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!

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!

“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!

Dear Class of 2020,

Welcome to the big leagues! Now that you have weathered the long days and (hopefully) fun nights of Orientation Week, the real journey into dental school begins. I would like to offer a few bits of advice as you all navigate the starting blocks of first year.

1. Embrace your variety. The people in your class come from a diverse background. You’ll have those who come from dental dynasties and those who are blazing a brand new trail. You’ll have those who are undergoing a career change and those who are fresh off the college campus. You’ll have those who can speak three languages and those with a killer topspin serve. Everyone in your class has something unique to offer. It may not be obvious this month or this semester, but pay attention and everyone will surprise you at some point over the next few years. That’s the awesome thing about having a small class; you will make friends that you’ll have for the rest of your life.

2. Stop planning for the future. I know this is a difficult one. It’s easy at the beginning to get so caught up in all of the things you have looming in the distant future…a seemingly scary amount of finals, seeing your first patients in clinic, graduation, life as a practicing dentist, etc. Stop it. Live in the present. That’s not to say you should ignore future events altogether, but don’t be consumed by them. Enjoy your time as first years. Even if at times things seem irrelevant or tedious. You will be much less stressed if you take each challenge of dental school one day at a time. (And for the love of all things dental, do not start asking about Boards until at least January…)

3. Take a day off. Memorizing endless anatomy will get stressful, and exams will pile up. You will get tired of burning yourself with wax. You will get frustrated with some of the people around you. When that time hits, give yourself a mental break. Go fishing. Go to a movie. Go adopt a puppy (just kidding, don’t do this on a whim). Take the time to disconnect from school and stress. It’s that reset that is the key to success—not how many sleepless nights you can spend making flashcards.

4. Trial-by-fire is an excellent way to learn. You’ll quickly realize that with dentistry, what is applicable in lecture is limited. You can learn only so much be listening and visualizing. At some point, you just have to do. This can be a frustrating transition, but it’s a transition that will force you to grow and become a better dental student. And this is not just limited to getting your hand skills in lab. Go assist some upperclassmen in clinic. You may not be in the driver seat, but you will learn some lessons that the classroom will never teach you.

5. This is much more than just “school” or the beginning of a “career.” This is the rest of your life. Be extraordinary.

Cheers!

Your ASDA Electronic Editor,

Luke A. Harden

(Shoutout to the nine from Costa Rica '15 for the sand molar...see, you can have fun in dental school)

Oral hygiene is important--no matter how furry you may be. Happy Summer Break to all! --Milo, the Samoyed 

ALL LICENSURE PATHWAYS NOW ACCEPTED IN COLORADO FOLLOWING A STATE DENTAL BOARD POLICY AMENDMENT

DENVER, Colorado—The Colorado Dental Board voted to amend their licensure policy to accept all existing licensure pathways including all regional clinical examinations, PGY-1, hybrid-portfolio, and the OSCE.

ASDA has been working for some time now to make changes to the current licensure model that includes the use of live-patient exams. Little by little, steps have been taken in Colorado to ensure that this change would happen.

In 2013, DORA released a document as part of the Sunset Review stating that one of their top 3 “Key Recommendations” was to revise the clinical examination requirements for the state in order to allow acceptance of alternative licensure pathways including those that do not require a live patient.

In 2014, the state adopted new wording to the Dental Practice Act adding letter C to statute 12-35-119 (1) saying that the state will accept “other methodology, as determined by the board, designed to test the applicant’s clinical skills and knowledge, which may include residency and portfolio models” in lieu of a traditional live-patient clinical exam.

And lastly, just this year, the Colorado Dental Board amended their 1.A Clinical Examination policy to officially accept all existing licensure pathways in the US including all regional clinical examinations (ADEX administered by CITA and CDCA, CRDTS, SRTA, and WREB), the completion of a PGY-1 program or hybrid-portfolio model from the state or jurisdiction where licensure was originally obtained, and the Canadian OSCE for initial licensure, making Colorado the first state to make this change.

Here is what we know:

• You can take any regional clinical examination to apply for initial licensure in Colorado
• You can take the Canadian OSCE to apply for initial licensure in Colorado
• If you went to school in California and were licensed via the hybrid-portfolio model, you can now apply for licensure in Colorado
• If you went to school and were licensed in a state that accepts PGY-1 (a one-year residency), you can now apply for licensure in Colorado

Although some details are not known at this time, this is a huge step forward for licensure reform in the United States.

Stay tuned for updates and more information as we receive it. Get all the news first right here with Colorado ASDA on your number one advocacy blog—the Colorado Quickset.