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Volume IX, Issue 2 August 2009

Page 2 USPHS Dental Newsletter August 2009

In this issue of The USPHSDental Category Newsletter

COVER STORYContinuing Promise 2009…….…….1

FEATURESCPO Column………………….. …….2DePAC Chair Column ……….. …….3DePAC Vice Chair Column … …….4Dental Category Day………… …….6Dental Category Awards…….. …….7

Dental Officers at NI H ………..…..14Clinical Column………………. …....16Senior Officer Spotlight………. ........19Junior Officer Spotlight………..……22Associate Recruiter Program.. ……23

ITEMS OF INTEREST2010 DePAC Nominations……. ……14Welcome CAPT Belcher……………18‘Click’ FAQ…………………… ……20Dental Coin Order Form……..……21Educational Resources………..……24Upcoming Events………………. ……25

NEWSLETTER STAFFCo-Editor CDR Shani LewinsCo-Editor CAPT Todd TovarekConsultant CAPT Coleman Palmertree Consultant CAPT Hsiao Peng The USPHS Dental Newsletter is published 2-3 times annually, and is distributed electronically through the USPHS Dental Bulletin Board, agency distribution lists, and the USPHS Dental Directory. The next issue of the newsletter will be published in the fall of 2009. If you have suggestions or comments about the newsletter, or would like to submit an article, please contact the co-editors CAPT Todd Tovarek at [email protected] or CDR Shani Lewins at [email protected]

CCONTINUINGONTINUING P PROMISEROMISE 2009 2009**

DDAMONAMON A. S A. SMITHMITH, MPH, L, MPH, LIEUTENANTIEUTENANT, USPHS, USPHSSSENIORENIOR R RESPONSEESPONSE P PROGRAMROGRAM M MANAGEMENTANAGEMENT O OFFICERFFICER, OFRD, OFRD

Last summer, the U.S. Public Health Service (USPHS) Commissioned Corps supported three components of an inter-service, interagency Health Diplomacy initiative utilizing U.S. Navy ships in missions designed to increase the operational capacity of U.S. government personnel to deliver humanitarian assistance, perform public health assessments, conduct public health infrastructure repair and provide health care training of indigenous health care workers. The USPHS Commissioned Corps has again been specifically requested to participate in similar training missions, the first of which is the Continuing Promise 2009 mission, which began 01 April 2009.

Continuing Promise 2009 is utilizing the USNS Comfort (T-AH20), a U.S. Navy hospital ship, which will sail for a 120-day period to the Dominican Republic, Antigua, Colombia, Panama, El Salvador and Nicaragua.

Aside from personnel from the Commissioned Corps, the U.S. Navy has engaged partners from other uniformed services and from other partner nations as well as from partner non-governmental organizations.

Continued on page 13

GGREETINGSREETINGS FROMFROM THETHE C CHIEFHIEF P PROFESSIONALROFESSIONAL O OFFICERFFICER FORFOR THETHE DDENTALENTAL C CATEGORYATEGORY

New This Issue!

Bringing it back to the chair – Clinical Column Page 16

Educational Resources & CE Opportunities Page 24

Front Row (L to R): LT Derek Sakris (CDC); LT Mivoyel Jean Paul (ACF); CAPT Carol Lindsey (HRSA); LCDR Gayle Kostyack (IHS); LT Alia Legaux (CDC); LT Timothy McCreary (IHS); CAPT Arturo Bravo, OIC (HRSA) Back Row (L to R): LCDR Steven Sauer (IHS); LCDR Alexis Mosquera (FDA); LCDR Bryan Buss

