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Dec. 2018 CDA JOURNAL, VOL 46, Nº12 DEPARTMENTS 741 Guest Editorial/Are We Doctors or Not? 744 Letter to the Editor 747 Thank You to 2018 Journal Reviewers 749 Impressions 779 RM Matters/Posttreatment Care Crucial in Foreign Object Aspiration Incidents 783 Regulatory Compliance/Mandated Reporting 786 Tech Trends 788 Index to 2018 Articles 749 FEATURES 755 Antibiotic Prescribing and Stewardship in Dentistry: A Public Health Perspective Antibiotic resistance is one of the most serious public health threats of modern times. Jane D. Siegel, MD, and Erin Epson, MD 757 The Core Elements of Antibiotic Stewardship in Dentistry This article offers suggestions for applying the four core elements of antibiotic stewardship in dentistry and dental practices. Peter L. Jacobsen, PhD, DDS 767 Coronectomy of Mandibular Third Molars: Our Experience With 250 Consecutive Patients Coronectomy of mandibular third molars has become an accepted alternative to extraction in cases where there is a close proximity of nerve and roots. Emily Ehsan; Paul Hauser, PhD; and David Ehsan MD, DDS 773 Recognition of Non-Hodgkin Lymphoma of the Maxilla This article discusses the importance of early recognition of the symptoms of this aggressive disease that can lead to earlier treatment and improved outcomes. Joel B. Epstein, DMD, MSD; Alexa Martin, DMD; Ali M.M. Sadeghi, DMD, MD; and Dimitrios Tzachanis, MD, PhD DECEMBER 2018 739 CDA JOURNAL, VOL 46, Nº12 Volume 46, Number 12 JournaCALIFORNIA DENTAL ASSOCIATION December 2018 CDA Classifieds. Free postings. published by the Editorial Production Letters to the Editor California Kerry K. Carney, DDS, CDE Randi Taylor www.editorialmanager. Priceless results. Dental Association EDITOR-IN-CHIEF SENIOR GRAPHIC DESIGNER com/jcaldentassoc 1201 K St., 14th Floor [email protected] Sacramento, CA 95814 Upcoming Topics Subscriptions Ruchi K. Sahota, DDS, CDE 800.232.7645 ASSOCIATE EDITOR January/CAMBRA/PBRN Subscriptions are available cda.org February/E-cigarettes only to active members of Brian K. Shue, DDS, CDE March/Opioids the Association. The CDA Offi cers ASSOCIATE EDITOR subscription rate is $18 and Advertising is included in membership Natasha A. Lee, DDS dues. Nonmembers can PRESIDENT Gayle Mathe, RDH Sue Gardner SENIOR EDITOR ADVERTISING SALES view the publication online [email protected] at cda.org/journal. [email protected] R. Del Brunner, DDS Andrea LaMattina, CDE 916.554.4952 PUBLICATIONS MANAGER Manage your subscription PRESIDENT-ELECT online: go to cda.org, log in [email protected] Permission and Kristi Parker Johnson and update any changes to EDITORIAL AND Reprints your mailing information. Richard J. Nagy, DDS COMMUNICATIONS SPECIALIST Andrea LaMattina, CDE Email questions or other VICE PRESIDENT PUBLICATIONS MANAGER changes to membership@ [email protected] Blake Ellington [email protected] cda.org. TECH TRENDS EDITOR 916.554.5950 Judee Tippett-Whyte, DDS SECRETARY [email protected] Jack F. Conley, DDS Manuscript EDITOR EMERITUS Submissions Steven J. Kend, DDS www.editorialmanager. TREASURER Robert E. Horseman, DDS com/jcaldentassoc HUMORIST EMERITUS [email protected] CDA classifiedsclassifieds workwork harder to bbringring you resuresults.lts. SeSellinglling a practice Craig S. Yarborough, DDS, MBA Stay Connected cda.org/journal or a piece ooff equipment? Now you SPEAKER OF THE HOUSE [email protected] can include photos to help buyers Clelan G. Ehrler, DDS see the potential. IMMEDIATE PAST PRESIDENT Journal of the California Dental Association (ISSN 1043–2256) is published monthly by the [email protected] California Dental Association, 1201 K St., 14th Floor, Sacramento, CA 95814, 916.554.5950. And if you’re hiring, candidates Periodicals postage paid at Sacramento, Calif. Postmaster: Send address changes to Journal of the California Dental Association, P.O. Box 13749, Sacramento, CA 95853. anywhere can apply right from Management Peter A. DuBois The California Dental Association holds the copyright for all articles and artwork