On Tuesday, November 2^nd (or early the next day), millions of Americans retired to their beds. As they closed their eyes, some felt hopeful and excited; others felt angry, depressed, or even confused. Regardless of the divergent emotions that night, the sun still rose in the morning. Life continued, as it always does. Now that the election frenzy has subsided, we can begin to examine the impact our newly elected leaders, referenda, amendments, and miscellaneous ballot initiatives can have on our personal and professional lives. As a lawyer and self-proclaimed political junkie, I spend a substantial amount of my free time fixated on articles and news commentary about the candidates, the issues, and the future. After countless hours of examining the impact of our new president, the power dynamic within Congress, and my local elections, I must confess that I cannot make any concrete assessments at this point.

However, I can conjecture what the main issues confronting dentistry and health care will be based on my own perspective and that of the ADA. I will continue to examine how the new administration, nationally and locally, will shape the future of these issues.

According to the ADA website, the main issues its advocacy branch monitors include access to dental care (including health insurance coverage), health care reform vis-à-vis the Affordable Care Act, and continuing oral health science and research initiatives at the federal level. Additionally, the ADA routinely reviews regulatory issues that face dentists as employers and business owners—from taxes, workforce safety requirements (i.e. the regulation of amalgam), labor and employment laws, and Medicare coverage for patients.

In addition to the issues that the ADA has identified, I also hypothesize that the general cost of health care and drugs will affect dentistry either directly or indirectly. As many have noted, non-dental insurance premiums have risen significantly and will continue to do so. Many blame the Affordable Care Act as the culprit. Regardless, those who must pay heftier insurance fees may exhaust any allotted funds they had for healthcare in general. Thus, it is possible that those most stretched by increases in insurance will forego dental treatment.

Additionally, the shifting environment of drug regulation may impact dentistry. Over the past year, senators and political candidates have questioned why some life-changing, necessary drugs come with exorbitant price tags, precluding many patients from taking them. The drug companies have responded that the price reflects the cost of investment in research, development, and the countless clinical trials required by the FDA to bring that drug to market. Since dentistry strives for continuous improvements to its techniques and methods, this issue may have an impact on the rate of investment in private oral health-related R&D.

I remain cautiously optimistic that regardless of this year’s election outcome, the dental profession will continue to thrive, and patient care will continue to improve. Members of our profession are passionate about improving dentistry, and will do whatever it takes to make it better. We are also fortunate to have one of the most successful national lobbies in history, which continuously advocates for patient’s interests and our personal interests. With a high percentage of dentists being members of the American Dental Association, the collective voice of dentists is one that lawmakers hear loud and clear.

As members of the dental profession, a profession that has a large health and economic impact on our country, it is imperative for all dentists and dental students to stay apprised of the political landscape. We must proactively work to make oral health care better for our patients and our own livelihood. Otherwise, we might wake up to a political climate that contradicts our profession altogether.

The other day I went on a run for the first time in a long time. When my hands stopped tingling due to a lack of oxygen and I finally caught my breath, I stopped focusing on the simple act of running and, instead, on letting my mind clear. That is my goal with running. I’m not particularly good at it, which is evident by the scar on my knee from falling on dry pavement not once, not twice, but three times. And, unfortunately, I do not have steel-cut abs from it (I like ice cream and beer too much for that). However, in spite of those things I still love to run. It helps me to clear my mind and accomplish new perspectives by seeing past the tunnel vision of dental school. Once I let the thoughts go that were occupying my mind, I took notice of the environment around me. I ran past a house with about 15 feet of sidewalk in front of it, and thought, “What is the point of that?” The sidewalk was not continuous, which basically rendered it useless. The only purpose that sidewalk served was to be stood on when the house owners checked the mail or for a short game of hopscotch for the kids that lived in the house. While those things do serve a small, individualized purpose, they do not serve the purpose for the goal of a sidewalk—to make a continuous path for pedestrians.

The more I thought about it, the more I saw the reflection of my dental school education in that oddly configured sidewalk. My classmates and I establish squares of concrete and temporarily learn as much information as we can about a certain subject. The newfound knowledge is then promptly “brain dumped” after a final. We learn essential details to get us through our most recent assignment in lab, but we fail to understand the big picture. While these segments of sidewalk serve a great and noble purpose for the task at hand, they will not be very useful when it comes to walking around the block.