(CDC); CAPT David Robbins (DHS) Not Pictured: LT Beth Carr (FDA)

mailto:[email protected]?subject=DePAC%20Newsletter







RADM C RADM CHRISTOPHERHRISTOPHER H HALLIDAYALLIDAY

As calendar year 2009 briskly marches on, I hope that everyone is enjoying the summer. It has been a busy summer for the Commissioned Corps and for the Dental Category. We started the summer with the 2009 Commissioned Officer Foundation (COF) Scientific and Training Symposium on June 1 – 4 in Atlanta, GA. Since September 2008, the Category Day co-coordinators and the members of the planning committee were busy selecting lecture topics, inviting guest speakers and developing the agenda for the dental category day. The agenda was a combination of clinical, research and dental public health topics such as dentistry based on evidence vs. evidence-based dentistry, photo-curing in dental procedures, early childhood caries, a panel comprised of CDC oral health providers, and a presentation based upon complications resulting from dento-alveolar surgery. Fostering strong relations with organized dentistry, dental academic institutions and promoting the public-private interface, the category day coordinators contacted the leadership of the private sector dental programs and educational institutions to join the PHS Dental Officers for the day. Honored guests included representatives from national, state and local dental associations as well as executive leadership and faculty from dental academic institutions. The combination of clinical, community-based and research lecture topics pertinent to the practice of public health dentistry, coupled with an impressive turnout of dental providers, resulted in a category day session which fostered an atmosphere of collaboration and promoted participant interaction during each lecture topic. Thank you to all who participated in the planning process of the 2009 COF Category Day. The day was a great success and I would like to encourage anyone interested in helping with the planning of the 2010 COF Category Day to please contact CAPT Coleman Palmertree soon – it’s never too early to start the planning process!

On June 19, 2009, Dr. Howard Koh was confirmed as the Assistant Secretary for Health (ASH). Dr. Koh, the former Massachusetts Public Health Commissioner and an Associate Dean for Public Health Practice and Director of the Division of Public Health Practice at the Harvard School of Public Health, will oversee major health agencies under the Department of Health and Human Services (DHHS). Dr. Koh will also serve as the leading health adviser to the HHS Secretary, Kathleen Sebelius.

In an effort to facilitate communication between Office of Commissioned Corps Force Management (OCCFM) and the PACs, OCCFM has assigned a staff member to serve as liaisons to the PACs. The OCCFM liaison for the DePAC is CDR Paul Wong, a dental officer, who will provide general policy related information to the DePAC as well as provide OCCFM Leadership with information from the dental category. CDR Wong is a strong advocate for the dental category and has worked on numerous dental pay related policies with RADM Halliday. CDR Wong will be joining us periodically on our monthly DePAC conference calls and will be a point of contact on policies matters impacting the Commissioned Corps as well as our category.

According to the June 30 readiness report issued by the Officer of Force Readiness and Deployment (OFRD), dental was 94.82%, down slight from our category’s Mach 30, 2009 readiness of 95. 62%. While I would have liked to have seen our readiness numbers rise to an all-time high with the last report, the dental category still commands an admirably high number of members meeting readiness. Thank you to all who maintained your readiness status and a special note of thanks to the Readiness and Deployment Workgroup for the quarterly savvy readiness reminders.

On June 23rd, I met with American Dental Association Council on Access, Prevention and Interprofessional Relations (CAPIR). During the meeting, the Council and I discussed the challenges facing the dental programs under Department of Health and Human Services, Department of Justice and the Department of Homeland Security, and I was encouraged by the showing of support from the members of the CAPIR. During the visit to Chicago I was also able to meet with the new Executive Director of the ADA, Dr. Kathy O’Loughlin, and I was excited by the enthusiasm and energy that she is brining to the ADA. The ADA continues to be a strong


advocate for our dental public health programs and I am grateful for the support that the Association has provided.

I was recently honored to co-teach at the Gorgas Institute, in Panama, a train-the-trainers workshop on caries prevention for communities in Central America. The three-day long course was offered in cooperation with the Pan American Health Organization (PAHO) and the Department of Health and Human Services, and was an adaption of techniques and curricula developed by the Indian Health Service on oral health promotion/disease prevention methodologies. A key aspect of the training was discussion about community-based oral health programs and the goal was that at the completion of the course, those trained would be able to apply skills learned during the training in their own communities. Thirty-eight dentists attended the training and PAHO has indicated that they would like to offer the course again in South America as well as in the Caribbean. I am optimistic that there will be future opportunities for dentists from our category to assist in such training, and the materials have great potential for use during Health Diplomacy deployments.