published the site. Looking for a job? You can EXECUTIVE DIRECTOR herein. The Journal of the California Dental Association is published under the supervision of post that, too. And the best part— CDA’s editorial staff . Neither the editorial staff , the editor, nor the association are responsible for Carrie E. Gordon any expression of opinion or statement of fact, all of which are published solely on the authority it’s free to all CDA members. CHIEF STRATEGY OFFICER of the author whose name is indicated. The association reserves the right to illustrate, reduce, revise or reject any manuscript submitted. Articles are considered for publication on condition Kristine Allington that they are contributed solely to the Journal. All of these features are designed to CHIEF MARKETING OFFICER Copyright 2018 by the California Dental Association. All rights reserved. help you get the results you need, Alicia Malaby faster than ever. Check it out for COMMUNICATIONS DIRECTOR yourself at cda.org/classifieds. Cris Weber CREATIVE AND UX DIRECTOR 740 DECEMBER 2018 Guest Editorial CDA JOURNAL, VOL 46, Nº12 Are We Doctors or Not? Robert S. Roda, DDS, MS m I a doctor? I think I am, but there have been times when I have not been so sure. Yes, the status of someone’s oral preventive skills is When I was in dental school, personal, but it’s not the same as discussing sexual the med students reveled in Atheir status as “RDs” (real doctors) and behaviors that can result in picking up this STI. tended to throw it in our faces regularly. Back then, dentists were considered “tooth doctors,” with the implication that the mouth was somehow disconnected from rubber dam was precluded at that stage comfort, but I knew that once any doctor the rest of the body. As time has gone on, due to the confi guration of the section used the word “cancer,” anything said the realities of medicine and dentistry of bridge to be removed, and I feared after that was not heard by the shocked have forced us together, and there are that despite all precautions the bur had patient. This was, by far, the most diffi cult few in the medical profession who think been lost down the patient’s throat. interaction I had ever had with a patient. of me as less of a doctor than they are. I sat the patient up and she said Among all of the other emotions I was There is no doubt that I know my nothing went down her throat and dealing with, I was also heartbroken profession and my specialty inside and out. nothing had been swallowed or aspirated. because she was such a great person. I work very hard to keep up with the rapid A check of our operatory and suction traps I fi nished the root canal procedure changes in both medicine and dentistry showed no bur, so out of an abundance within a week or two and the patient had and the allied health fi elds by reading of caution, I advised my patient that entered the medical system by then. Tests extensively, by attending courses and she would need to get a chest X-ray were going to be performed the next week through the many personal contacts that and that I would pay for it. She wanted and she was certain that no matter what I have made over the years. My review of to fi nish the appointment fi rst so that it was, she was going to be cured. What medical histories is thorough and every was done uneventfully and she went to an optimist, I thought. She returned for a day I have to adapt my clinical procedures get the radiograph. I was called by the six-month re-evaluation and was cancer- to the medical needs of my patients. I radiologist at the imaging center that free. The tumor had been found at a very contact physicians routinely to discuss afternoon and he said it was a good- early stage, was surgically removed, and the medical status of mutual patients, news, bad-news situation: There was no with some radiation and chemotherapy, and I have enjoyed seeing many of these foreign object in her thorax or abdomen, the oncologists were as optimistic as she physicians enter my practice as patients. but she had a “spot” on her left lung was.