As we slowly (and I’d like to think gracefully) crawl towards the graduation finish line, we must keep this in mind. Our snippets of knowledge will only get us so far; it is the segments that connect those pieces of knowledge into a contiguous and fluid path that will allow us to smoothly navigate to our endgames. No matter where we are in our dental careers, we need to be sure to construct our sidewalks so the stroll around the block can be as seamless as possible. After all, you can have all the knowledge in the world, but if you can’t see the forest through the trees, then that knowledge simply becomes facts rolling around in your head.

My thought process wouldn't be complete without including this popular and all-too-relevant poem from Shel Silverstein(1.):

1. Silverstein, Shel. Where the Sidewalk Ends: The Poems & Drawings of Shel Silverstein. New York: Harper and Row, 1974.

A truly historic and special weekend in Chicago happened to fall on the same weekend of ASDA’s National Leadership Conference this year. With the Cubs winning it all and the Ireland v. New Zealand rugby matchup the next day, the city was alive and buzzing. The energy of the city undoubtedly seeped its way into the already hyped up leadership conference. Opening the conference was keynote speaker Adam Kreek, an Olympic gold medal rower who took us through his journey rowing across the Atlantic Ocean and his subsequent trials and tribulations. His message on achieving happiness was simple and consisted of the fantastic four: health, relationships, community involvement, and self-awareness. Happiness is not, however, achieved through money, fame, and beauty.

The carefully selected speakers and quality content are what make the NLC one of the best dental student conferences in the country. Every year, Colorado ASDA sends our members to build a network with 600 other dental students while growing and developing as leaders. Although there is nothing like being present at the conference, it is worth sharing some of the gems and takeaways from the breakout sessions. Here are some of my notes from a couple of sessions:

Building Your Personal Brand

By Dr. Ryan Dulde

• A personal brand is a true story about who you are and why you matter. If you don’t know, there is no way anyone else does.
• Brands are not invented. Find something real. Make it intentional.
• Brands set expectations, start relationships, and make you unique.
• Futuredontics conducted a survey to figure out why people go to the dentist. Here are some of the results: 70% go for ratings, 70% education background, 70% location and availability, 80% insurance, 86% scope of services.
• Would you go back to the dentist? Here’s what people are concerned about: 87% say it’s important that the dentists is cost sensitive, 91% want cleanliness, 91% want upfront costs, 93% want options well explained, and 95% want quality work.
• Without a brand you are just a commodity.
• A great brand does not leave its story to chance.

How Not to Fail Miserably in Private Practice

By Dr. Chris Salierno (Chief Editor for Dental Economics)

• It is important to take the pulse of your practice.
• Take a look at your practice daily, monthly, and quarterly to assess how you are doing.
• Daily: How much did you produce? How much did you collect?
• Monthly: Productions, collections, and new patients.
• Quarterly: Income statement, profit and loss statement.
• The overhead monster: the national average for dental office overhead is 75%.
• Goals for overhead by specialty:
• 59% for GP
• 42% for Endo
• 49% for Ortho
• 49% for Pedo
• 50% for OMFS
• 51% for Perio
• 64% for Prost
• Overhead breakdown for GP practice:
• Staff = 25%, Lab = 10%, Rent = 5%, Supplies = 5%, Misc. = 14%, this leaves you with a 41% Net Income.
• Patients don’t care about what you do in their mouth unless it hurts, turns black, or falls out.
• The patient experience starts before you meet them.

This is just a snapshot into the 20+ breakout sessions that were offered over the weekend. Other topics included were mindfulness, non-traditional post graduate options, and effective communication. CE credit was given for each session attended and can be used towards an Academy of General Dentistry Fellowship Award after graduation. The closing session was a story told by Doc Hendley, the founder of Wine to Water, and described his journey through Sudan in an attempt to bring clean water to those in need. Side note: A surefire way to make your dental school problems feel small is to do a little research on the water crisis.

The National Leadership Conference attracts students who are excited about dentistry, want to make a difference, and strive to be better leaders. Valuable breakout sessions, CE credit, and epic five star social events in the evenings are all part of the experience. If you are interested in attending a National Leadership Conference in the future, be sure to ask how you can get involved!

Various professions, trades, and groups of individuals with similar interests have so-called annual “conferences”. Many of these are similarly structured in that they have a “kick-off” session, an inspiring keynote speaker, and various breakout sessions with a myriad of topics. On the surface, the American Dental Association (ADA) annual meeting seems no different. However, any attendees can tell you that attending the ADA Annual Session results in a deeper, more meaningful connection to the dental profession than imaginable.