I would like to express my sincere appreciation to each and every one of you for your contributions and dedication to the Dental Category and to the U.S. Public Health Service. Thank you for all that you do to protect, promote and advance the health and safety of our nation!

Have a safe and wonderful summer!

DDENTALENTAL P PROFESSIONALROFESSIONAL A ADVISORYDVISORY C COMMITTEEOMMITTEE CCHAIRPERSONHAIRPERSON C COLUMNOLUMN,,CCAPTAINAPTAIN C COLEMANOLEMAN P PALMERTREEALMERTREE

Hello and welcome to all dental officers in the PHS, both active duty and retired Commissioned Corps officers as well the dedicated civil servants and contract dentists who are giving care in many agency sites and facilities across the country and world.

Where is the year going? It seems like we just started and yet, here it is summertime. First let me extend a very big thank you to all of the officers and leadership who support each other and our mission in the field. RADM Halliday has shown great patience and mentoring abilities by helping me this year and CDR Phillip Woods, DePAC vice char, CAPT Bill Stenberg, DePAC secretary, and our past chairs have also been invaluable resources with their insight and vast institutional knowledge. Each of the voting members of DePAC, Ex-Officios and Guests are steadfastly committed to improving our category and advancing the mission of the PHS. It is a very humbling experience to see the dedication and selflessness of the dental officers in our organization. There is not a day that goes by that I am not reminded of the hard work and extra hours given freely by our dental officers to further the mission of their local program and the PHS mission at large, “Protecting, Promoting, and Advancing the Health and Safety of the Nation.”

This year DePAC is attempting to reach out to more dental officers. Our goal is to make communications more open, both into and back from the field in an effort to facilitate support and encourage resource sharing. Our efforts this year include active involvement of all dental category agency leadership with invites extended to each of the DePAC meetings with time allotted for their input and discussion. The PAC also intends to broaden the Newsletter to include more information than ever concerning relative and timely events, updates that dental officers may need for their local missions, and opportunities that exist regarding continuing education and pertinent dental conventions. The Inactive Reserve Commission is being assisted by DePAC in organizing and


obtaining contact information for its membership in an effort to make a readily available pool of officers to meet emergent and urgent needs in the field when they arise. A Career and Development Guide for officers is under construction, with the new officer portion nearing completion. Work on national level awards for deserving officers is a continual process all year. The Dental Category website has been constantly undergoing changes and with the migration of new website formats will undergo extensive changes under new Web Masters in the months ahead. Minority and Women Issues are constantly being reviewed and new avenues to assist officers continue to develop related to awards through increased collaborations with similar stakeholders and the development of training modules. A new Gold CAM group from OCCO is working closely with DePAC to aid new dental officers and agencies make smooth transitions into PHS. A new mentoring system as well as a new Associate Recruiter Program have been developed to assist prospective new officers prior to and after their entry into the PHS dental category.

I’m looking forward to a productive year and I’m honored to serve with such a dedicated cadre of professionals.

DDENTALENTAL P PROFESSIONALROFESSIONAL A ADVISORYDVISORY C COMMITTEEOMMITTEE VVICEICE C CHAIRPERSONHAIRPERSON C COLUMNOLUMN

PPHILLIPHILLIP W WOODSOODS, DDS, MPH, , DDS, MPH, BOP NBOP NATIONALATIONAL P PERIODONTALERIODONTAL C CONSULTANTONSULTANT

When I started this year, I knew it would be an adventurous, “full out” one for me. I’d need to work hard to learn as much as possible about the policies, procedures, and diverse components of the DePAC; I’d also do my best to support CAPT Palmertree as his Vice-Chair, often conversing daily - all while maintaining my daily responsibilities at my BOP PHS duty station. Some six months later I must admit it's really been a great year for me thus far. I’ve had the unique opportunity to meet many of you through our monthly DePAC teleconferences, through our Work Group and Subcommittee meetings, and as part of planning for regional and national meetings. I'm proud of the work DePAC is doing and I certainly realize none of this work would be possible without your! In the spirit of a more focused effort to disseminate important clinical information to the Dental category, I’ve enclosed a brief synopsis of an emerging discipline in the field of periodontics. Perhaps it will whet your appetite sufficiently to seek a more detailed discussion of the topic.

