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JournalVOLUME 102 2023 ISSUE 1WWW.INDENTAL.ORGThe JOURNAL of the INDIANA DENTAL ASSOCIATIONUNVEILING THE MYSTERY OF THE EMPLOYEE RETENTIONTAX CREDIT PAGE 10MEET ADA EXECUTIVE DIRECTOR DR. RAY COHLMIA PAGE 30FINDING AND HIRING THE RIGHT CANDIDATE FOR YOURDENTAL PRACTICE PAGE 16The Dental Workforce | PAGE 10IDA
The Journal is owned and published by the Indiana Dental Association, a constituent of the American Dental Association.The editors and publisher are not responsible for the views, opinions, theories, and criticisms expressed in these pages, except when otherwise decided by resolution of the Indiana Dental Association. The Journal is published four times a year and is mailed quarterly. Periodicals postage pending at Indianapolis, Indiana, and additional mailing oces.ManuscriptsScientic and research articles, editorials, communications, and news should be addressed to the Editor: 550 W. North Street, Suite 300, Indianapolis, IN 46202 or send via email to kathy@indental.org.AdvertisingAll business matters, including requests for rates and classieds, should be addressed to Kathy Walden at kathy@indental.org or 800-562-5646. A media kit with all deadlines and ad specs is available at the IDA website at www.indental.org/adverts/add.Copyright 2023, the Indiana Dental Association. All rights reserved.Journal IDAPersonnelOfficers of the Indiana Dental AssociationDr. Jill M. Burns, PresidentDr. Thomas R. Blake, President-ElectDr. Lisa Conard, Vice PresidentDr. Rebecca De La Rosa, Vice President-Elect and Speaker of the HouseSubmissions Review BoardDr. Rebecca De La Rosa, AvonDr. Caroline Derrow, AuburnDr. Steve Ellinwood, Fort WayneDr. Sarah Herd, Co-EditorKathy Walden, Managing Editor Dr. Jenny Neese, Vice Speaker of the HouseDr. Nia Bigby, TreasurerDrs. Karen Ellis and Sarah Herd, Journal IDA EditorsDr. Steven C. Hollar, Immediate Past PresidentMr. Douglas M. Bush, Executive Director, SecretaryDr. Jerey A. Platt, IndianapolisDr. Kyle Ratli, IndianapolisDr. Elizabeth Simpson, IndianapolisDr. Karen Ellis, Co-Editor
4 Editor’s Message Dr. Karen Ellis 6 IDA President’s Message Dr. Jill Burns 8 Executive Director’s Message Mr. Doug BushCover Story 10 Unveiling the Mystery Surrounding Employee Retention Tax Credit Jill Moore CPA 12 Retaining Your Employees is Cheaper Than You Think: Three Ways to Keep Valued Employees Kate Erdel, Katie Jackson 15 What’s In Your Employee Handbook? 16 Finding and Hiring the Right Candidate for Your Dental Practice Sydney Andersen 19 IDA and ADA Resources for Your Dental Practice 20 Is Selling My Practice to a DSO the Right Choice for Me? Blake Ring 24 What If the Solution Was Not Recruiting and Hiring? Adrienne Twigg News & Features 28 Dental Day at the Capitol Shows the Importance of Advocacy 30 Meet ADA Executive Director Dr. Ray Cohlmia Kathy WaldenClinical Focus 34 Diagnostic Challenge: Winter 2023 Dr. Angela Ritchie, Dr. Philip Wong Member Zone 38 IDA Preferred Vendor Directory 40 Component News 42 Classied Ads 43 In Memoriam 44 New Members Out of the Operatory 45 Ultramarathons Cultivate Mental and Physical Health Dr. Jessica NowakCONTENTS Issue 01 20232416302845
4 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1In a TED Talk entitled “The Secret Ingredients to Great Hospitality,” Guidara described an encounter with dining patrons that forever changed the way he delivered service and his concept of hospitality. One night while helping out on the dining room oor, he overheard a table of foodies visiting from out of town. They were commenting on their trip and gushing about all of the amazing dining experiences that they had. They talked about eating at Daniel, Momofuku and Le Bernardin to name a few and raved about each one until one of the guests remarked, “The only thing we didn’t get to try was a New York City hot dog.” Upon hearing that, Guidara described a lightbulb going o above his head and he had an idea. He rushed out to the nearest street vendor cart and purchased a hot dog. He was able to convince the restaurant chef to not only serve it but to plate it with ramekins of sauerkraut and relish and smears of ketchup and mustard. Guidara presented it to the table of diners stating, “To make sure you don’t go home with any culinary regrets, I present a New York City hot dog.” The table went wild. They loved it. As many of them later told Guidara, they found the gesture not only the highlight of their dining experiences but the highlight of their entire trip and one that they would talk about for many years to come. Up until that moment, Guidara realized his approach to service and hospitality was solely a focus on excellence and all the minute details that make a meal great. He had not considered the other aspects of a truly special dining experience were to make the patrons feel seen, feel welcome and give them a sense of belonging. He said “The food, the service, the design are the ingredients in the recipe of human connection. That is hospitality. I wasn’t in the business of serving people dinner. I was in the business of serving people memories.” Most of the population is in the industry of serving others. The United States has seen a large shift from a primarily manufacturing economy to a service economy. It is estimated that three-fourths of our national GDP is driven by service industries. So no matter if you are in real estate, retail, construction or dentistry, it is no longer enough to have a good product or ecient service. It is how you make people feel that is important. And to reach the highest levels of success you have to give people more than they possibly could ever expect. It is not the cost of the gesture that matters. Dr. Karen Ellis, Journal IDA co-editorEDITOR'S MESSAGE 11 Madison Park11 MADISON Park is an elegant restaurant in the heart of New York City. It has retained a 3-star Michelin rating since 2012 and has been consistently named one of the top 50 dining experiences anywhere. When famed restaurateur Will Guidara sold it in 2020, 11 Madison Park was named the number one restaurant in the world. In a restaurant where you could eat creative dishes utilizing preparation techniques that took years to perfect, it was a simple hot dog that radically changed Will Guidara’s outlook on business and life. A hot dog. A $2, New York City, “dirty water” street vendor hot dog. ABOUT THE AUTHORDr. Karen Ellis is co-editor of the Journal IDA along with Dr. Sarah Herd. Dr. Ellis is a general dentist for the Marion County Public Health Department and can be reached at ellis_karen@yahoo.com.
5VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationThere are multiple facets of our profession of dentistry that could benet from a shift of perspective to focus more on hospitality. Imagine the impact on patient care if we strived not only to improve our clinical skills but also worked to improve our listening skills so our patients felt seen and heard. Workplace culture is ever important in the retention of sta. What impact would we have on our sta if we worked to make our teams feel connected? Looking at our tripartite membership organizations, what are we doing to truly focus on the needs of our members? Is our hospitality on display at member events?In my own experience, I have tried to be a better listener for concerns of patients and sta. Excellent standards for care will not change but sometimes the dentistry is no longer the prime focus of the appointment. Working in public health, I have patients with unique barriers to care and treatment. Many times it is counseling patients on the importance of seeking medical intervention for excessively high blood pressure or helping them with making better dietary choices to regulate their diabetes. Other times it may be helping them with resources for substance abuse disorders. The overall health and well-being of the patient has become a primary concern, and sometimes the teeth may be secondary to another issue. I know I can’t solve all of their issues, but at least being aware of what is going on allows me to assist them in the right direction. I have learned to ask what struggles a patient may have with getting to appointments or completing treatment. I can’t provide hospitality to my patients if I don’t truly understand the needs unique to them. At the end of his TED talk, Will Guidara gives three guidelines for creating memorable moments centered in human connection: 1. BE PRESENT: Slow down and listen to what people are saying…and not saying. You can’t be focused on the needs of others if you are distracted or mentally absent. Be engaged. 2. TAKE WHAT YOU DO SERIOUSLY WITHOUT TAKING YOURSELF SERIOUSLY: Don’t let self- imposed standards get in the way of what people really want3. ONE SIZE FITS ONE: Don’t treat people like a commodity but a unique individual. Look for ways to meet people’s needs that are specic to them.I hope that you are inspired. I hope that you look for ways to increase connection with others. I hope that you discover unique ways to provide hospitality and service for your patients, colleagues, sta, family and friends. I can only imagine the ripple eect that this would have. I would love to hear what you are doing. Will Guidara’s story has inspired me. And I will denitely never look at a hot dog in the same way again. Source: Will Guidara: The Secret Ingredients of Great HospitalityTed.com/talks/will_guidara
6 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1“In our view, ve factors, exacerbated by the pandemic, have combined to yield the changes that we’re living through in today’s labor market. We call these factors the Five Rs: retirement, relocation, reconsideration, reshuing, and reluctance. Workers are retiring in greater numbers but aren’t relocating in large numbers; they’re reconsidering their work-life balance and care roles; they’re making localized switches among industries, or reshuing, rather than exiting the labor market entirely; and, because of pandemic-related fears, they’re demonstrating a reluctance to return to in-person jobs.”1In the dental eld we have felt each of these factors. Sta have reconsidered their work-life balance especially if they have small children at home. They are reshuing, either going to non-clinical dental jobs, i.e., in sales for dental related products, or getting a job in a completely dierent eld. We all have denitely seen the reluctance of clinical personnel to return to in-person dental care. I’ve reappointed an IDA Workforce Task Force and charged them with nding practical ideas to help out our Hoosier dentists. They have quite a few ideas in the works, and I wanted to share a few with you. Here are some ideas to nd and entice people to the dental eld. One thing to take into consideration is that job seekers are in control right now. Most want higher pay and more benets. As many of us are small business owners, this is a dicult pill to swallow. The dental industry may have to start paying sta higher wages to retain excellent sta, and then this would result in higher overhead costs for the owner dentist, which would result in higher fees for patients. This certainly has been the case with hygienists. They are asking for and receiving much higher wages than before the pandemic. One answer is to retain your present sta, keep them happy, and pray no one comes along and hires them away. At the MDA in May, we will be having a course called Dentist Charm School led by former Dean John Williams and based on work by Daniel Goleman on “EI” Emotional Intelligence to help assist you with ideas on retaining the sta you have. I took a poll of friends on how they retain their sta. Here are some of their comments. • Put your sta rst and treat them like family• Having well laid out systems that can easily be followed and allow them to have autonomy to follow the system without micromanaging. Verbal praise and appreciation have been shown in multiple studies to be more eective than money or PRESIDENT'S MESSAGE Workforce WHAT IS the number one buzzword in dentistry today? Why, yes, it’s workforce. Nationwide, it’s a crisis for many industries. Why is this happening? The great resignation of 2021 is slowly fading away and those who left the workforce are hopefully ready to come back. Here’s a quote from a Harvard Business Review article that the authors feel are reasons for today’s labor market. ABOUT THE AUTHORDr. Jill Burns is a dentist in Richmond and 2022-23 IDA president. She can be reached at drjill333@gmail.com.gifts with retaining employees.• Treating them well and showing them that they are a valued part of the team• Have a positive work culture, and reward sta using their particular love language. Some sta prefer a bonus check, others prefer a public recognition when they do things well, others prefer “stu,” like food or gifts. Find out what your team member needs to feel valued and try to value them in their preferred language. Additionally, pay the right people what they are worth.
7VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationWhere do we look for new sta? Services such as Betterteam, Indeed, and ZipRecruiter are one place to start. Another idea may be to look in unexpected places. We are all looking for sta that want to help people and to take care of them. How about looking at institutions and facilities that do just that? YMCA, community centers, volunteer organizations usually have job boards either physically in their buildings, or on their websites. Post a job on some of these. You may have to train them in dentistry, (which of course takes some time), but hiring for attitude and work ethic goes a long way. Another place to look for sta would be the local hospital. Many workers have experience in patient care that could translate to dentistry. Another place that would take a commitment from you would be to volunteer your oce as an intern site for the local dental assisting or hygiene school. Our oce has done this over the years and I have hired assistants that were our interns. Or you could even volunteer as faculty at these schools, if it is within their policy to do so. At the very least, get acquainted with the program director and then ask for their recommendations on hiring personnel out of their student population. Denitely use word of mouth in your community in looking for new team members. If the word gets out that you are looking, there may be people out there who are eager to have a boss like you. They just need to know that the opportunity is available. And never throw away a resume that was dropped o at the oce. They can be a real goldmine of talent for you.A resource for planting the idea of a job in dentistry is contained right in this issue! Look in the middle for a poster that you can place in your oce to attract interest in dentistry.The IDA can help you in your hiring eorts. They have products that you can oer to your sta as benets. The online CE oerings can be used by your sta. They can apply for health insurance through the IDA. There are always great classes for sta at the MDA. In fact, there is an entire section of the IDA website devoted to workforce:www.indental.org/category/workforce/ The ADA website has resources for practices for hiring and managing your team, as well as a toolkit with many sta hiring resources: www.ada.org/resources/practice/practice-management/managing-dental-sta Here are some other links that might interest you: Avoiding the Top Ten Hiring Mistakes: www.ada.org/publications/dental-practice-success/avoid-the-top-10-hiring-mistakesDental Sta Career Descriptions:www.ada.org/resources/careers/dental-team-careersManaging the Dental Team: www.ada.org/publications/guidelines-for-practice-success/gps-managing-the-dental-team-resourcesThe Health Policy Institute, which is aliated with the ADA, has an on-demand webinar, Dental Workforce Shortages: Data to Navigate Today’s Labor Market, moderated by Marco Vujicic PhD. It is 54 minutes long and worth the time:www.ada.org/resources/research/health-policy-institute/dental-practice-research/dental-workforce-shortages The State of Indiana can also help in your search. The Indiana Career Connect website can furnish resumes for your stang needs: www.indianacareerconnect.com/vosnet/default.aspx In addition, Workforce Ready Grants can get dental assistants training for free: nextleveljobs.org/workforce-ready-grant/There are many factors that go into hiring and retaining the right sta for you. Times are denitely hard right now in this area. I hope some of these resources might help you in your practice. The IDA is working behind the scenes to support and help you nd the people you need. But we need your help as well. Let us know if you have a secret weapon for hiring and retaining sta. Let us know if you nd a resource that would be helpful for other members. The Workforce Task Force is open to any ideas large and small to help our member dentists. It may seem that you are ghting this alone, and we can’t hire someone for you, but we’re trying to help in any way we can. Contact me if you would like to contribute to our knowledge base and I will pass it on to the Task Force. Thank you for being a member of the IDA.1. The Great Resignation didn’t start with the Pandemic, Fuller and Kerr, Harvard Business Review March 23, 2022
8 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1IDA’s primary goals remain unchanged:• Membership – Make membership valuable to every dentist.• Management – Make ecient use of volunteers, sta, nances.• Advocacy – IDA is the most inuential voice on oral health issues.• Oral Health – Improve oral health. Dubbed IDA’s “Green Dreams,” when by happenstance they appeared in a report in green ink, the name stuck. They are, in fact, “dreams.” Aspirations. Areas of primary focus that were determined fundamentally important to you, our members. Our desire is to make membership so valuable, you never contemplate not being a member. We want to make sure we use our nite resources prudently. And we want IDA to be the primary driver of oral health policy in the state, with the ultimate goal of improving the public’s oral health. Under each Green Dream there are three to six priority items. This is where the rubber meets the road. These are the action steps we will take to advance our Green Dreams. When possible, we made the goals measurable so that we can monitor our forward progress. We don’t expect these priority items to remain static. They are regularly reviewed and as circumstances change, some will be discarded and replaced with new strategies to help us achieve our ultimate goals. The primary driver of these priority items will be our various workgroups: committees, subcommittees, subsidiaries and task forces. The priority items are intended to help these groups set their agendas for the upcoming year. Certainly, the Mem-bership Committee and New Dentist Subcommittee will be focused on helping us meet our recruitment and retention goals. Likewise, the Finance Committee will be watching how we use our nite resources. The Governmental Aairs Committee and IDPAC will target our advocacy goals and the Public Health Committee and Infant Oral Health Subcommittee will focus on how we can improve the oral health of Hoosiers. While the application to other workgroups may not be as readily apparent, everything we do aects our ability to achieve these goals. The Dental Practice Committee supports the value of membership, as does the Workforce Task Force that is exploring how to help member dentists fully sta their practices. The Professional Development Committee and MDA Sub-committee develop CE programing that helps practitioners stay abreast of new science and technology, which in turn, helps members and benets the patients they treat. Overarching all of our various activities, the Communications Committee helps members understand the resources available to them, and how IDA sta and volunteers are working on their behalf. While I am proud of the eorts of the IDA sta, everything we do is based on the direction and counsel we receive from you, Mr. Doug Bush, IDA Executive DirectorEXECUTIVE DIRECTOR'S MESSAGE Dreaming Big DreamsAT ITS January 2023 meeting, the IDA Board of Trustees approved updates to our Strategic Plan. This wraps up a year-long process that included multiple meetings of the executive committee ocers that oversee the plan, and discussion at the Leadership Retreat held last summer.ABOUT THE AUTHORMr. Doug Bush is serving his 26th year as IDA Executive Director. He can be reached at doug@indental.org. our members. We need your help! So pick an issue that is near and dear to you and step forward to serve on a committee or subcommittee: www.indental.org/volunteerTogether, we will move the IDA forward to achieve our big dreams.
9VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Association
10 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1Jill Moore CPAUnveiling the Mystery Surrounding Employee Retention Tax CreditIF YOU have attended a continuing education conference in the past year or opened your business’ mail since 2021, you have likely heard that you might be eligible for a tax credit of up to $26,000 per employee! While that might be true, there are several questions to work through before making plans of how to spend that money. How do businesses qualify for the Employee Retention Tax Credit (ERTC)?There are two ways to qualify for the credit. The rst way is through revenue reduction. The 2020 credit requires a reduction in gross revenue of 50 percent or more as compared to the same quarter in 2019. For the 2021 credit, a revenue reduction of 20 percent or more is required as compared to the same period in 2019. For the revenue calculation, be sure to exclude any non-taxable income received during the periods – many practices received forgiveness on their paycheck protection plan loans during that time period, which qualies as non-taxable income.The second way to qualify is through direct government mandates that more than nominally changed the way in which you were able to conduct business. The key with this qualier is that the change was necessary by a government mandate. While ‘more than nominal’ is somewhat grey, there are specic guidelines that help. More than nominal is generally considered 10 percent or more of labor hours or revenue. In order to dispel some mystery around the credit, let’s look at several of the common claims:Claim: If you received money through the Paycheck Protection Plan (PPP), you are not eligible for the ERTCInitially the ERTC was only available to employers who did not take advantage of the PPP. However, that changed at the end of 2020 and employers were able to take advantage of both the ERTC and the PPP. The caveat for receiving both is that employers cannot use the same payroll costs for both the credit and the PPP forgiveness. The money received from the two programs is treated dierently for tax purposes. The funds from PPP are non-taxable; however, the funds received from the ERTC are taxable and do require amending your income tax return and your payroll tax lings for the year or years of eligibili-ty.Because of the closure of dental practices in March 2020, we have seen a number of dental practices that experienced a signicant revenue reduction in quarter 2 of 2020. However, many of these practices received the PPP loans and used them to cover payroll costs during that time period. You cannot use the payroll expenses for forgiveness for your PPP loan and then claim the credit on the same wages.Claim: If you had to change processes in your business, you qualifyThis might be true, but the change in process had to be mandated by the government – not based on your comfort level or your patient’s comfort level.COVER STORY
11VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationClaim: I couldn’t get supplies from my preferred vendor, so I qualifyIn order to qualify based on supply change issues, three things had to ALL be true. Vendors were unable to deliver your supplies due to a government order, you were unable to purchase the needed supplies from another vendor, and as a result of not having supplies your business experi-enced more than nominal decline.Claim: I amended my Form 941s and claimed the ERTC, so my work is complete!This is a common misconception, however claiming the credit requires you to also amend your income tax returns to remove the expenses that the credit reimbursed. When you amend your income tax return, you will owe income tax on the credit you received at both the federal and state level. Additionally, the IRS is aware of the fraud surrounding the ERTC and they are taking extra precaution and do anticipate auditing the claiming of these credits.Contact Blue & Co.’s ExpertsCertainly, we recognize and appreciate the strain related to the cost increases of supplies and payroll for dentists. However, that is not the deciding factor for credit eligibility. If you would like to speak with a healthcare employee retention tax credit expert, please contact us, and we would be happy to discuss the particulars of your scenario.About the AuthorJill Moore is a senior manager with Blue & Co specializing in for-prot healthcare tax matters. Jill is dedicated to helping taxpayers strategically plan for and understand their tax situation. Jill can be contacted at jmoore@blueandco.com or 317-713-7927.
