Volume 3, Issue 2

Inside this Issue:

Getting to Know YOU Page 1 American Dental Association Page 1 Ethics Scenario: The ReTreatment Page 3 Is ASDA Relevent? Page 4 A Glimpse of AYUDA in

Getting to Know YOU

December 2012

Recent Graduates!
By Tracy Welc Ostrow School of Dentistry of USC, Class of 2014 We all count down the days until graduation from dental school, but when these days are truly over, whats next? Some students go to work right away in a private practice; others seek further education through residency programs. Some graduates work for the military at home or overseas; others, in this economy, struggle to find the next road to take. No matter which road you take when you graduate, it is always helpful to hear from those who have been there before you. This quarter, we explored the current paths of recent graduates from California dental schools and asked them to describe their successes, hardships, and most importantly, to give advice to those of us looking forward to those roads.

Cartagena, Colombia Page 5

Piercings of the Oral Cavity and Oral Health

Dr. Dan Hammer University of the Pacific Class of 2011

(Read on page 3)

Dr. Joey Chiu University of California, Los Angeles Class of 2012

(Read on page 5)

Page 7

Upcoming Events:
ASDA Annual Session Mar 6-9 Atlanta, Georgia Talk to your ASDA delegate OR Check out www.asdanet.org

Dr. Veena Vaidyanathan University of the Pacific Class of 2012

(Read on page 6)

Dr. Trishia Contreras University of Southern California Class of 2012

(Read on page 4)

American Dental Association

Editors:
Tracy Welc USC School of Dentistry Class of 2014 Jennifer Yau UCLA School of Dentistry Class of 2013

By Simi Fabiyi University of California San Francisco, Class of 20151 The American Dental Association (ADA), a major organization dedicated, since 1859, to providing oral health care information for dentists and their patients, organized their 153rd Annual ADA session in San Francisco, CA at the Moscone Center from October 17-21, 2012. Americas leading advocacy for oral health as their motto states, strives to provide professional and public resources relating to dental education and careers, as well as introducing dental manufacturers from all over the nation to showcase and market their latest dental products and services. (Continue on page 2)

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American Dental Association

(Continued from page 1) With ADA introducing over 25 CE courses, over 33,000 attendees and more than 600 exhibitors, the goal for the session as stated by Dr. William R. Calnon, ADA president, was to introduce a total experience- world class continuing education, an exhibit floor that allows an opportunity to interact with our vendors and see the newest products and services, professional networking, fabulous entertainment, venues and the policy-making deliberations of the ADA House of Delegates. On October 17th, opening ceremonies included distinguished speakers Dr. Calnon, Mr. Robert Reich and Mr. George Will, speaking about the recent election and their candidates, and Dr. Ron Lamb on receiving the Humanitarian Award for 2012. Educational seminars from Council on Members Insurance and Retirement Programs, as well as new CE courses that focused on biopsy techniques, crown lengthening, TMJ, mini implants, masticatory system anatomy, local anesthesia and socket and bone grafting were a big hit with the attendees. Also incorporated, were business courses and tools to enhance dental practices. lectures, hands-on seminar to dental professionals looking to improve and advance their practices. Most of them, when asked about their end goals for the weekend, explained they only hope that their target population would give their products a try. Top new products introduced include True Definitions Scanner from 3M ESPE (CAD/CAM); Oral Bs brush head, the cloud backup from Patterson Dental called DDS Rescue; DenMats Porcelain Composite Hybrid, an anterior direct composite system; Air Techniques Polaris Intraoral Camera and Spectra Caries Detection Aid; GC Americas GC Fuji CEM 2, a second generation, resin modified glass ionomer luting cement and much more just to name a few.

With ADA introducing over 25 CE courses, over 33,000 attendees and more than 600 exhibitors, the goal for the session as stated by Dr. William R. Calnon, ADA president, was to introduce a total experience

October 18th highlights Dr. John Greenspan, awarded for Excellence in Dental Research, pioneering work in oral AIDS; acknowledgements towards the Give Kids A Smile organization over 700 volunteer students involved in a three day oral hygiene screening and educational seminar that catered to pre-kindergarten, kindergarten, second and fifth graders across San Francisco Public Schools; and the Golden Apple Awards that recognized dental societies for their leaderships in the communities was also recognized by the ADA in their efforts to reach out to communities. October 19th and 20th highlights included Dr. Clanon acknowledging the strength and impact the ADA has on the community, as he presented the Distinguished Service Award and declared the new district trustees. The Student Clinician Research Program by ADA/DENTSPLY also showcased their projects and engaged in an interactive seminar with their audience. Over 600 vendors presented, showcased and marketed their latest products by offering free samples, podcasts