TTHEHE E EMERGINGMERGING D DISCIPLINEISCIPLINE OFOF P PERIODONTALERIODONTAL M MEDICINEEDICINE**BBYY P PHILLIPHILLIP W WOODSOODS, DDS, MPH,BOP N, DDS, MPH,BOP NATIONALATIONAL P PERIODONTALERIODONTAL C CONSULTANTONSULTANT

As a dental specialty, Periodontics has come a long way in recent decades. Significant research has shed light on the pathogenesis, risk factors, and the impact of systemic conditions on periodontal diseases. Several World Workshops in Periodontics were convened in the last two decades, providing the profession an opportunity to re-evaluate the art and science of Periodontics, and to support only

evidenced-based periodontal therapies.[i] New nomenclature systems emerged for classifying the periodontal diseases.[ii] All of this growth is notable when one considers the fact that as recently as the 1960s, bacteria still had not been widely recognized as the cause of what was then known as periodontal disease, or pyorrhea.[iii]


A landmark 1989 paper introduced the association between oral infection and systemic disease, supported by sound, scientific methods.[iv] Subsequent studies by DeStefano, Neck, Offenbacher and others supported the idea that Periodontitis might confer independent risks for systemic conditions. At the 1996 World Workshop in Periodontics Offenbacher introduced the term “Periodontal Medicine”, describing it as a “discipline focused on validating this disease relationship and its biological plausibility in human populations and animal models”.[v]

We’re all aware that Periodontitis is an oral disease for which risk factors include smoking, specific plaques bacteria and diabetes mellitus. Earlier thinking supported the notion that the link between systemic disease and periodontitis was unidirectional, that the diabetes caused periodontitis in certain diabetics. However, recent studies have revealed that this relationship may be bi-directional, such that improving a patient’s periodontal health might lead to improved glycemic control in diabetics. Certain cross-sectional and case control studies demonstrate that periodontal diseases may increase risks for a number of systemic conditions.[vi]

What systemic conditions have been associated with periodontal diseases?

Key researchers in periodontal medicine have described the following[vii]:

Tobacco use is a major risk factor for periodontal disease. A smoker's risk of developing periodontal disease is increased anywhere from 2 to 10 percent, depending on the amount that person smokes.

A person’s genetics can amplify or reduce the severity of periodontal disease. High production levels of interleukin-1 (IL-1) – which indicate that people may be more susceptible to severe periodontal disease – run in families. A genetic test now can determine if a person has this genetic marker, and this knowledge could provide further information about a patient's prognosis.

Eighteen percent of all pre-term, low-birth-weight births may be attributable to periodontal disease.

People with severe periodontal disease may be twice as likely to have the type of stroke caused by blocked arteries as those with good oral health.

People with severe periodontitis may be more than six times as likely to have poor glycemic control as those without periodontal disease.

Decreased bone mineral density and osteoporosis appear to be related to tooth loss. Hormone replacement therapy seems to be effective in saving teeth.

Where are we now?

Since the introduction of periodontal medicine, many in the field have moved quickly to assign “causation” to these systemic conditions - for example, describing periodontitis as the cause of pre-term, low-birth weight. However, most studies have only been able to demonstrate that these conditions are “associated with”, versus “caused by” periodontitis. Future research will indeed shed more light in this area.

What can we expect from future research?

In the future we can expect to see physicians working more intimately with dental professionals as they treat periodontal conditions and the systemic conditions to which they have been linked, such as diabetes, cardiac disease, adverse pregnancy outcomes and osteoporosis. Through their collaborative treatment efforts, we can expect to see not only improved oral health but systemic health as well in our patients.

As dental professionals it is our job to stay informed on the latest advances in this emerging area of periodontal medicine. Rest assured that our patients will have questions to ask about it. Only by keeping informed and providing our patients with science-based therapies will we be able to provide the best care possible, and ensure that we indeed “do no harm”.


These are exciting times for our profession. For more information, please visit the website of the American Academy of Periodontology at www. Perio.org Stay tuned!