12 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1Retaining Your Employees is Cheaper Than You ThinkThree Ways to Keep Valued EmployeesAS YOU likely know, employees are leaving their workplaces at higher rates than ever. According to Work Institute’s 2022 Retention Report, in 2021 alone, more than 47 million employees quit their jobs voluntarily, which is the highest number of departures since the Bureau of Labor Statistics began tracking this specic statistic in 2001.1 This same statistic was only 25 million people just ten years ago.Not only is employee turnover disheartening and time-consuming for employers, but it is also expensive. According to Work Institute, it costs a business approximately 33 percent of an employee’s annual base pay when they quit. The time and resources spent advertising open positions, interviewing potential hires, and training new employees adds up quickly. While the statistics of how many employees are leaving and how much it is costing businesses may be alarming, they are likely not surprising to employers. However, the reasons that people leave may be more dicult to understand.According to Work Institute, less than one in ten employees cited their pay as the main cause for leaving a job in 2021. This should be good news for employers. Retaining employees may not be nearly as expensive as you think; it may not be about the cash. While there are many ways to improve your workplace and retain employees, we, as employment lawyers, suggest three action items that have been shown to make employees stick around: clear expectations, regular constructive perfor-mance reviews, and a safe and ecient workplace, free from harassment.Establish and Enforce Clear Expectations Most employees want to be good at their jobs. They want to be a valuable member of the team and meet or exceed an employer’s expectations. The rst step in meeting expectations is…knowing the expectations. The employer is responsible for establishing, communicating, and maintaining expectations. An employee handbook is an excellent way to lay out your expectations as an employer. The primary purpose of any employee handbook should be to provide employees with information regarding their employment in a way that maximizes cooperation and communication between management and employees and promotes high employee performance. An eective employee handbook is just one of many tools that employers can utilize to organize, manage, attract, and retain Kate ErdelKatie JacksonCOVER STORY
13VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Associationemployees. An eective employee handbook is one that is both practically and legally useful. Such handbooks typically include:• Comprehensive information about the employer’s policies, rules, and employee benets• A clear statement of the employer’s uniform performance and behavior expectations that puts employees on notice regarding conduct that will not be tolerated in the workplace• A concise statement of the employer’s intentions to comply with all employment-related laws and regulations, including its status as an equal opportunity employerEective employee handbooks are also current and regularly revised to reect changes that have occurred in both the law and the operation of the workplace. Though employee handbooks are not contractually binding, an eective employee handbook can help to support a legal defense in the event of an employment-related claim led against the employer by a disgruntled employee. In the same vein, an employee handbook that is not eective can provide a disgruntled employee with a source of direct or circumstantial evidence that could be harmful to the employer in the event of an employment-related claim. Conduct Regular, Fair, and Constructive Performance ReviewsRegular performance reviews, both formal and informal, help employers manage expectations and can be a great way to have a productive conversation with your employees regarding whether those expectations are being met. If expectations are not being met, performance reviews provide a constructive and ecient way to present employees with opportunities for improvement. Performance reviews are also an eective way to implement any promotions or pay increases.In smaller workplaces, like dental oces, the perception of treating one employee more favorably than another can be problematic when not all employees have an understanding of how decisions are made. It is important that employees know that they are being given the same amount of attention and consideration for promotions or pay increases as their fellow coworkers. It is also important that employees do not feel like they are being singled out with a list of areas for improvement. If employees know that everyone is partaking in performance reviews, they may be less likely to feel defensive about suggested improvements and instead, more likely to feel like performance reviews are an eort to make the whole team and oce better.Before conducting performance reviews, it is important to go in with a plan regarding the criteria of how you are going to evaluate your employees, especially with respect to promotions and pay increases.Prior to meeting with employees about their performance, it may be benecial for your workplace for employees to complete a self-evaluation. Self-evaluations can help employees feel like they are being listened to and that their input is valid. Self-evaluations may also help with any defensiveness associated with suggestions for improvement. Employees likely know what areas of their job they can do better at. For example, if one of your employees struggles with being on time, they are made aware of this fact with every minute that passes while they are sitting in trac. If you ask this employee to complete a self-evaluation prior to a performance review, they will have some time to think about how to approach the conversation with the employer and may provide the employer with some insight into why they are always late. Then, at the performance review, the employer won’t have to spend time explaining to the employee that he or she is always late, and instead, the employer can remind the employee of the attendance policy (and cite the handbook) to ensure that expectations are clear. Then, the two can spend the remainder of the meeting brainstorming ways that the employee can improve their timing.Provide a Safe and Efficient WorkplaceIn 2022, 7 percent of employees who left their jobs cited the environment as their main reason for leaving. The subcategories under the umbrella of “environment” were organizational culture, facilities or physical environment, mission and values, safety, diversity, or coworkers. Over half of employees who cited environment as the reason for their departure cited organization culture as the reason. It is clear from these statistics that a healthy work culture free from harassment and discrimination is essential to retaining employees. One way to create such a culture is by ensuring that your anti-discrimination and anti-harassment policies are current and up-to-date.As you know, numerous federal and state laws make various employment-related behaviors including discrimination and harassment on the basis of protected characteristics like race, sex, gender, and age illegal. Although Indiana has not enacted any law dealing with
14 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1“workplace bullying” or generally negative behaviors that do not rise to the level of discrimination or harassment, Indiana courts have made it clear that workplaces should be free of this type of behavior.The Indiana Supreme Court, in Raess v. Doescher, ruled that workplace bullying, though not a form of prohibited discrimination or harassment under Title VII, could rise to the level for an employee to have a valid cause to sue an employer or other employee. In that case, the employee sued a doctor at an Indianapolis hospital for assault and intentional iniction of emotional distress after the doctor aggressively approached the employee, screaming and cursing, with clenched sts, in the hallway of the hospital. The court concluded that this behavior, though clearly not “discriminatory,” could cause the employee serious emotional distress and thus be a valid basis for an award of damages. Thus, the decision in Raess has opened the door to a state court cause of action for employees who have been verbally and emotionally abused in some way while on the job. While the decision in the Raess case did not specically aect the employer of the perpetrator, the negative eects that workplace bullying can have on employees and business in general should encourage you to take an active role in preventing workplace bullying at your worksite before it begins. Several steps may help to curb workplace bullying including: prohibition of such conduct, company policies that emphasize cooperation and respect, and clear, publicized internal complaint procedures for such conduct. By creating an environment of non-tolerance for bullies, you can avoid the negative energy caused within the workplace by such conduct while also helping to avoid the reputational damage caused by potential lawsuits for workplace bullying.ConclusionWhile it may seem harder than ever to attract and retain employees for your workplace, there are concrete policies and procedures that you can put into place to make employees more likely to stay. As discussed, it is certainly cheaper to retain your current employees than it is to go through the process of hiring new ones.References1. Work Institute. Employee Turnover Insights and Trends in 2021. https://info.workinstitute.com/hubfs/2022 Retention Report/2022 Retention Report - Work Institute.pdfAbout the AuthorsKate Erdel is a partner with Dentons Bingham Greenebaum LLP, where she is a member of the Litigation and Dispute Resolution and Employment and Labor practices. Kate has nearly 15 years of experience representing employers of all sizes. Kate focuses her practice on providing human resources-related advice and counsel to new and established companies.Katie Dickey is a lawyer in Dentons Bingham Greenebaum’s Litigation and Dispute Resolution group. Prior to attending law school, Katie was a member of Teach for America and taught middle school for three years in Phoenix.COVER STORY
15VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Association9BAbout the AuthorsWhat’s In Your Employee Handbook?The previous article stressed the importance of making your oce policies and expectations clear. Every dental oce should have an employee handbook that is well crafted and regularly reviewed. Below are some must-have topics for your oce’s handbook.Introduction• Oce mission statement, if applicable• Explanation of at-will employment status• Acknowledgment of receipt (include a page to sign to verify receipt of and having read the handbook)Legal Policies• Statement of equal employment opportunity employment• Explanation of zero tolerance regarding harassment• Denition of employee status: full-time, part-time and temporaryAttendance, Schedules, Meeting• Attendance and participation policies• Work schedules and/or denition of work week• Time-keeping requirements and procedures• Pay schedule• Policy for payment for meetings, training, overtime, bonuses, etc.• Inclement weather or natural disaster policies• Holidays — Be sure to clarify whether holidays are paid• Jury duty policy• Election days• Leaves of absence: include bereavement, military, maternity/paternity and disability• Family leaveBenets• Insurance benets• Retirement plan and policies• Vacation, sick time and PTO and related payment policies• Outline time o policies for CE and which CE, if any, are paid for by the oce• Clarify oce policy regarding payment of licensing feesEmployee Conduct• General standards of conduct• Frequency of employee evaluations and evaluation criteria• Disciplinary procedures• Procedures and criteria for termination of employmentHealth and Safety• Health and safety issues (includes federal regulations and postings)• Emergency protocols for employees and patients• General oce security policies• Smoking policy• Workers’ compensationThe ADA oers online and print resources for employee manuals and trainings. Visit the ADA website: www.ada.org/resources/practice/practice-management/27_creating_policy_manual
16 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1COVER STORYFinding and Hiring the Right Candidate for Your Dental Practice GROWING your dental practice team is both an exciting and stressful time. Finding someone who has the skills you need and who will also mesh well with your team may seem like nding a needle in a haystack. But it doesn’t have to be.Having a clear idea of the type of person and skills you want your next team member to have is key to making the hiring process ow as smoothly as possible. It’s good to have a full list of both hard and soft skills your ideal candidate should have and then prioritize that list with what’s most important to your team. Here are some examples to get you started:Hard Skills – Technical skills (how to do x-rays, prepare supplies, disinfect rooms, etc.), computer knowledge, hand-eye coordination, motor skillsSoft Skills – Team player, attention to detail, compassion, dependabilityOnce you have a clearer picture of the type of person you’d like to add to your team, it’s time to start actively recruiting. According to The National Association of Colleges and Employers, it costs businesses on average $7,645 to hire a new employee. Making sure you nd the right team member the rst time will not only save you time, but it will save you money too. Here are some things to consider when posting a job opening:• Create a compelling job title and description. LinkedIn reports job seekers lose interest after 14 seconds, so you want to make sure your rst impression is the best. • Make sure your posting isn’t too long (or too short). Between 300-700 words is ideal.• Post on multiple sites. You never know where the right candidate will come from, so it’s best to post your job openings in more than one place. Aside from large national sites like LinkedIn and Indeed, also consider posting on local job boards, Facebook groups, and your website. If you don’t have a website, or if you need help with your website, ProSites can help!When it comes time to interview candidates, asking the right interview questions will ensure you nd the best team member for your practice. Here are a few examples:Tell Me Why...An open-ended introductory question requires a candidate to go beyond just sharing facts and stock answers and think deeper to share some of their motivations and personality. This will help you gauge how a candidate will gel with your team and how they align with how your practice serves patients.A few open-ended introductory questions:• Why do you want to work here?• What made you choose a career in the dental eld?• What do you nd most rewarding about your work?Sydney Andersen
17VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationTell Me How...Asking candidates technical interview questions such as how they prepare for patients or how they perform specic procedures provides dental assistants and hygienists with the opportunity to share their knowledge of processes that would likely be part of their daily duties and demonstrate that they have learned and performed them correctly.Some sample questions that lead to “tell me how”:• Do you have experience assisting with llings, crowns, or extractions?• Do you have experience making dental impressions?• How do you help keep patients calm during procedures?How do you explain the need for a dental procedure to a patient who doesn’t understand the importance of the treatment?This open-ended question can tell you a lot about the candidate. It gives them the chance to share both their technical knowledge of procedures as well as their communication and compassion for patients. What experience do you have with practice efficiency?Your practice may be like others. Where practices are commonly understaed and busy with appointments, dental teams with a collective knowledge of important tools and systems to save time and improve practice eciency can leanly navigate toward the better tomorrow that so many practices now seek.Asking candidates about what they bring to the table beyond traditional dental skills invites them to share what they have to oer that other candidates perhaps don’t. In doing so, you have the chance to identify a potential team member whose experience can benet many or all aspects of your practice, including operational eciency, time-savings, patient relations, protability, and team well-being.Make sure candidates know practice eciency experience is not a prerequisite for the job (unless it is). You’re simply letting them know that you value the whole of their experience and you’re inviting them to share it.Example questions:• Do you have experience with practice management software?• Do you have experience with automated patient communication systems?If a candidate doesn’t have direct experience with a particular system, ask them how they think a particular system might improve practice eciency. This tells candidates that you’re a forward-thinking practice (which may dierentiate your practice if a candidate is shopping around for such a practice) and informs them that you value their input, which is a retention factor.What kinds of challenges are you seeking in this position?With this question, candidates can share specics about what they hope to gain from being hired and you gain further insight into retaining them if you hire them. It could be something missing from a prior position that a practice
18 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1didn’t oer (for example, a more active role in leadership or decision-making) or something you provide in your practice, which becomes an attractant and retention factor for a candidate.What are your interests outside of work?In addition to shedding additional light on a candidate’s personality, this question shows that you care about work-life balance, and you’re interested in what they do to help maintain it.About the AuthorSydney Andersen has been helping both large and small businesses create their content and social media strategies since 2012. She currently lives in Phoenix, where she is the Content Team Marketing Manager at ProSites, an IDA preferred vendor for dental websites, marketing and social media support.What do you see as some of the biggest challenges that are facing our industry?As dicult as it can be for some dentists and management to hear how dental assistants, hygienists, and oce sta really feel about the state of the dental industry, some of these candidates believe practices are unaware of (or choose to ignore) workplace issues that can cause team members to quit, either their job or the profession entirely. Asking what they see as some of the biggest challenges facing the dental industry informs candidates that you care about a healthy workplace, that you value their voice, and that you can see the big picture.COVER STORY
19VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Association7BIDA and ADA Resources for Your Dental PracticeIDA Posters Attract Interest in the Dental ProfessionNotice something dierent in this issue of the Journal IDA? We’re including a full size poster to help your practice attract interest in the dental profession. Place it anywhere that patients, parents and other visitors might see it. You can also visit our website to download this poster and two other options: www.indental.org/posters/ADA Information Sheets Detail Responsibilities of Dental ProfessionsThe ADA has created detailed information sheets that explain more about various professions within dentistry and the great career benets of each. Share these sheets with anyone who’s looking for a rewarding, growing profession in health care: www.indental.org/dentalcareers/IDA LogosDo your oce materials and website show that you’re an IDA member? The IDA website oers the latest IDA logo for digital and print use: www.indental.org/ida-logo-downloads/NEW! “Sip Tip” VideosYou probably witness the negative eects of sugary and acidic beverages every day. Keep your patients and community educated with new “Sip Tip” videos that emphasize the importance of keeping sugary and acidic drinks to a minimum. This is an exclusive benet for IDA members! Members will be free to use the videos on their practice websites, social media channels, community presentations, or other settings as appropriate. IDA will be making these videos available to members soon.See the center of this Journal for your copyof the dentistry careers poster
20 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1COVER STORYIs Selling My Practice to a DSO the Right Choice for Me? An inside look on who DSOs want to acquire and why “CORPORATE DENTISTRY” has been a hot topic in the industry recently. Corporations, private investors, venture capital groups and the like have seemed to develop a strong appetite for dental practices, which begs the question, “Why is Wall Street interested in dental practices?”Dental service organizations (DSOs) or “corporate dentistry” as they are sometimes called, are companies generally owned and managed by non-dentist, private investors that seek to own, co-own or manage dental practices, usually large groups of multi-doctor dental practices. The presence of DSOs was rst noticeable in the mid 1990s. Their initial track record was bumpy as they sought to gure out how to own and operate dental practices while considering state laws governing the ownership of dental practices and how to convince dentists to work for them and make less than they would otherwise as practice owners. But they soon gured out how to address both of those issues, as well as other challenges, and they have been growing and gobbling up the market share ever since. There was a key point in the evolution of the DSO as a player in the dental industry. That came when Wall Street (i.e., private equity groups, venture capitalists, investment bankers and other investors) “discovered” dental practices as the next industry they could consolidate.Investment bankers generally see dental practices as undervalued assets. Through the volume created by acquiring many practices, they can create substantial equity and strong dividends for less than the cost of other investments. In order to understand how this works, it is important to consider the process employed for valuing a dental practice. The value of any professional practice can be summarized as its capacity to generate cash ow. That capacity consists of two essential elements: tangible and intangible assets. The tangible assets consist primarily of the clinical equipment, oce Blake Ring
21VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Associationequipment, furniture, xtures, instruments, supplies on hand, and so forth. The intangible assets consist primarily of goodwill, or essentially the relationships existing with patients and referral sources that have been cultured and nurtured over the years, as well as the relationships between the doctor(s) and sta members. Generally, business investors use income-based valuation methods to evaluate investment opportunities. These methods are also widely used when valuing professional practices primarily due to their accuracy in assessing the value of the cash ow of the practice. An income-based approach is not limited simply to an analysis of the historical nancial information of a practice, but also takes into consideration many other elements of the practice that contribute or detract from the value.There are several elements that can and will inuence the value of a professional practice; however, as a rule-of-thumb, a general dental practice will typically sell at a price in the range of four to seven times its excess earnings or prots. By denition, excess earnings in a dental practice equate to the net income after operating overhead expenses and a reasonable, going-market-rate doctor compensation, but not including specic expenses such as interest, taxes, depreciation, amortization and certain discretionary items. Investment bankers and business appraisers often refer to excess earnings as “Earnings Before Interest, Taxes, Depreciation and Amortization” or “EBITDA.” The EBITDA of a dental practice gives an indication of the current operational protability of the business. It shows them how much prot the business makes given its current set of assets and operations and the services it renders to patients.Consider the following example: A practice has averaged $1,500,000 in gross collected revenues per year over the past three years. It is also averaging net income of about $600,000 per year before payment of any compensation to the doctor (which equate to an average operating overhead of 60 percent, excluding doctor compensation). Let’s say, in this case, the doctor’s compensation (inclusive of benets and commensurate with market rates) equals $300,000. Based on these gures, the adjusted net income or EBITDA is $300,000. Using the general rule of six times EBITDA (for a healthy practice with other positive and attractive characteristics), the estimated enterprise value of this practice would be approximately $1,800,000. There is no empirical formula to calculate EBITDA. DSOs use vastly dierent methods to calculate EBITDA on the same practice. Here are some expenses or add-backs that can dier from DSO to DSO: supplies, lab, health insurance considerations, legal, accounting, marketing, payroll taxes, employee wages, lease rates, performance bonuses. Many sellers get excited because they are told they are getting a high multiple of EBITDA. In actuality, the EBITDA was depressed by the DSO’s method used and the practice should have been valued much higher. Although the enterprise value is a critical component of the oer, most will argue that the deal structure is of greater signicance. How much cash at close are you receiving? How long are you required to work? Does the DSO obligate or oer investment opportunities or equity rolls? If so, are you getting common stock or preferred stock? Is the stock at the holding company level, site level, sub level, etc.? This is particularly important because you need to know the pecking order on how and when you will be paid. Does the oer include holdbacks, earnouts or clawbacks? What are the “put” or “call” options? The DSO and private equity world are very sophisticated, it is in most seller’s best interest to establish a team of advisors to represent their interest. This team should include advisors who are well versed in the DSO space. Although many sellers believe the heavy lifting has been completed once the LOI has been signed, realistically the process is just starting. In most instances, DSOs will only acquire a well-run, protable practice in a good location. Unfortunately, many practices do not t that bill, i.e., they do not fall within the parameters most DSOs have set for practices they would be interested in acquiring. So what are some of those parameters? 1. The practice should be grossing no less than $800,000-$1 million per year in collected revenues. It requires essentially the same amount of time to manage a practice grossing $600,000 per year as it does to manage one grossing $2 million per year from the DSO’s standpoint. 2. A facility that can accommodate two or more doctors. DSOs mitigate their risk when the practice has two or more providers.3. Practice consists of repeatable production and procedures. The sweet spot is bread and butter dentistry at a level that can be repeated without a rockstar producer.Continued on page 22
22 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1COVER STORY4. A market area that has the potential and capacity to provide a signicant pool of prospective employee dentists. Location is important for hiring and retaining key employees. 5. Practice EBITDA that is greater than $200,000. DSOs typically recapitalize every three to ve years. DSOs don’t acquire practices with lofty goals to grow them. 6. Sellers who want to work three or more years. It’s important that the practice has stability prior to the recapitalization event. The risk for the DSOs typically starts when the providers retire or are replaced.7. Sellers that have skin in the game. Investing in the DSO is required by many DSOs. The equity roll naturally creates alignment within the investor group and their goals. If a practice falls within these basic parameters, it may be appealing enough to a DSO to garner an oer for its purchase, and in some cases, those oers can be quite lucrative.About the AuthorBlake Ring is a graduate of Indiana University Bloomington and has over 20 years of consulting and brokerage experience. He has worked with hundreds of doctors across the country buy, sell, and merge their practices, and he has acquired a deep knowledge and understanding of the DSO and private equity space.There are myriad arguments both in favor and against corporate dentistry and the changes it is making to the face of dentistry. Whether for or against them, corporate dentistry is here to stay and DSOs are having a signicant impact on the dental industry. The rise and growth of corporate dentistry is being fueled by Wall Street’s appetite for consistent and less risky returns on investment. Private practices won’t be eliminated and plenty of opportunities will continue to exist in the owner/operator model. We see private practices thriving today and for many years to come.If you have been approached by a DSO to buy your practice or you are considering a sale of your practice to a DSO, take the time to understand the uniquely dierent options available to you. Too often dentists make simple but costly errors when considering a partnership with a DSO. Do not make a decision you may later regret. The DSO will have skilled, knowledgeable, experienced business personnel representing them and you should too!
23VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Association
24 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1Adrienne TwiggWhat If the Solution Was Not Recruiting and Hiring?PRIOR TO the pandemic, we were experiencing a tight labor market. This was a result of an expanding economy and fewer available workers for the number of job openings. Now, as a result of the pandemic, the labor market is even tighter, especially in dentistry, but for dierent reasons. Some of which include:1. Many have chosen to retire.2. Many have chosen new or dierent career paths, given perceived risk factors of working in a dental oce environment.3. Many are needed at home for childcare, home schooling and/or care giving.4. Many have chosen to delay re-entering the workforce due to underlying health conditions or stimulus checks or extended unemployment benets.5. Many dental assisting and hygiene schools closed and have yet to re-open, thus graduating fewer students.6. Many of the testing options for licensing and certifying were postponed or suspended, meaning smaller numbers of qualied candidates.Given these factors, it is no wonder that the “pool” of available candidates is quite small and causing a lot of frustration for many dentists.When it comes to recruiting and hiring there is a “short game” and a “long game.” The short game is doing whatever you can now to ll the openings. The long game is: 1) focusing on developing quality employees, and 2) putting conscious eort into employee engagement and creating the type of organizational culture that supports long term retention, thus reducing the need to recruit. COVER STORY
25VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationThe Short GameMost dentists want some “silver bullet,” or guaranteed, fool-proof set of tactics for recruiting and hiring. Unfortunately, such a thing does not exist. That being said, there are some basic principles that can help your recruiting and hiring success.First rule of thumb: “Clarication of your USP.”Everyone one (seemingly) is familiar with “USP” or Unique Selling Proposition. This term is used over and over in marketing and sales discussions, courses, and books.Essentially, USP is about dening and clarifying what makes you and/or your business unique. One of the goals is to ascertain why would/should someone buy from you or patronize your business/practice, as opposed to other businesses/practices providing the same or similar products or services.Getting to your USP is about answering some questions, like:• What dierentiates you?• What is unique about what you do or even how you do it?• What sets you apart? What makes you dierent?• What is unique or special about you, your business, and your practice?Once dened and claried, your USP becomes an integral part of your marketing messaging and communication. Your USP becomes part of your identity, a key claim, and an integral element of your brand and reputation.As such, USP’s can be a powerful tool in driving business opportunities and establishing expectations—getting a “leg up” on the competition (whatever that may be).As such, USP’s can be very detrimental if you fail to meet those expectations (dierentiators) that you have established. Your reputation and brand will suer and referrals will lag from not-so-positive reviews on Facebook, Google and other sites that potential patrons might access to evaluate you and your business. Bottom line: to benet from your USP, you must “walk-your-talk”.Immense parallels exist between your USP and your “UEP.” What is my UEP, you ask? Your UEP is your Unique Employment Proposition.You’ve spent a lot of time and money on your USP. In today’s tight (and competitive) labor market, you must be spending time, energy and money on clarifying and accomplishing your UEP. And most people aren’t paying attention to this most fundamental aspect of owning and running a successful business.Similar to USP, your UEP is about dening and clarifying what makes you and/or your business unique from an employment perspective. Why would/should someone come to work for you, as opposed to the myriad other employment opportunities that currently exist?Here are some important questions to answer for establishing your UEP:• What kind of employer are you?• What is your reputation as an employer/boss/leader?• Is your practice one where people want to come to work?• Would You Work for You? Why?• Why should someone come to work for you as opposed to someone down the street?If such a thing existed, what would your Google or Facebook reviews be for you as an employer and as a place to work? Great place to work? Lousy place to work? So-so place to work?Among the benets of having a great reputation as an employer is that potential employees will seek you out, thus relieving a lot of pressure when you are looking to hire. How nice would it be to already have resumes of people who have said, “I don’t know if you are hiring now, but when you are, I’d like to be considered”?Once dened and claried, your UEP becomes an integral part of your recruiting, hiring, onboarding and employee engagement process.Second rule of thumb: “Hire rst for the things you cannot teach or train.”You cannot teach attitude and personality. Attitude and personality are things that all of us, including your patients, experience when we interact with others. You can’t teach it. You can’t train it. So, you look for these things rst and foremost. Experience can be gained by working with you and skills can mostly be taught and/or trained so they are next in line for consideration.
26 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1To set the stage for a more eective recruiting and hiring make sure you clearly dene the job. Have an accurate, up-to-date, and concise job description. This should truly delineate the duties, responsibilities, requirements and expectations of the job. A comprehensive job description acts as a form of communication that supports performance and accountability—It’s the recipe for success in that position. It can provide a road map for training and onboarding. It should be focused and clear. Do not make assumptions about people’s knowledge of the job. Use all of the common sources for nding candidates, such as: Indeed, Agencies, Craigslist, Dental Post, Zip, etc. Don’t forget to contact and network with schools or professional organizations in your area, and especially internally with your existing (good) employees and patients who might know of someone looking for a job or a career change.Once you have a candidate pool (large or small), engage in applicant screening. The primary purpose of screening is to quickly assess who stays in the running. Eliminate those who, for whatever reason, are not going to be moved forward in the process. It is far easier to eliminate at this stage and saves you time in the long run.Screening is done via a phone call (with or without Zoom) and lasts only a few minutes. Ask each person the same relevant 2-3 questions and evaluate whether you like them (attitude and personality), can communicate well with them, and you want to learn more about them. Anyone who passes the screening “test” is then asked to complete and sign an application (if that hasn’t been done yet) and moves on to an actual interview.When interviewing:• Prepare by reviewing the applicant’s application and developing questions (i.e., don’t shoot from the hip!)• Avoid yes/no questions• Behavioral-based questions should comprise 60 percent of the questions you ask• Focus on “t” over experience• Ideally interview multiple times with multiple people• Avoid snap judgments, biases and stereotyping• Allow the candidate to do most of the talkingFor the top one or two candidates, create opportunities to “unmask” them to get a deeper idea of what they’re like. This could be something like taking them to lunch, which aords an opportunity to “see” and experience this person and how s/he interacts with servers (respectfully or not) and other people. This might prove to be the best $25 you ever spend!Rounding out the recruiting and hiring process is the incorporation of: skills assessments, job match personality assessments, and reference and background checking, all of which are valuable components to increase success and minimize risks.Third rule of thumb: “Selling the value, benets and the opportunity of a career in the dental profession.”The Long GameThe long game is: 1) focusing on developing quality employees, and 2) putting conscious eort into employee engagement and creating the type of organizational culture that supports long-term retention, thus reducing the need to recruit.A big reason to take the “long game” seriously is that there is no “silver bullet,” or guaranteed, fool-proof set of tactics for recruiting and hiring. Another big reason is that you have control over the “long game.”Question: Which of these two is more important to the success of your practice?1. Learning recruiting and hiring tactics (assuming they exist), so you can eectively pick the “needle-from-the haystack” of candidates every time, or2. Being the kind of employer with an organizational culture that supports long term retention of quality employees so you rarely have to recruit and hire?Kind of a no-brainer, right?What if you didn’t have turnover? Turnover is not the guaranteed, inevitable consequence of having employees. Many practices experience little to no turnover. Many practices only have to go through the hiring process because of growth or someone retiring or relocating.Focusing all of your energy on hiring and recruiting is like putting the cart-before-the-horse and ignoring the foundational importance of the kind of employer you are. It also ignores the organizational culture you have.This is analogous to a patient only focusing on wanting white teeth, while ignoring his/her underlying periodontal disease. Or spending all kinds of time, energy and money getting patients in for hygiene visits, only to lose them through the cracks and holes in your recare retention program, resulting in a low ROI.COVER STORY
27VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationRelative to human resources, long-term success and lower stress is more associated with the type/kind of employer you are and the type/kind of organizational culture you have.Ask yourself:• What is my reputation as an employer?• Why would someone come to work for me rather than someone else down the street? Many practices are not nding it hard to hire new employees. Why? Because they have a reputation as a great place to work, and thus have resumes of potential employees who have said: “when you have an opening, I’d like to come to work for you.” These practices eectively avoid the nancial and emotional toll of turnover.Your leadership and organizational culture goal, and the “magic” of employee retention is: Employee Engagement.Employee Engagement is characterized by:• The extent to which employees feel valued (appreciation and recognition).• The extent to which employees enjoy and believe in what they do (making a dierence).• The extent to which employees are committed to something or someone in the practice.• The extent to which employees will stay in or with the practice based on that commitment.The extent and degree to which each of the above is true is the extent to which you have (or don’t have) high employee engagement.The benets of increased employee engagement, in addition to lower turnover, are:• Commitment• Loyalty• Pride• Contribution• Sense of ownership• Sense of belonging, and• Employees who won’t go somewhere elseIn other words, long-term retention with little to no turnover.“But I pay them, in fact, I pay them well, isn’t that good enough?” No, today, like it or not, that is not good enough. Today, your people represent your primary source of About the AuthorAdrienne Twigg is Principal/Co-owner of Bent Ericksen & Associates and an HR compliance consultant. Having both the experience of managing a large dental group practice with 35 team members for over 17 years, and working with dentists across the country, Adrienne has presented nationally on the topics of practice management, human resources and employment compliance. competitive advantage. And an engaged workforce (i.e., team) is the true competitive edge. Achieving an engaged team is not exclusively about pay.To be successful at the “long game,” a leader’s or employer’s primary focus has to be on his/her people and outcomes, not just results. This means the leader’s focus and commitment has to be on increasing employee engagement through communication, mentoring, coaching, problem-solving, and supporting his/her employees.Success with employee engagement boils down to you, your leadership, and the organizational culture you create. Successful practices provide employees with a sense of purpose and belonging. Coveted employees aren’t interested in working for practices that don’t provide motivation, opportunity, or trust them.Focusing on employee retention (leadership, culture and engagement) maybe a little more work than just tactics of recruiting and hiring, but is well worth it in the long run.Adrienne Twigg and Tim Twigg are the Principals/Co-Owners of Bent Ericksen & Associates, a resource for dental industry Human Resources and Employment Compliance. To receive a complimentary copy of the company’s quarterly newsletter or to learn more, contact Adrienne at 800-679-2760 or at adrienne@bentericksen.com. www.bentericksen.com
28 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1NEWS & FEATURES Dental Day at the Capitol Shows the Importance of AdvocacyEACH YEAR the IDA hosts Dental Day at the Capitol, an advocacy day dedicated to sharing the importance of advocacy, observing the state legislature in session, and meeting with individual legislators about issues related to oral health.The 2023 Dental Day was held on February 6 and was attended by IUSD D3 students and approximately 50 IDA members. The day began with presentations about advocacy and important legislation the IDA is working on, and a panel discussion with State Representatives Bob Heaton, Rita Fleming and Denny Zent, a retired endodontist and IDA member. Lt. Gov. Suzanne Crouch gave a presentation on the importance of treating mental, physical and oral health issues in Indiana. Following the morning session, attendees headed to the statehouse for lunch and to meet with individual legislators to advocate for the IDA’s legislative priorities. Please consider joining us in 2024 for Dental Day. The event is a tremendous opportunity to learn more about the legislative process and to share your voice at the Indiana Statehouse.
29VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationAll photos on this page by Adam Wolf.
30 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1NEWS & FEATURES Kathy WaldenMeet ADA Executive Director Dr. Ray CohlmiaMEMBER DENTISTS might not have reason to give much thought to ADA administration, but membership is always on the mind of ADA Executive Director Dr. Raymond Cohlmia. Chosen after an exhaustive search to replace the retiring Dr. Kathleen O’Loughlin, Dr. Cohlmia began his new role in November 2021 and immediately embraced the challenge of leading an organization with more than 159,000 member dentists and hundreds of employees.“I’ve always been a person of service, and when you work with an organization like this, you get the opportunity to change people’s lives,” he said. “What brings pleasure to me is making sure that other people succeed, that they achieve their goals, and I’m trying to improve the people we serve and make their lives better so that they can serve more people and provide better care. I enjoy being surrounded by people who are really incredible, and the people here at the ADA are truly wonderful and they’re very committed to improving the profession and serving the members and the public every day.”Following his graduation from the University of Oklahoma College of Dentistry in 1988, Dr. Cohlmia became a faculty member at the OU College of Dentistry and began working alongside his father and brother in private practice. In 2011, he created the college’s division of comprehensive care and was named its rst director. He became assistant dean for patient care in 2013 and was appointed dean of the dental college in 2015.Dr. Cohlmia has been heavily involved in state and national leadership for much of his career. He was president of the Oklahoma Dental Association in 2001 and has led the ADA New Dentist Committee and Council on Membership. His other ADA involvements have included the Council on Annual Sessions, Council on Dental Benets, American Dental Political Action Committee, and the ADA Science & Research Institute Board of Directors. Dr. Cohlmia has also represented his district as a delegate to the ADA House of Delegates.After years of seeing the inner workings of the ADA from a membership and leadership standpoint, Dr. Cohlmia hit the ground running in setting key priorities for the association. He wants to move governance into a direction that better supports the ADA’s goals, and he’s established ambitious technology goals: The ADA launched its new member app at SmileCon in October, and Dr. Cohlmia emphasizes that the app will continue to evolve, improve and provide custom content for users. The organization is also working on developing a new customer management system that will go live in 2024. Dr. Cohlmia is determined to bring collegiality and synergy to the ADA, and he’s already established strong ties with other dental organizations to create common goals. “I believe in building up Dr. Cohlmia and his wife of 37 years, Sherry, at the U.S. Open.
31VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Associationaliate organizations and reaching out to them and doing more incredible things with them, because when they become stronger, we all become stronger,” he said. “We’re not focusing on our areas of disagreement, but in places where we agree. So I’ve been reaching out and embracing these organizations so that we have a relationship like we’ve never had before.”Likewise, he has made signicant strides in collaborating with multi-site dental practices, which include dental support organizations (DSOs) and ADA President Dr. George Shepley has formed the Association’s Task Force for DSO Engagement to help attract and retain DSO dentists as members. “We’re going to see more and more of these groups in the future, so we’ve got to start advancing ourselves and reaching out to them and embracing them,” said Dr. Cohlmia. “They’re trying to do the same thing we’re all doing: Improve people’s lives. I’m working directly with the Association of Dental Support Organizations and their executive director to collaborate on what we can do to move the profession forward together.”As a former dean and dental college faculty member, Dr. Cohlmia is naturally inclined to foster strong ties with the dental education community. He visited 15 dental colleges in 2022, and he hopes to double that number in 2023. “As a former dean, I know many of the deans around the country and I’ve let them know that I’m here to support them and their faculty,” he said. “Further, those emerging professionals are our future colleagues and future ADA members.”Dr. Cohlmia believes that every level of the ADA can work together to achieve the goals of streamlined governance, technology modernization, collegiality and synergy with dental education. “My philosophy has always been that the local, state and national associations are on the same level. We’re all equal,” he emphasized. “We all play a critical role in supporting dentistry and members. I meet with the state executive directors on a regular basis to make sure we’re in sync and that we have a streamlined message and streamlined membership operations. It’s like the dental oce: It takes everyone in the oce to put that one patient in a chair.”Growing up in Oklahoma, Dr. Cohlmia grew up witnessing what it took to put patients in a dental chair: His father and uncle were dentists, and their work inspired him to seek the same career. “In school I was on the path for both medicine and dental, but I loved working in my father’s oce and seeing how he treated patients,” Dr. Cohlmia recalls. “In the end I chose dentistry, and I’m so glad I made that decision.” His brother, three sons, numerous cousins, and a nephew also became dentists.Dr. Cohlmia has been married to his wife, Sherry, for 37 years, but he still describes her with the joy of a newlywed. “Sherry is amazing, she’s incredible, she’s my whole Top: Dr. Cohlmia and Sherry with sons Dr. Derek Cohlmia (seated at left), Dr. Brandon Cohlmia (standing) and dental student Joshua (seated at right).Bottom: Dr. Cohlmia with his father, retired dentist Dr. Ray Cohlmia, and son Dr. Derek Cohlmia.Continued on page 32
32 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1NEWS & FEATURES About the AuthorKathy Walden is the IDA’s director of communications. She can be reached at 317-634-2610 or kathy@indental.org. world,” he said. Last year the couple had a challenging year after Sherry was diagnosed with breast cancer, but she’s completed her treatments and is doing well. The Cohlmias have three sons: Derek and Brandon are both dentists, and youngest son Joshua is a student at University of Oklahoma College of Dentistry. Dr. Cohlmia admits that the biggest challenge of his new position with the ADA—other than dealing with Chicago winters—is giving up treating patients on a daily basis. “I do miss direct patient care,” he said. “But I’m keeping my skills up. I do all my CE, read up on everything, and I volunteer at Mission of Mercy events. But I do miss the day to day engaging with patients that have been with me for generations. Right before I left my practice I had a family of three generations still coming to me, a grandmother, mother and daughter. That’s always something a little special in dentistry.”“My philosophy has always been that the local, state and national associations are on the same level. We all play a critical role in supporting dentistry and members. It’s like the dental office: It takes everyone in the office to put that one patient in a chair.Left: Dr. Cohlmia and son Joshua, a student at the University of Oklahoma College of Dentistry. Right, Dr. Cohlmia and Sherry at their son Brandon’s graduation from dental school.
33VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Association
34 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1Diagnostic Challenge: Winter 2023THE CHALLENGE: A healthy 26-year-old female presented to her dentist with swelling of the left mandible for the last six months. She also reports paresthesia began approximately four weeks ago and describes occasional pain and diculty chewing. Medical history is signicant for depression, anxiety and hypertension all well-controlled with medication. Her social history includes smoking a half pack of cigarette per day for the last eight years. Extraoral exam was within normal limits. Intraoral exam revealed a 1.0 x 1.0 cm uctuant lesion in the left mandibular buccal vestibule.A panoramic radiograph was obtained (Figure 1) revealing a well-dened, expansile, unilocular radiolucent area in the left mandible extending from the mesial of 19 to the mesial of 22. External root resorption in the apical half of 21 was also noted. Given these radiographic ndings, the patient was referred to the department of oral surgery at Indiana University School of Dentistry to obtain a diagnostic biopsy. A cone-beam computed tomography (CBCT) volume was obtained and revealed severe thinning and expansion of the buccal cortex (Figure 2) throughout the lesion. The superior border of the mandibular canal is eaced at the distal third of the lesion and appears involved. Histologic examination (Figure 3) reveals multiple fragments of soft tissue. Most of the specimen consists of a solid epithelial odontogenic neoplasm. The epithelium forms duct-like structures surrounding acellular basophilic material. Between these duct-like structures are rosette like areas.Can you make the diagnosis?A. Adenomatoid odontogenic tumorB. Idiopathic bone cavityC. Odontogenic keratocystD. Radicular cystE. Unicystic ameloblastoma Dr. Angela RitchieDr. Philip WongFigure 1: Panoramic radiograph of the patient at the initial appointment.CLINICAL FOCUSFigure 2: Cross-sectional view of a CBCT depicting marked expansion of the buccal cortex (yellow arrow) in the center of the lesion. The mandibular canal (red circle) also appears involved within the lesion.
35VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationThe Diagnosis: Adenomatoid odontogenic tumorAdenomatoid odontogenic tumor (AOT) is a rare, benign neoplasm of odontogenic epithelial origin. They are slow-growing neoplasms frequently associated with cortical expansion. There are three clinical variants: follicular, extrafollicular, and peripheral.1 AOTs may be referred to as the “two-thirds tumor” given approximately two-thirds of these tumors present before the 2nd decade of life, roughly two-thirds present in the anterior maxilla, around two-thirds present in females and around two-thirds present surrounding the crown of an impacted tooth.1 The follicular variant accounts for most clinical presentations and presents radiographically identical to a dentigerous cyst. Unlike the dentigerous cyst, the radiolucency in AOTs frequently extends apically beyond the cemento-enamel junction and may also present with small radiopaque foci.1 Given AOTs propensity for the anterior jaws, it most frequently presents surrounding the crown of an impacted canine. The extrafollicular variant has no association with an unerupted tooth. The peripheral variant presents solely within the gingival soft tissue and may mimic a pyogenic granuloma, peripheral ossifying broma or peripheral giant cell granuloma. The peripheral AOT may show slight erosion of the alveolar cortex but usually will not cause radiographically detectable changes.5 Histologically, all variants are identical and are composed of spindle-shaped epithelial cells forming a variety of patterns including strands or whorled masses. The epithelial cells also tend to form rosette like structures. The most characteristic histologic feature of an AOT is the formation of ductlike structures. Small foci of calcication may also be present throughout the tumor. The tumor is often encapsulated in a thick brous wall. Treatment of the AOT includes enucleation. The initial treatment is often curative with little risk of recurrence. Idiopathic bone cavityIdiopathic bone cavity is a non-odontogenic intra-osseous lesion that aects the jaws. It has been known by many other names throughout the years including traumatic, simple, solitary, hemorrhagic, extravasation, or unicameral bone cyst.2This lesion is usually seen in young patients, under 40 years of age, in the posterior mandible. They usually present radiographically as well-dened radiolucent lesions, sometimes with a scalloped border and with an angular or rounded contour.4 It is atypical that it would cause resorption of adjacent teeth or signicant cortical expansion as seen in our case. Normally, these are empty cavities, sometimes lined with a thin layer of brous connective tissue without epithelium; they can also contain serosanguinous uid, clots, erythrocytes, brin, and giant cells. Typically, the lesions are asymptomatic and are incidentally detected by panoramic radiography; they may resolve without treatment.4Odontogenic keratocystThe odontogenic keratocyst (OKC) is a developmental odontogenic cyst arising from the cell rests of the dental lamina. Compared to other odontogenic cysts, the OKC has a greater growth potential, a higher recurrence rate and a potential association with nevoid basal cell carcinoma syndrome.1 OKCs occur across a wide age range and are most often found in teenagers or young adults with male and posterior mandibular predilection. They may present as unilocular, unilocular with scalloped border or multilocular radiolucencies. Lesions can become quite large with a propensity to grow in an anterior and posterior direction with minimal to no clinically evident buccolingual expansion of the cortices.1 A denitive diagnosis is established through histopathologic examination and consists of cyst lining of roughly six to 10 epithelial cell layers and surfaced by parakeratin in a wavy architecture. The basal cell layer of the epithelium is characteristically palisaded and hyperchromatic. Management of the OKC includes enucleation +/- peripheral ostectomy, marsupialization or resection. Histologic ndings such as satellite cysts and Figure 3: 10x Photomicrograph.
36 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1subepithelial splitting may contribute to the OKCs high recurrence rate.Radicular cyst Radicular cysts (RC), also known as periapical cysts or apical periodontal cysts, are cysts of inammatory origin and are the most common type of odontogenic cysts. By denition these cysts must be associated with the apex of a nonvital tooth. Radiographically RCs are identical to periapical granulomas and present as well-dened radiolucencies at the apices of a nonvital tooth. Since lateral or accessory root canals may be present, radiolucent lesions may not be centered at the apex of the root and may appear in a lateral periodontal position.1 If left untreated, RCs may lead to continued expansion. Histologic examination of RC reveals nonkeratinized squamous epithelium lining chronically inamed granulation tissue. Treatment consists of root canal therapy or extraction of nonvital tooth. Unicystic ameloblastomaUnicystic ameloblastoma is a variant that has a relatively benign biologic behavior and better response to conservative treatment. It accounts for 15 percent of all intraosseous ameloblastomas and often aects the younger population with half of the cases occurring in the second decade of life. Unicystic ameloblastomas have a slight male predilection and frequently originate from the posterior mandible.6 Unicystic ameloblastomas are characterized as a slow-growing and relatively locally aggressive cystic lesion. Radiographically, the lesions commonly show expansive unilocular radiolucencies with a well-demarcated border. Approximately 50–80 percent of cases are associated with an impacted or unerupted tooth. Therefore, the clinical and radiographic presentations of unicystic ameloblastoma are sometimes indistinguishable from those of dentigerous cysts.6The three histological subtypes are luminal, intraluminal, and mural. This classication has a direct bearing on their biological behavior, treatment, and prognosis. In contrast to solid/multicystic ameloblastomas, unicystic ameloblastomas are less aggressive and respond more favorably to conservative management including enucleation, curettage, and marsupialization. More aggressive surgical interventions such as resection are only considered until recurrence occurs.3ConclusionThe case reported highlights the importance of tissue submission for histopathologic diagnosis. Diagnosing lesions based on radiographic appearance alone may lead to improper denitive diagnoses and delayed treatment of potentially morbid conditions. References1. Bilodeau, E. A., & Collins, B. M. (2017). Odontogenic Cysts and Neoplasms. Surgical Pathology, 177-222.2. Chrcanovic B.R. & Gomez R.S. (2019) Idiopathic bone cavity of the jaws: an updated analysis of the cases reported in the literature. International Journal of Oral and Maxillofacial Surgery, 886-94.3. Hsu M.H., Chiang M.L., & Chen J.K. (2014) Unicystic ameloblastoma. Journal of Dental Sciences, 407-11.4. Perdigão P.F., Silva E.C., Sakurai E, de Araújo N.S., Gomez R.S. (2003) Idiopathic bone cavity: a clinical, radiographic, and histological study. British Journal of Oral and Maxillofacial Surgery. 407-9.5. Philipsen, H.P. Reichart, P.A., Zhang, K.H., Nikai, H., Yu, Q.X. (1991). Adenomatoid odontogenic tumor: biologic prole based on 499 cases. Journal of Oral Pathology & Medicine, 149-2006. Philipsen H.P. & Reichart P.A. (1998) Unicystic ameloblastoma. A review of 193 cases from the literature. Oral Oncology. 317-25.CLINICAL FOCUS
37VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationAbout the AuthorsDr. Angela Ritchie is an assistant clinical professor in the department of oral pathology, medicine and radiology and is director of laboratory services for the Oral Pathology Group at Indiana University School of Dentistry. Dr. Phillip Wong is a Clinical Assistant Professor in the Dept. of Oral Pathology, Medicine and Radiology at Indiana University School of Dentistry. Dr. Wong received his DMD from Roseman University of Health Sciences in South Jordan, Utah and his specialty certicate in oral and maxillofacial radiology from the University of Florida.
38 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1MEMBER ZONEIDA Preferred Vendor DirectoryIDA’s preferred vendors can help your practice run more smoothly by providing products, services and discounts on nearly every aspect of the dental oce. These vendors can help with your work-life balance with discounts and guidance on vehicles, vacations and more. You can view more information about each of these companies on our website, www.indental.org/products-services.INSURANCEBUSINESS SERVICESPERSONAL AND PROFESSIONAL FINANCINGIDA Insurance Services oers a full line of insurance to protect you, your family, your employees and your practice. Don’t miss the aordable health insurance rates from the IDA Insurance Trust.800-417-6424Protect the ones you love and the practice that depends on you with quality, reliable life insurance from Protective Life.800-866-9933Practice Protection is an Indiana company that oers aordable, comprehensive malpractice insurance for dentists of all specialties.888-217-2779The Plan Forward software platform enables dentists to easily oer customized member-ship plans to uninsured patients.317-416-8548Make your practice’s online presence personal, professional and eective without taking time out of your busy schedule.888-932-3644OnPay gives you the tools to streamline and save money on payroll, time o management, and related services.877-328-6505Bank of America Practice Solutions give you the tools to nance a practice of your own.800-497-6076Give your nances some relief by renancing federal and private student loans.855-456-7634Expand your buying power with rewards, points and travel perks from the U.S. Bank Preferred Rewards Visa.888-327-2265
39VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationPAYMENT PROCESSING AND ASSISTANCEOFFICE AND DENTAL SUPPLIESPERSONAL DISCOUNTSSave an average of 24 percent on credit card processing fees with Best Card.877-739-3952CareCredit gives your patients exible options for payments and nancing.800-859-9975Save money on all your practice needs, from dental supplies and capital equipment to lab and other purchased services.800-975-1651Oce Depot is a one-stop shop for all oce needs. Your IDA membership qualies you for discounts on oce supplies and exclusive special oers.855-337-6811 Ext. 12810The Solmetex Amalgam Separator keeps your oce in compliance with federal laws regarding amalgam separation.800-216-5505Quality and luxury engineering are yours with a Mercedes-Benz. Save up to thousands of dollars on a purchase or lease.866-628-7232AHI helps you plan your time away from home, from quick weekend getaways to dream vacations.844-205-1171Looking for more? The ADA has an extensive selection of endorsed products and services for members. Visit the ADA Member Advantage website for more information:www.adamemberadvantage.comVolvo is proud to oer ADA members $1,000 o the purchase or lease of any vehicle, including its growing eet of hybrid and electric vehicles.800-550-5658CyraCom’s remote interpretation services can help you develop strong communication between your sta and patients with limited English prociency.844-737-0781
40 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1Component NewsMEMBER ZONEIndianapolis District Dental SocietyIDDS held its annual Women in Dentistry event on March 2 and honored Drs. Nia Bigby, Sarah Herd and Mandy Miller for their contributions to dentistry in Central Indiana. Pictured below from left are IDDS President Dr. Megan Keck, Dr. Nia Bigby, Dr. Sarah Herd, Dr. Mandy Miller and IDDS board member Dr. Jillian Brady.Indiana Well Represented at ADA Lobby Conference in WashingtonMore than 700 dentists, dental students and state association sta from around the country gathered in Washington, D.C. to attend the ADA’s annual Dentist and Student Lobby Day. The IDA was well represented, with 10 dentist leaders and eight IUSD students in attendance. The group met with numerous Indiana representatives and both Indiana Senators during their two days in the capitol.Photos of the event are on page 41. The Indiana delegation met with Senators Todd Young (top left) and Mike Braun (top right) to share their views on issues related to oral health.Middle right: Dr. Steve Holm and Dr. David Wolf with Andrea Holwager, daughter of Dr. David Holwager, who died in 2019. Dr. Holwager was honored with a memorial brick (bottom right) at the ADA House in Washington for his tireless advocacy eorts on behalf of the dental profession.Bottom left and middle left: Members of the Indiana delegation together and meeting with legislative sta members.
41VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Association
42 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1ClassifiedsINTRAORAL X-RAY SENSOR REPAIR/SALESWe repair broken sensors. Save thousands in replacement costs. Specializing in Kodak/Carestream, major brands. We buy/sell sen-sors. American SensorTech 919-229-0483 www.repairsensor.comEQUIPMENT REPAIRASSOCIATE DENTIST FOR FAMILY ORIENTED PRACTICEMiddleton Family Dentistry is looking for a dental associate to join our growing practice! This is a wonderful opportunity for either a full time or part time long-term career. We are a four doctor practice with two locations. Great benets. Email Connie.shim.mfd@gmail.comDENTIST The University of Southern Indiana College of Nursing and Health Professions is seeking a dentist for a one-year renewable, non-tenure track, nine-month clinical faculty position (August 15-May 15). The successful candidate will hold a valid Indiana dental license in good standing or be eligible for licensure. Responsibilities include clinical and laboratory teaching in the Dental Hygiene and Dental Assisting Programs and participation in academic program evaluation and cur-riculum revision, and other program and college related activities. Visit https://usi.peopleadmin.com/postings/10466 to learn more.ASSOCIATE DENTIST - GENERAL DENTISTRY Established dental practice in Knightstown seeking associate general dentist to join our team. Ideal applicants have good communication, strong clinical skills, and ability to treat patients of all ages with com-passion and respect. Please send resume and cover letter describing your career plans and experience to smiles4u@myninestar.net with attention to Dr. Ploeger.PEDIATRIC DENTIST A private pediatric dentistry practice needs a full-time or part-time pediatric dentist or general dentist to join our busy and growing prac-tice (Currently 3 oces: Fishers, Greeneld and Lawrence). Position is available 2, 3 days or 4 days a week. Oces are a state-of-art with all updated technology with experienced and devoted sta and already 4 pediatric dentist on the sta. Email Dr. Juan Yepes, jfyepes@iupui.eduASSOCIATE DENTIST OPPORTUNITY IN SOUTHERN INDIANA Join an established and thriving Dentist-Owned General Dental Practice. Family Dentistry is a well-established, privately owned dental oce in Newburgh, located next to Evansville. We are seeking a full-time Associate Dentist to help us care for our ever-growing patient base. You will have the opportunity to work with 3 other practicing dentists that will provide exceptional mentorship and guidance. Call 708.807.5526 (ask for Peter) or email peter@familydentalcare.EMPLOYMENT OPPORTUNITIESOMS PRACTICE IN GREATER INDIANAPOLISAn exciting opportunity to own and operate a thriving oral surgery prac-tice in the Greater Indianapolis area! Conveniently located in a prime retail center with two fully-equipped operatories and the adjacent space is available for expansion. This is a rare chance to take over a well-es-tablished practice with room for growth. Email Bailey Jones: bailey@professionaltransition.com or 719-694-8320. REFERENCE #IN12522.INDIANAPOLIS NORTH SUBURB GENERAL PRACTICE FOR SALE Beautiful 5 op general practice available in second fastest growing county in Indiana. NW suburb of Indianapolis, with 1,000+ active patients, collects $525K with $200K net, on a 3 days/week schedule. Implants, Endo, Ortho and most surgical referred out. Fantastic growth opportunity that will not last long! For more information, please contact Joe Gurskey, joe.gurskey@henryschein.com, 502.565.9116. #IN3124VIGO COUNTY GENERAL PRACTICE FOR SALE6 Operatory Digital oce, paperless, CAD/CAM, Dentrix. Nice oppor-tunity for growth as currently only 32 patient hours per week. Good location on major 3 lane boulevard within professional building. Contact Al Brown, al.brown@henryschein.com, 630-781-2176. #IN3134PRACTICES AVAILABLEMEMBER ZONEASSOCIATE DENTIST FORT WAYNELooking for a part time associate dentist (1-1.5 days/week) for a well established private practice, north Indianapolis. We are mostly PPO/FFS oce with great sta and patients. We are a true family practice and see patients of all ages! We are looking for a doctor who is pas-sionate about dentistry, compassionate and strives to do quality work. Base compensation for rst 3 months followed by % of collections after (we collect 99% of production!). Kasie Nam, kasienam@gmail.com.DENTIST OPPORTUNITY IN FORT WAYNEWe are currently seeking an Associate Dentist to join us Wednesday and Fridays in our technology advanced dental facility. Competitive compensation, 35% collection based. Malpractice is provided and Eligible for 401k! 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43VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental AssociationIN MEMORIAMDR. CARL W. BOLLMAN of Frankfort and member of the West Central Dental Society passed away December 26, 2022. Dr. Bollman graduated from Indiana University School of Dentistry in 1951.DR. RICHARD “RICH” AARON BONNESS of Plaineld and mem-ber of the Indianapolis District Dental Society passed away February 3, 2023. Dr. Bonness graduated from Indiana University School of Dentistry in 2000.DR. ARDEN G. CHRISTEN of Indianapolis and member of the India-napolis District Dental Society passed away December 30, 2022. Dr. Christen graduated from the University of Minnesota School of Dentistry in 1956.DR. WILLIAM P. CRIBBS of Muncie and former member of the East Central Dental Society passed away February 21, 2023. Dr. Cribbs graduated from Indiana University School of Dentistry in 1976.DR. ROSS L. LAWRENCE of LaPorte and member of the Northwest Indiana Dental Society passed away December 4, 2022. Dr. Lawrence graduated from Indiana University School of Dentistry in 1964.DR. PHILIP M. MCKEAN of Fort Wayne and member of the Isaac Knapp District Dental Society passed away December 19, 2022. Dr. McKean graduated from Indiana University School of Dentistry in 1972.DR. J. KEITH ROBERTS of Bloomington and member of the South Central Dental Society passed away January 14, 2023. Dr. Roberts graduated from Indiana University School of Dentistry in 1963.DR. JOHN E. STEINMUELLER of St John and member of the Northwest Indiana Dental Society passed away January 14, 2023. Dr. Steinmueller graduated from Loyola University School of Dentistry in 1985.DR. BILLY ASHLEY STEWART of Fort Wayne passed away October 2022. Dr. Stewart graduated from University of Detroit-Mercy School of Dentistry in 1958.DR. PAUL VAN DORN of Anderson and member of the East Central Dental Society passed away March 8, 2023. Dr. Van Dorn graduated from Indiana University School of Dentistry in 1968.
44 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1New MembersEASTERN INDIANA DENTAL SOCIETYDr. Brent Swinney (IU 1998)FIRST DISTRICT DENTAL SOCIETYDr. Jenny McWilliams (IU 1997)Dr. Betsy Smith (Univ Louisville 2021)INDIANAPOLIS DISTRICT DENTAL SOCIETYDr. Brittany Braden (MUI 2018)Dr. Wonsik Jung (Howard Univ 2019)Di. Michelle Kohler (IU 2006)Dr. Caitlin Miller (Univ Iowa 2017)Dr. Tetlu Myint (IU 2018)Dr. Meenarin Panittaveekul (IU 2019)Dr. Emily Summerlin (IU 2013)Dr. Elisheva Tinsley (IU 2015)Dr. Todd Walters (IU 1986)MEMBER ZONEISAAC KNAPP DISTRICT DENTAL SOCIETYDr. Sheri Crawford (Univ Louisville 2015)Dr. Kajal Nehra (Univ Colorado 2020)Dr. Prejith Philip Varghese (IU 2019)NORTH CENTRAL DENTAL SOCIETYDr. David Buksar (IU 1996)Dr. Tia Jeers (Univ Michigan 1994)NORTHWEST INDIANA DENTAL SOCIETYDr. Oluseyi Ayangade (IU 1996)Dr. Creshinda Ayangade (Univ Kentucky 1997)Dr. Marcus Biggs (IU 2018)Dr. Gelsy Calvo Hernandez (Univ Puerto Rico 2020)Dr. Pete Grubnich (IU 1981)Dr. Emily Smythe (Univ Maryland 2007)SOUTH CENTRAL DENTAL SOCIETYDr. Courtney Fust (Univ Louisville 2014)Dr. Franklin Miller (IU 2012)Dr. Ashley Zehnder (Univ Kentucky 2009)SOUTHEASTERN INDIANA DENTAL SOCIETYDr. Joseph Cardosi (Univ Kentucky 2020)WEST CENTRAL DENTAL SOCIETYDr. Christy Chen (IU 2017)Dr. James Lalonde (Ohio State Univ 1980)Dr. Saurabh Uppal (Univ Colorado 2022)
45VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Association I RAN my rst ultramarathon in 2020, and have since run a variety of races ranging in distance from 50k to 50 mile, 100, 200, and 300+ miles. I run on road or trail, single day or multi day, supported or unsupported, and really anything in between.The most interesting race I have participated in to date is called “The Last Annual Vol State Road Race.” It is the brainchild of Lazarus Lake (creator of The Barkley Marathons), and is so jokingly named because it is only the last annual race until next year’s race. In fact, it has been occurring since the 1980s. Simply referred to as Vol State, it is a 314 mile course across the state of Tennessee in the steamy heat of July. The race is unsupported, meaning runners carry and obtain their own supplies. My pack weighed approximately 15 pounds, holding enough to get me through stretches of up to 30 miles between towns. At times, it seemed like a never-ending lesson in crisis management. Reach a town just after all the stores have closed, including the Walmart that claimed to be open 24 hours. Spend hours doctoring the blisters that cover most of your feet. Ask a local how late the gas station leaving town is open and hear the response “when trac slows down” - hmmm. Develop a hive-like heat rash on your legs and then spend 12 hours traveling (hobbling?) by blistered foot under the scorching sun. Then run to seek shelter when the subsequent thunderstorm creeps up from behind you. Try to interact with normal people when you are visibly dirty and likely quite smelly. Oh, and did I mention the BLISTERS?! My husband may or may not have answered a couple of teary phone calls from me while resting roadside on a guardrail. I’ll never say for sure! For eight days, until I reached the nish line in 2022, this was my life. I only slept in a hotel one of those nights and otherwise sought rest spots like benches, gazebos, church porches and even a cemetery or two (hey, nobody bothered me there). Steeped in tradition, the course has remained the same since its inception. The tiny Tennessee towns are supportive of the runners passing through and many would set out coolers full of water and snacks, chairs or even rst aid supplies. One rehouse set out cots and ordered pizza for us, and then — I am not kidding — went on to save a kitten and respond to a house re! I also had many pleasant encounters with the spontaneous “road angels” who would stop to check on me and then insist on gifting whatever they had that may be of use, be it batteries, water, sunscreen or snacks. I hit the jackpot one day when a lady chased me down her long driveway on an ATV with cold bottles of water. This came fortuitously soon after my hydration bladder had burst and leaked all over me. After an experience like this, you can’t help but be refreshed by the goodness that still exists in the world. It may sound strange to spend precious vacation days in this way, but I have found that these challenges cultivate a mental toughness and appreciation for humanity that helps navigate life’s daily challenges.I I would suggest the documentary entitled “The Barkley Marathons: The Race That Eats Its Young” (available for free on YouTube) for a little insight into the niche hobby of ultrarunning.Ultramarathons Cultivate Mental and Physical HealthOUT OF THE OPERATORY See page 46 for more photos of Dr. Nowak's ultramarathon adventures.Dr. Jessica Nowak
46 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1OUT OF THE OPERATORY
47VOLUME 102 · 2023 · ISSUE 1 | Journal of the Indiana Dental Association
48 Journal of the Indiana Dental Association | VOLUME 102 · 2023 · ISSUE 1