH Dolly Morrow Molly Pereira Sara Salter Steven Johnson Stacie Malin Ian Morse David Perell DDS Vidhya Sampath DDS Ted C Johnson DMD Kerri Manhart Brandi Mortensen Pamela Perell DDS Maria Sanabria Ankur Jolly DDS Andrew Maples DDS Jack Moss DDS Martha Perez Leonor Sanchez Kim Jolly Kate Maples-Andrade Connie Motter Andrea Peters Lupe Sanchez Peggy Jolly Stephanie Mari EDDA Elizabeth Moua Ken Peters DDS Sara Sanchez Cheryl Jones EFDA Sharyn Markus Parvin Movaffagh Teresa Peters RPh Monica Santa Cruz Christine Jones DDS Tabitha Marquez Erin Mullins Charles Peterson BS Ph Erika Santoyo Domitila Jones Amanda Marsh Haylee Mullins Jerry Peterson DDS Jeanette Sathre Bob Jordan Amanda Martin Damien Mulvany DMD Michael Peterson DDS Richard Sathre DDS Claudia Junenez Kate Martin Jodi Munderback Susan Peterson Michael Savage DDS Gabe Kampeska Cindy Martin Ciaran Murphy DDS Sue Petty CMT Bonnie Scarlett RMT Dawn Kanzler April Martinez F. Robert Murphy DDS Jill Pfankuch Karen Scarpella David Kaplan DDS Kathy Martinez Philip Murphy Sherri Pfleiger-Elliott EDDA Pasco Scarpella DDS Marsha Kaplan LaDawna Martinez Robert Murphy DDS Maggie Phillips Jeff Scheib Daniel Keith Marvine Martinez Sara Murphy Tammy Phung Kathryn Scheidt RN, MSN Linda Kelley Lori Matejka Carmen Murray Tamara Pierce CMT Michael Scheidt DDS Amy Kendall Marie Matthews Krystina Murray Dianne Pierson DDS Catherine Schirmer RDH Deborah Kenehan Amanda Matus-Creapo Angela Nagel Craig Pinkner DDS Barb Schlidt Jeanine Kennedy Gabriella Mayer Jan K Nansel Sandra Pinon Denise Schlosser RDH Ethan Kerns DDS Tresa Mays Robert Nassimbene DDS Mackenzie Piper Laura Schmid RDH Kevin Kester Vanessa Mays Sarah Nazeri DDS Tom Pixley DDS Amy Schmidt Khia Khan RDH Darlene McCarthy Jackie Ness Giura Polar Chelsea Schmidt John Kiley Melisa McCarthy John Ness Jan Pollard Don Schoonover Daniel Kim Elese McClarie Kerri Ness RDH Ken Pollary DDS Jennifer Schranz Lisa Kime Molly McDermott Trent Nestman DDS, MS Cherie Pollock RJ Schultz DDS Andrew Kirsch Dilys McDole Jana Newman Roxanne Powers RDH Lisa Scott Maureen Kirsch Donna McDowell Richard Newman DDS Janie Prendergast Brooke Seat RDH Ellen Klaver Julie McIntre Steven Nguyen Pat Prendergast DDS Fran Sebastian Mark Klein DDS Brock McKinley DDS Tim Nichols DDS Michelle Qadi Fel Idrissi Toni Segura LuAnn Klida James McKinney Jeanne Nicoulin Beatrice Quintela-James Tracy Sellard CMT Joan Kniss Cathy McMahon RDH Hilary Nieberg Baskin DDS Tonya Rainwater Gary Sellers DDS Abby Knutson Leah McQuigg Candice Niquette Serena Ramirez Leah Selvage Selina Koeder Darcey McQuiston Lasha Nisogi EDDA Julie Ramsey RDH Dawn Semmen Rachael Koenig Molly Meehan RDH Cathie Nobles Tara Rathburn DDS Barry Shapiro Malgorlata Korosciel DDS Brita Meijs David Nock DDS Tiffani Rauch RDH Cynthia Sheeks DDS Debbie Kowalczyk David Meisner DDS Hilary Norberg RDH Audrey Rayniak Chelsea Shellhart Jeanne Kracht Ali Melander Shannon O'Bleness Kristin Reda RDH Marilyn Shidler Kathy Krajecki Sandra Mendez Rev. Rose O'Connel Deana Reifschneider Deborah Shook RMA Rhonda