[i] Annals of Periodontology Volume 1: 1996 World Workshop in Periodontics.

[ii] Annals of Periodontology1999; Volume 4:1-6.

[iii]"Periodontal Medicine in the Next Millennium: Implications for Clinical Practice," Dr. D. Walter Cohen; 1999 Harvard/AAP Symposium.

[iv] Mattila K et al. Association between dental health and acute myocardial infarctiion. Br Med J 1989;298: 779-782.

[v] Offenbacher S, Katz V, Fertik G et al. J Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996:67: 1103-1113.

[vi] Paquette DW, Madianos P, Offenbacher S, et. al. The Concept of "Risk" and the Emerging Discipline of Periodontal Medicine. J Contemp Dent Pract 1999 Oct;(1)1: 001-008.

[vii] "Periodontal Medicine in the Next Millennium: Implications for Clinical Practice," Dr. D. Walter Cohen; 1999 Harvard/AAP Symposium.

USPHS DUSPHS DENTALENTAL C CATEGORYATEGORY D DAYAYBBYY CDR R CDR ROBERTOBERT C. L C. LLOYDLOYD J JRR., S., SUPERVISORYUPERVISORY D DENTALENTAL O OFFICERFFICER (C (CLINICALLINICAL P PROGRAMSROGRAMS))

FFORTORT D DEFIANCEEFIANCE I INDIANNDIAN H HOSPITALOSPITAL, F, FORTORT D DEFIANCEEFIANCE, AZ, AZ

“Leading a Strong Public Health Workforce for a Healthy America” was the theme for this year’s USPHS Scientific and Training Symposium in Atlanta, GA. The Dental Category Day was a tremendous experience for everyone in the audience and began with a call to order by the DePAC Chair CAPT Coleman Palmertree and Chief Dental Officer, RADM Chris Halliday. They enthusiastically welcomed all of the dental officers and guests from organized dentistry and dental schools and reminded everyone about the unique opportunity this meeting offered to network with colleagues, obtain valuable dental public health and clinical knowledge, and ultimately improve themselves as dentists while strengthening the Dental Category.

The Dental Category Day started with a presentation by RADM Isabel Garcia entitled “Dentistry Based on Evidence vs. Evidence-Based Dentistry”. She is the Deputy Director of the National Institute of Dental and Craniofacial Research (NIDCR), one of the Institutes of the National Institutes of Health. RADM Garcia (pictured right) described the basic elements for evidence-based dentistry, gave examples of selected clinical procedures and their level of evidence and

described the role of Public Health Service programs in promoting evidence-based approaches.

Dr. Fred Rueggeberg, from the Medical College of Georgia School of Dentistry presented on “Photocuring in Dentistry - Providing Optimal Results”. Dr. Rueggeberg is currently a tenured Professor and Section Director of Dental Materials in the Department of Oral Rehabilitation at the Medical College of Georgia School of Dentistry. He provided information about the successful use of a light-curing unit in dentistry and a range of clinically useful techniques to optimize chair side results. He explained the light tip positioning during exposure with a light-curing unit, minimizing intrapulpal temperatures when a tooth is exposed to a light-curing unit and proper evaluation of light unit output.

http://www.Perio.org/


The Dental Category was honored to have Dr. Gary Rozier (pictured left) deliver the David Satcher Keynote Lecture. Dr. Rozier is a Professor of Health Policy and Management at the University of North Carolina at Chapel Hill Gillings School of Global Public Health where he directs the

program in dental public health. He finished the morning session with a review of scientific evidence in supporting early childhood caries (ECC) prevention programs. He described the effectiveness of individual and community based programs in helping to reverse national trends with early childhood caries.

Lunch provided an opportunity for everyone to met and reunite with old friends. During lunch, the entire Dental Category went outside the meeting room to have several pictures taken with Acting Surgeon General RADM Steven Galson. RADM Galson congratulated the entire Dental Category for their achievements as a category since the last Symposium. Following lunch, officers from the Dental Category were recognized at the awards presentation (see following article).