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Dr. Dan Hammer:

Where do you work now? I am a staff dentist for the department of oral surgery with the second dental battalion, Camp Lejeune, NC. We support the warriors of the 2nd Marine Logistics group and the II Marine Expeditionary Forces. What is the best part about being out of dental school? Not having someone need to check every step of the procedure you are completing. It is incredible how much more efficient you can be when the only thing you need to check-in with during a procedure is your own conscience. What is the toughest part about being out of dental school? The same response as what is the best part of being done: you are on your own; during dental school it is really nice to have specialists available at all times to assist in treating advanced cases. Look for mentors, study clubs or continuing education in you local area (your local dental society can be a great place to start to). Just don't get stuck in your own ways and think you know all you need to know. What is the biggest obstacle you have faced since graduation? Even with the military scholarship, I had to take out loans for both undergrad and dental school. I pay a significant portion of

my income to every month and I know for some colleagues it is an even greater challenge start looking into how you will pay back your loans. What is the best advice you could give a current dental student? Know that you do not have to have the answer to the perennial question, "So, what are you going to do after school?" Do externships, get involved with professional organizations, intern at local community clinics, tutor or participate in the many other opportunities at your school. It is through these experiences outside the classroom or clinic that you begin to realize what your truly enjoy in the clinic. What are your plans for the future in your career? I will begin a residency in Oral and Maxillofacial Surgery at Walter Reed National Military Medical Center in July 2013. After, I will continue to serve the sailors and marines on an operational tour, most likely on an aircraft carrier.

Dr. Dan Hammer

University of the Pacific Class of 2011

Ethics Scenario :The Re-Treatment

By Ryan Simarro Western University of Health Sciences, Class of 2013 As a successful endodontist you have created an exemplary reputation for yourself in the community. You have been in practice for almost 15 years, in the community where you grew up. You pride yourself in maintaining good communication with all your referring practitioners and maintain a busy schedule as a result of many referrals. You regularly check in with your referring dentists regarding patient care and how you are treating mutual patients. A younger dentist, Dr. Black, who is new to the area has sent you his first referral; an endodontic retreatment of tooth #30. After a thorough evaluation you determine that the tooth can be retreated and that the prognosis is favorable. You perform the re-treatment without complications and send the patient back to the referring dentist with a letter and a recall schedule in your office. Several months go by without receiving any further referrals from Dr. Black. When the patient finally returns for her recall appointment it is noticed that tooth #30 has been extracted. You question the patient as to why the tooth was extracted. The patient tells you that the root canal didnt take, so they had to take out my tooth. You are surprised, as you were unaware that there were any problems with the treatment you had rendered. What ethical principals come into play in this situation? How would you respond if you were the endodontist? Would you still want to continue working with this referring dentist? What do you tell the patient? If you are the treating dentist, how will you proceed in solving the situation? If you have any suggestions, please write to newsletterdistrict11@gmail.com . Your response may show up in the next edition.

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Is ASDA Relevant?
By Doug Baasch Loma Linda University, Class of 2014 District 11, Communications Chair As dental students, we all know that our time and energy is limited. We are constantly beset with academic, clinical, and leadership challenges that must be met, and often that leaves us with very little for our extracurricular lives. Within that small space, a vast number of leadership opportunities compete for our attention. So how is ASDAs voice distinct among the cacophony of others? Why be involved in an organization like ASDA at all? My answer: ASDA not only impacts your future career as a dentist, but it impacts your life as a dental student right now. ASDA s mission statement says that it advocates on behalf of dental students a unified body that protects and advances our causes. But what are those causes and how do they impact our life in dental school? Let me give you three quick examples. You can tune out a lot of things in dental school, but there are some common realities we all must face: 1. We all have to take boards 2. We all have to become licensed to practice dentistry 3. Most of us will have significant student loan debt to repay ASDA was a proponent of the NBDE Pass/Fail system, and has rigorously educated its members on the new testing guidelines. Similarly, ASDA consistently promotes its policy of a national, non-patient based licensure exam, such as the portfolio licensure pioneered in California. Among many other initiatives, ASDA students lobbied members of congress this April during ASDAs National Dental Student Lobby Day on H.R. 4170 Student Loan Forgiveness Act of 2012. These are just a few examples of the many ways in which ASDA advocates on behalf of dental students. Advocacy is at the very core of ASDAs mission and becoming involved in ASDA means advocating on behalf of some of your biggest problems as a dental student. And this advocating isnt simply among other students at national meetings; its with local and national dental societies, political organizations, and state and federal lawmakers the very people who can make the changes we would most like to see. So if youre ever wondering why being involved in a student-run organization such as ASDA makes a difference, think about the significance of joining 18,000 other dental students in advocating for your profession. That unified voice can help decide what tests you take in school, how you get your dental license and how fast youll be able to pay off your student loan debt. And if you ask me, thats relevant.