Krause DDS Sarah Mertz Richard O'Day DDS Al Renke Sailuja Shrestha Julie Kroun Keith Messersmith DDS Melody Olivarez Debra Reyes Mario Silva Jessica Krupp Rebecca Metherd RDH Cecelia Ollila CDA Daniel Rhodes Kris Simcoe Chris Lacy Chris Meyer Bob Olsen BSRN Tom Rhodes Holly Simpson Edward Lacy DDS Diane Meyer Bradford O'Neill DDS Troy Richard Debora Skelton Mary Ladwig Robert Meyer DMD Karen O'Neill Jordan Richards Gretel Skelton Kim Lamb Christine Page Meyerding Linsey Ord RDH Christa Riojas Martha Skelton DDS Laura Lamos Alyssa Milam RDH John Ordahl DDS Kelliann Rita Abigail Skinner Cathy Landen Linda Miller Patricia Oscarson Norma Rivera Seth Skinner Lynda Larsen RDH, BS Ted Mioduski DDS Miranda Osier Peggy Robertson Pattie Small Brittany Larson RDH Theo Mioduski DDS Andrea Owens Jay Robson Carolen Smiley RDH Michael Larson DDS Terri Mirasol EDDA Brian Ozenbaugh DDS Lupe Rodriguez CDA Jessica Smith Kelly Last DDS Alix Mizoue Alan Packard Rick Rogers John Smits Susan Lawrence Paul Mizoue DDS Cindy Packard RDH Katie Rollyson Traci Snyder JoAnn LeClaire RDH, MS Genie Mjelde Jan Paczosa CMT Stefany Root Jasmine Solano Perry Lederbrand Marjan Mohajer Amber Palacio April Ropken CDA Joseph Solano Tracy Lederbrand Reggie Monson Ronald Palmer DDS Deborah Rosenfeld Sheryl Sorenen
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Sheri Southern CMT Ariana Tarin Diane Trujillo Michael Webb DDS Qian Wu Cheryl Spayd Brisa Tarin Shirley Tsuchimoto CDA Kelly Weil Mao Yang Jaclynn Spencer DDS Jenny Taylor Celia Turner DDS Gordan Wells DDS Bill Yoh Nickling St. Fleur Kaelyn Taylor Jessica Twibell RDH Thomas Welsh DVM Rachel Yoh Mollie Stecher Kristen Taylor RDH Calvin Utke DDS John Wheeler DDS Corryn Young Shawna Stewart Adriana te la Casa Genevieve Valdez RDH Julia Wheeler Janine Young Kristina Stone Nestor Tejada Christine Valentine Daniel Wherley DDS Jim Young T. Jean Strausser Lisa Tennyson Elet Valentine Sandy Wherley Summer Yubeta Chris Studer Curtis Terry Callie Van Well Bill Wiering Annette Zacharias Erin Suhler Lisa Thomas RDH Eric Van Zytveld DDS Scott Williams DMD Angelina Zamora Bernadette Sullivan Michael Thomas Susan Vasilakos RDH Jenny Wilson Corina Zamora Susie Summerhays Dale Thompson Jenifer Velasquez Myron Wilson Marjorie Zamora Donna Svendsen Sally Anne Thompson Johnna Vestal Ryan Wilson Christine Zeitlin Pete Sweeney Brenda Thorpe EDDA Maxine Wagoner Mitzi Wimer David Zeitlin DDS Taylor Swesey Susan Tolbert Ebony Wake Susan Wolcott DDS Marcus Zeller Joni Swinford RDH Jennifer Torr Tina Wake RDH Julie Wood RDH Desmond Zoller Travis Taberes Tara Toste Sally Walker Maggie Woodcock Steven Tanner Igor Traktinskiy Annette Wand Michelle Wright
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APPENDIX F IMAGES
COLORADO MISSION OF MERCY Brighton, Colorado September 11 and 12, 2009
The video of the Brighton Mission of Mercy can be viewed online at http://www.youtube.com/watch?v=KzXmOmkNtic .
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05-01-10
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