The afternoon session started with a panel of five dentists from the Centers for Disease Control and Prevention from this host city (Atlanta, GA) discussing some topics of significance. The moderator for this session was CAPT Carolyn Tylenda. The five dentists provided their subject matter expertise in their focus areas with the CDC. The five dentists and their subject matter were: CAPT William Bailey, School Based Sealants; CAPT Monina Klevens, Hepatitis; CAPT Michael Campsmith, HIV; Dr. Valerie Robison, Tuberculosis and Dr. Jennifer Cleveland, Influenza (H1N1).

The afternoon session concluded with Dr. Steven Roser providing information about “Complications with Dentoalveolar Surgery”. Dr. Roser is the Chief for the Division of Oral and Maxillofacial Surgery at the Emory University School of Medicine in Atlanta, GA. He lectured about the management of displaced teeth and oral-antral communications (sinus exposures).

All participants really enjoyed themselves for the entire 2009 Dental Category Day. Please remember to make a note on your calendar for the May 2010 USPHS Symposium in San Diego, CA. Updates on meeting dates and location will be posted at: http://www.phscofevents.org

DENTAL CATEGORY AWARD RECIPIENTSDENTAL CATEGORY AWARD RECIPIENTSTTHEHE D DENTALENTAL C CATEGORYATEGORY AWARDSAWARDS WEREWERE PRESENTEDPRESENTED ATAT THETHE 2009 USPHS S 2009 USPHS SCIENTIFICCIENTIFIC ANDAND

TTRAININGRAINING S SYMPOSIUMYMPOSIUM HELDHELD ININ A ATLANTATLANTA, G, GEORGEEORGE. C. CONGRATULATIONSONGRATULATIONS TOTO THETHE DESERVINGDESERVING DDENTALENTAL O OFFICERSFFICERS WHOWHO WEREWERE RECIPIENTSRECIPIENTS OFOF THETHE AWARDSAWARDS!!

Ernest E. Buell Dental Award

CDR Shani Lewins is the recipient of the 2009 Ernest Eugene Buell Dental Award. CDR Lewins is a 2000 graduate of the State University of NY at Buffalo. Following graduation, she spent two years in a dental general practice residency

program and expanded her knowledge and experiences in a trauma level 1 hospital at the Wake Forest University Baptist Medical Center (USMMA). In 2004, she joined the U.S. Public Health Service Commissioned Corps and was assigned to the U.S. Coast Guard at the U.S. Merchant Marine Academy to provide comprehensive dental care and after-hour emergency care to over 900 Midshipman. A strong advocate for preventive traumatic dental injury, she collaborated with the Department of Athletics at USMMA to provide custom mouth guards for both

http://www.phscofevents.org/


varsity and club sports. Despite the demands of her position she has continued to participate in DePAC activities and serve as the Co-Editor of the DePAC Newsletter helping bring a fresh and exciting new look to the publication. She exemplifies the characteristics of a Junior Officer in the USPHS.

Ruth Lashley Mid-Career USPHS Dental Award

CAPT Gary Pannabecker is the co-recipient of the 2009 Ruth Lashley Mid Career Award. CAPT Pannabecker received his commission with the United States Public Health Service (USPHS) in 1995 to began an exceptional career with

the Indian Health Service (IHS) at Browning, MT. His efforts to promote fluoridation in the new community water system serving the 5000 residents of the Blackfeet Reservation will have a long term impact on public health. He collaborated with the Montana Special Health Services agency on the Northwest Montana Cleft Palate Clinic at the Blackfeet Community Hospital. In addition to his clinical responsibilities, he also serves as adjunct clinical professor at the University of Louisville School of Dentistry, University of Texas Health Science Center at San Antonio, and Boston University School of Dentistry. He is not only a dedicated clinician and administrator; but he is also a motivated Public Health Service officer. He served as the Chair of DePAC in 2005 and as the Vice Chair in 2004. In 2005, he was deployed to New Orleans after Hurricane Katrina to ensure civilian hospitals remained operational and served on the Katrina Dental Response Group. In 2004, he represented the USPHS in a deployment with the Department of Defense to Camp Pendleton providing comprehensive exams and routine treatment for Marines being deployed to Iraq. He earned the Field Medical Readiness Badge and two Crisis Response Ribbons in recognition of his deployment contributions. His efforts have consistently resulted in exceptional performance and have led to a positive impact on the USPHS and the IHS.