This year, as a student at the University of Colorado School of Dental Medicine, I was fortunate that the ADA chose Denver as the host for the annual meeting. As supporters of organized dentistry and continual learning, the school administration also chose to close our school to allow enthusiastic students and faculty to attend the conference.

While I knew that over 20,000 individuals with some connection to dentistry attended the conference, along with hundreds of exhibitors, I never anticipated the invigorating effect attending the conference would have on me indefinitely.

As President of Colorado ASDA, I was honored to have a small role in the Opening Session. During the rehearsal, I spoke with several presenters for the Opening Session---all dentists who had overcome adversity in some way to become successful dentists and role models. Their relentless pursuit of dentistry demonstrated to me that our profession is a special one—a profession that people pursue despite numerous financial and personal roadblocks.

After the Opening Session, admittedly, I was overwhelmed with my breakout session choices. The ADA had dozens of interesting breakout sessions, ranging from the use of dental photography and botox for cosmetic cases to the status of global oral healthcare and how to better market yourself. No matter your interest, the ADA had a breakout session with a distinguished speaker for you!

Additionally, throughout the conference, the Exhibit Hall was open where one could learn about the various dental-related products and services available. This too was an educational experience, since all dentists must be thoroughly knowledgeable about the products they are using, the professionals they use for other needs, and the organizations that can help them.

Often, other dental-related groups hold meetings or corollary events during the annual meeting, since so many dentists will be congregated in one place. Our Colorado ASDA chapter also took advantage of this by hosting a private session with Dr. Gordon Christensen (along with the University of Colorado School of Dental Medicine, the LDS Academy and the Metro Denver Dental Society). Dr. Christensen is a pioneer in dental education and world icon in dentistry. We were honored to have him speak to our students and local new dentists. As with other distinguished speakers, he was also in Denver for the ADA Annual Session.

Another highlight for me, as with many others, would be the keynote speaker, Nobel-laureate Malala Yousafzai. As you may know, Malala is a global icon for vocalizing the importance of seeking an education.

At first glance, it may not seem like her cause is directly related to dentistry. But it is. As dentists and future dentists, we are automatically leaders. We are leaders of dental teams. And as professionals who must abide by a code of ethics and seek to do what is in the best interests of the people whom we serve, we are leaders in society.

As leaders, it is our duty to stay engaged in discourse about the status quo and continuously use our influence and respected position to make positive change—not just regarding dentistry, but any other injustice we see fit. As educated, and therefore, privileged individuals, we should never hold back. Instead, we should continuously be proactive to challenge our communities and ourselves.

Attending the annual session is just one way for dental professionals to stay connected with each other, reaffirm their commitment to the profession, and continuously evolve as professionals and people.

I was never much of a coffee drinker when I was younger, but this quickly changed once I got into dental school. Starting with the occasional cup on early mornings, it eventually progressed into a daily routine around Boards studying. I would set the coffee maker to brew the next morning at 6:45am so I could come upstairs to the smell of fresh-brewed, dark roast coffee. Most people—including myself—associate frequent coffee consumption with somewhat of a negative effect – especially esthetically. Staining of teeth and restorations are a common side effect of consistent coffee indulgence. Caffeine is an addictive substance, and can be responsible for withdrawals, producing symptoms such as fatigue and irritability. A person’s circadian rhythm can be affected, which can result in sleep disturbances. What I didn’t realize until reading an article last month in the Journal of the Academy of General Dentistry is that coffee has an incredible number of benefits, summarized as follows:

Liver: Coffee consumption is shown to be inversely related to the development of liver fibrosis. A European study done on over 500,000 men and women over the course of 11 years drew the conclusion that people who consume significant amounts of coffee (3+ cups per day) as opposed to very little (less than 1/2 cup per day) were 72% less likely to develop hepatocellular carcinoma.

Metabolism: Many studies have shown that people who consume coffee on a regular basis are 15-30% less likely to develop Type 2 diabetes.

Mind: The development of Parkinson disease is nearly 25% less likely in males who drink 4 cups of coffee per day, and 40% less likely in women who drink the same amount.

Cancer risk: The presence of chlorogenic acid, an antioxidant that repairs DNA, is likely to explain coffee’s protective effect against numerous cancers.

Heart health & strokes: A negative association has been discovered between coffee consumption and mortality due to heart disease and stroke. This is contradictory to coffee’s short-term side effects of increased heart rate and blood pressure, which is most likely due to the presence of chlorogenic acids and polyphenols.