Dr. Trisiha Contreras:

Where do you work now? I'm currently in the Pediatric Dentistry program at USC and we work everywhere from USC and Children's Hospitals for Long Beach, Los Angeles, and Orange County. What is the best part about being out of dental school? Being able to just work with kids and being called a doctor. What is the toughest part about being out of dental school? I miss the friends I have gotten to know really well for the past 4 years.

What is the biggest obstacle you have faced since graduation? I am trying to figure out how I am going to pay off those loans! What is the best advice you could give a current dental student? Networking and the connections you make in dental school go a long way. Also, dental school flies by quickly so learn as much from your classes and faculty while you can. Lastly, work hard and play hard. What are your plans for the future in your career? Open up a pediatric dental office, teach, and hopefully still participate in dental mission trips abroad..

Dr. Trishia Contreras

University of Southern California Class of 2012

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A Glimpse of AYUDA in Cartagena, Colombia

By Pehrson Hawkley Ostrow School of Dentistry of USC, Class of 2013 In April of 2012, sixty volunteers (thirty-one dental and two hygiene students from the University of Southern California, two dental students from the University of British Colombia, eighteen licensed dentists and seven volunteers) departed for Cartagena, Colombia. We planned to improve the oral health of children through clinical and educational efforts, and while that was achieved, the most lasting impression was the one that the community of Cartagena left on us as AYUDA volunteers. Arriving in Colombia, we set out to the clinic location on the outskirts of Cartagena. Weaving i n and out of traffic on bumpy buses with pot-hole filled roads, we arrived in a humble neighborhood with dirt roads and shanty homes. The clinic was a nice building in the center of the neighborhood and was the location of the foundation that we were working with called Granitos de Paz. The main goal of the foundation is to teach the neighborhoods inhabitants to become self-sustaining and to learn to work hard to improve their quality of life. AYUDAs role in this process would be to educate the families on proper oral hygiene as well as prevent and eliminate any signs of active decay. We worked closely with dentists and dental students from the Rafael Nunez University Dental School in Cartagena. They were able to inform us of issues that we would see in the community as well as their needs. One was obviously a high caries risk due to poor oral hygiene, but also a high level of fluorosis caused by the children consuming their toothpaste in times of hunger. We were also able to develop a referral form that was filled out by the operating dental student where a copy was given to both the foundation as well as the patient. We were all very excited about this because it marked a new level of international dental care in which the patients would have the chance to receive follow-up care even after we had returned home!

Dr. Joey Chiu:

Where do you work now? I'm not working yet, I still have to pass part 2. What is the best part about being out of dental school? I actually really enjoyed dental school and I really enjoy my life now too. I think this question is really a matter of personal philosophy. What is the toughest part about being out of dental school? Pretty much the same answer as above. I try to live my life to the fullest. Be thankful for everyday I wake up. Regardless of when I was in dental school or where I am now. I'm healthy, I have a loving family, awesome friends, food, house. The basics. Thats all I really need in life.

What is the biggest obstacle you have faced since graduation? Trying to pass part 2 of boards

What is the best advice you could give a current dental student? Just be thankful of all the opportunities you are given. I can't stress that enough. There are so many predents that are incredibly jealous of the position you are in. No one said being a dentist was easy. Just have strong morals. Do the right thing for your patients. Positive thinking when you are having a bad day. Work hard. Patience. Forgiveness. Perseverance. You know. All the goodies.
What are your plans for the future in your career? Work for my dad and possibly go back and specialize.

Dr. Joey Chiu

University of California, Los Angeles Class of 2012

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Dr. Veena Vaidyanathan:

Where do you work now? I work for the Center for Family Health Medicaid Health Center LMC as an AEGD resident in Jackson, Michigan What is the best part about being out of dental school? Not having to do a ton of lab work! What is the toughest part about being out of dental school? Not having every single resource and specialist at your disposal.

time figuring out my comfort zone versus what is out of my league. In dental school, you tend to tackle everything because you know there are people to help you out every step of the way. What is the best advice you could give a current dental student? Stay positive - there is a light at the end of the tunnel! It is amazing how fun it is to practice dentistry with a well-trained assistant! What are your plans for the future in your career? I am currently applying to pediatric dental residencies and hopefully with match in January!

Dr. Veena Vaidyanathan

University of the Pacific Class of 2012

What is the biggest obstacle you have faced since graduation? Knowing when to refer a case. It has taken

A Glimpse of AYUDA in Cartagena, Colombia

(Continued from page 3) On international trips, it can be difficult to gage whether or not the people are happy you are there. Part of it is the language barrier and also just simply being unfamiliar with the care we are trying to provide. But in Cartagena, it was clear that they were very happy to have us. Steven Kirby, USC class of 2014 and a current AYUDA student director said, The people of Colombia were so grateful for the work that we did for them. There were several times that I can recall when the patients treatment was finished and they gave both the operator and the assistant a huge embrace to show their appreciation. When a service is appreciated, it makes giving the service that much more meaningful. After four long but amazing days we treated 845 patients with varying treatments ranging from composite, amalgam, pulpotomies and stainless steel crowns, root canals, cleanings, extractions and more for an estimated value of $208,000. The treatments and the education they received will hopefully give the families a reason to care for and improve their oral hygiene. Tyler Whitehead, USC class of 2014 said, the restorations we place may not last forever, but the memory of AYUDA coming all the way from North America to help them will never be forgotten. It is our hope that beyond the dental work we did, we were good examples to the children and inspired them to become active members of their community.

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Piercings of the Oral Cavity and Oral Health

By Khushbu Aggarwal University of California, Los Angeles, Class of 2014 Whether through the lower lip, tongue, or cheek, oral and perioral piercings have undoubtedly become increasingly popular among the adolescent and young adult population. These rings, studs, and loops have not escaped the attention of oral healthcare professionals who question the shortterm and long-term effects of this jewelry on dental and systemic health. As a result, dentists should be informed of these sequelae because patients may present either before acquiring a piercing to inquire about the risks or in need of urgent care immediately afterwards. While most patients are well aware of the lingering pain of a newly inserted piercing, few are familiar with some of the potential shortterm consequences of even a correctly placed piercing into such a highly vascularized and innervated part of the body. In addition to the potential to develop major hemorrhage, lasting paresthesia, or permanent hypogeusia, 50% of patients will experience painful ulceration and inflammation that last 3-5 weeks and that may affect deglutition, mastication and respiration. Furthermore, the continued presence of jewelry in the oral cavity (especially that made of stainless steel) facilitates the entry of pathogens such as Staphylococcus aureus, A group and beta-hemolytic Streptococcus, Pseudomonas aeruginosa, and Erysipelas. These infections can easily spread through nearby lymph nodes and subsequently to vital organs, for instance in the case of endocardititis. In addition to experiencing mild to serious allergic reactions (such as contact dermatitis) to the jewelry itself, patients also risk contamination by infectious diseases as a result of improperly sterilized equipment. Such diseases include hepatitis B and C, HIV, tetanus, syphilis, and tuberculosis, as well as a variety of conditions caused by herpes simplex virus, Epstein-Barr virus, and Candida albicans. Moreover, the constant presence of a foreign object in the mouth may cause lasting consequences on both the dentition and surrounding soft tissues. One study found enamel loss in 80% of patients with tongue piercings, due to constantly playing with the jewelry. Unintentional orthodontic movement has also been reported to occur. In one interesting case, a woman with a barbell-shaped piercing presented with a midline diastema between the maxillary central incisors (see image). Patients should be aware of these long-term risks prior to acquiring a piercing, if possible, as removal of the piercing if so desired may become difficult if epithelial tissue (for instance, in the form of hypertrophic or keloid scars) grows over the insertion wound. Furthermore, the metal piercing provides a greater surface area for food particles, plaque, and calculus to collect, resulting in halitosis and gingivitis, especially in the region of the piercing. Constant irritation of tissues by jewelry may also lead to localized gingival recession, horizontal bone loss, and increased periodontal pocket depth, depending on the location of the piercing. Finally, Dentists must consider how oral and perioral piercings may impact dental work. First and foremost, dentists should remember to remove all metal objects above the neck, including piercings, prior to x-ray examinations to avoid inclusion of interfering artifacts. Second, when considering large restorations (especially those of porcelain) in patients with piercings, clinicians should remember that piercings increase the risk of cusp fractures. Thirdly, when selecting a material for a direct restoration, dentists should opt for composite instead of amalgam since the discrepancy in reduction potential between certain metals and amalgam may lead to corrosion of the restoration and pulpal sensitivity. Finally, even though patients may not always wear their piercings to dental appointments, piercings should be considered in differential diagnoses for both soft and hard tissue alterations.

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