Kidneys: Protective effects of the kidney associated with the consumption of moderate amounts of coffee, including increased efficiency of kidney filtration. ¹ 

While I’m not advocating for people to start drinking exorbitant amounts of coffee, it is nice to know the great benefits that it offers. More importantly, this is valuable information that we can bestow upon inquisitive patients when asked whether significant coffee consumption can be harmful. Patients will be excited to learn that coffee does more good than harm. So spread the good word on coffee consumption, and go enjoy those pumpkin spice lattes this October!

1. Sideman, L. M., K. N. Eckenrode, I.T. Bloom, & N. Bashirelahi. (2016). What every dentist should know about coffee. Academy of General Dentistry, 64(4). Retrieved from   http://www.agd.org/mtools/imis/contactmanagement/sign_in.aspx?returnurl=/mtools/lqpredirect.aspx&agdredirect= http://www.agd.org/publications-media/publications/general-dentistry/general-dentistry-archives.aspx.

You know that story that you hear from a friend of a friend that their friend was accepted into dental school days before the school year started? Well…that was me. And let me tell you…that was a complete disaster turned serendipitous blessing. However, let me rewind for a hot minute. I had a pre-December interview for CU (cue the excitement). Walking out of the interview, I thought I had nailed it. The interviewer even laughed during it, yet I eventually received the crushing news that I was waitlisted. If I didn’t get in, I wasn’t sure what I was going to do. At the time, I was working for AppleCare as their technology support specialist. I thought about taking a year off and continuing my work for Apple. This would give me ample time to improve my dental resume with more shadowing hours, retake the DAT, rewrite my personal statement, and attend various missions and outreach opportunities. However, on the Wednesday before Orientation Week, I was sitting in Pei Wei enjoying some Pad Thai when I got a call from Barbara telling me of my acceptance…I have never danced for joy as much as I did in Pei Wei at that very moment (and probably scarred some people with my horribly happy dance moves). My future was no longer uncertain! I packed up my entire house in the following two days and left for Colorado on a 16-hour drive from Arizona. Tack on a new apartment search, transportation, endless paperwork, and you can see why my life felt like COMPLETE CHAOS.

Fast-forward two weeks….

I was finally settled in and came to a realization that a mini life crisis had ended. I could now appreciate how amazing CU is and what I had to look forward to for four years. First of all, the campus is beautiful (from the classrooms to the grassy hangout areas). Everyone in my class is a gem, and the upperclassmen are extremely helpful with tips on how to succeed in different courses and wax labs. Thus far, I have learned so much academically – I’ve probably learned more information this month than I have from all of undergrad – and so much about myself. I have learned that my brain will absorb the most information between the hours of 8pm and midnight and that study groups do actually work. Over these next four years, I look forward to growing my involvement in and outside of the school. With all the constant studying, taking a break to volunteer, grab dinner, or even hangout in downtown Denver will definitely benefit the brain and give it a rest. This is a great place to call home right now.

Like many others, not everyone gets into the school of their choice on December 1^st, so I would say:

• Never give up. This is especially true with your personal statement – I can honestly say I went through at least five drafts, with two of those starting completely over. I would suggest asking different types of people (your acquaintance who knows everything about dentistry, your friend who obsesses over rap music, the tutor at your local library, etc.) to read your statement and ask for critical, honest feedback from their point of view. Variety is key. One more thing, I would advise you to not ask for feedback from your parents (at least I didn’t). They might not be the best choice to give you the blunt, constructive criticism you need.
• When people say that the hardest part is getting in, it is true. Once you are in, the faculty sincerely want you to succeed (one of my professors even offered us his lunch hour every day to come in for help for the exam).
• Life throws you curveballs, so take the risk and catch as many as you can. Be adaptable.
• Apply to the school you actually see yourself going to
• If you get waitlisted, write a letter of intent…or many (I wrote about five to Barbara. And yes, the admissions committee does actually read them. On my very first day of orientation, Barbara told me how excited she was for me because she knew how much I wanted it).

Good luck!

A few summers ago, my parents purchased a new German Shepherd puppy named Heidi. Heidi turned out to be a handful, as we soon learned that she was cleverer and more enthusiastic than any of our previous family dogs. For the next few months, we learned how to train a highly intelligent puppy to be obedient without being neurotic, to be playful without using her canine cuspids (ha, geddit?) to greet people, and to accept us into her “pack” (terminology used by the breeders themselves). As she grew, Heidi’s attention span doubled from about two seconds to four. In order to get Heidi to stay focused on learning how to sit, lay down, and heel, the breeders encouraged us to do two things: 1. Use little bits of hot dog as treats. 2. Keep the treats at our eye level and give Heidi the command, “EYES”, every time her attention slipped away to the endlessly more amusing pinecones in our backyard. The moments when Heidi successfully looked us in the eye before learning a new command, her success rate – and hot dog rewards – skyrocketed.

Having next to zero previous training working with patients, performing intraoral and extraoral exams, navigating Axium’s labyrinth, or staying afloat with lectures and lab work, second year of dental school is enough to make me feel uncannily like an untrained German Shepherd puppy. Dental school (the obedience training program) is meant to teach us dental pups how to be competent without overstepping our limitations, to be affable with patients without showing our frustrations, and eventually to be accepted into a highly respected and vital healthcare profession (our very own dental “pack”). As we graduate from first year to second year to third and fourth, our attention spans (hopefully) lengthen from about two hours to ten.

The analogy came full circle to me while listening to Dr. Sutton lecture: “Keep your eyes on me. That’s all you have to do. If you keep your eyes on mine, and your attention on what I’m doing, you will have no choice but to absorb at least eighty percent of what I’m saying. I just need your eyes.” At a time when everything we’re taught is new information and each tidbit could be beneficial for future success in clinic, I’ll gratefully take eighty percent of these dental school “hot dogs” – the skills that can lead to better patient care. While it’s easy to be distracted by fatigue, e-mails, Facebook (heaven forbid), and the Colorado Quickset blog during class, it’s just as easy to keep my eyes on the doctor standing at the front. The game gets easier still when I’m learning in the clinic setting -- undistracted by my shiny computer screen.

Whenever I find my focus slipping because I’ve been sitting in class for six straight hours, all I have to do is think of Heidi’s eyes looking up at me, eager to learn something new, and I am reminded how indispensable her attention is for her success. Attention is simple. If it works for a dog (who is undoubtedly smarter than I am), I trust that it can work for me too.

“Just do it already! Call him!” I say to myself as I pace around my apartment. I think back to my last conversation with J (I’ll shorten my patient’s name for the privacy savvy folk out there): “Have you done this before?” He asks this nervously. “Oh yes, absolutely, I’ve done a ton of these…you’re in good hands.” Sim Clinic counts, right? All the while, my inner voice is taunting me by calling me a phony. I practiced a more eloquent version of that line a few hundred times, anticipating this was going to be the natural progression of our conversation. As hard as I try the ol’ “fake it ‘til you make it” mantra, I am quite certain J knows that he is dealing with a newbie. The phone rings three times and goes to voicemail. I take a deep breath, my faux confidence dominating, and I leave my pre-rehearsed voicemail. Nailed it! All right, I think to myself, let’s try the cell phone. The phone rings once, and then goes straight to voicemail, and I am convinced he ignored my call. At this point, I am preparing myself to listen to another week of elated classmates talk about their first real patient experiences, and it will become increasingly difficult to feign excitement for them.

Exhaustion creeps in after checking my phone every thirty seconds for a return call, and I attempt to go to sleep—my phone just inches away from my pillow. At 7:00 AM, I am roused from sleep by the melodic sound of my ringtone and a surprisingly chipper man on the other end. “Hi, this is J! What floor are we on today!!?” In my head I am thinking, “WHY DIDN’T YOU ANSWER MY CALLS YESTERDAY!?” Restraining myself, I manage to say, “It’s nice to hear from you, J! We are on the second floor today. I hope you’re excited!” If you’re wondering…yes, I really did ask him if he’s excited.

Fortunately, the rest of the story is as smooth as a freshly polished composite. I did not prep the wrong tooth. I did not cause paresthesia. I did not cause a pulp exposure. I did not cut straight through his cheek with my #12 blade (a fun story an instructor likes to tell about a previous student). Instead, I broke my contacts, excavated caries, and filled that class II prep like a boss—all in only 2.5 hours of course!

Entering clinic has been absolutely terrifying, and I wish I could say I was the type of person to jump for joy at the thought of performing irreversible dental procedures on a human being for the first time. You know what I have learned though? It’s okay to be nervous. Unless you’re one of the lucky few whose mother, uncle, brother, or dog is a dentist and you’ve been prepping crowns since your 8^th birthday, understand that it’s okay to be nervous!

After a few weeks in clinic, this fear of the unknown has turned into excitement, and I love my clinical experience! There are so many more “firsts” to come while in dental school, and each time I will hear that inner voice (aka Dr. DeLapp) telling me to put on my “big girl pants” and go for it!