CAPT William Stenberg is the co-recipient of the 2009 Ruth Lashley Mid-Career Dental Award and has made exceptional contributions to improving the oral health care for American Indians/Alaska Natives and Coast Guard personnel. CAPT Stenberg is board certified by the American Board of Periodontology, a rigorous certification process

that only about 33% of periodontists accomplish in their careers. CAPT Stenberg completed a Masters in Public Health degree, and he is currently enrolled at the Northeastern State University for a Masters Degree in Education/ Biology to further enhance his teaching skills. After serving with the US Navy for three years and teaching Periodontology at the University of the Pacific for 12 years, CAPT Stenberg joined the USPHS with his first assignment with the Indian Health Service (IHS) at Tahlequah, OK. At Tahlequah, he served as an instructor in the Advanced General Practice Residency program at Hastings Indian Medical Center (HIMC). He developed a comprehensive periodontal curriculum to allow each resident to improve a variety of surgical and non-surgical periodontal skills thereby increasing the periodontal services available to the IHS patients. He has also taught in the Navy Periodontal Short Course in Bethesda, MD and is currently on the team developing the Navy Periodontal Correspondence Course. His involvement with DePAC to include but not limited to – served as a mentor on the Mentoring Workgroup, served as the Executive Secretary for two years, and was selected to serve as voting member since 2007. He has served as an Associate Recruiter and participated in recruiting booths at national meetings and dental schools. He has also served on the Commissioned Corps Music Ensemble for three years, performing at multiple national meetings. He has received the Field Medical Readiness Badge and served as the Admin/Finance chief of the Rapid Deployment Force Team #4. He volunteered with the Cherokee County Oklahoma Emergency Management team during his tenure at Tahlequah, OK. In his current


billet with the U.S. Coast Guard, he is responsible for maintaining the dental readiness of Coast Guard personnel in the Kodiak area which he has maintained at or near the 90% threshold since his arrival in 2008. He also serves as the Infection Control Committee chairman and Radiology Safety officer. In 2008, he volunteered for an international exchange/ Japanese language academic program in Japan in preparation for Asian deployments which proved to be valuable as he recently completed an International Engagement/Enforcement Patrol aboard the USCG Cutter Munro. Throughout his career, he has responded to challenging situations with creativity and innovation. His efforts have consistently resulted in exceptional performance and have had a positive impact on the USPHS. He is a highly motivated officer who is looked up to by his peers as a leader and a role model.

Senior Clinician Award

CAPT George Bird is the recipient for the 2009 Senior Clinician Award. Upon graduation from the University of TX San Antonio, he entered the USPHS in 1989 with the Indian Health Service (IHS) at the Yukon Kuskokwim Health Corporation in Bethel,

AK. In 2004, he completed the IHS Advanced General Practice Residency at Gallup, New Mexico. Upon completion of the residency program, he was selected as the Deputy Chief of the Tanana Chiefs Conference in Fairbanks, Alaska and two years later was selected as the Chief. As a senior officer with sixteen years of experience, he exhibits program accomplishment through the exceptional management of a large, complex IHS clinic. His management of the dental program includes the supervision and mentoring of twenty nine tribal employees and five commissioned officers. Also, he is able to utilize skills acquired in the residency program to make notable improvement in clinical areas. Due to the cost of referral from a remote location, he functions as a de facto pediatric specialist for the service unit of 16,000 patients and

provides all aspects of dental care including one month of field travel per year. In addition to his clinical duties, he also served as the Acting Area Dental Officer for Alaska and provided support to all the Alaska service units. He has received numerous PHS awards throughout his career for his accomplishments and contributions to the Commissioned Corps. He was selected to serve as a voting member of the DePAC from 2005 to 2007 and served as the Executive Secretary for the DePAC in 2005. His exemplary career reflects his tremendous personal drive and deep dedication to the mission of the USPHS.

Hershel S. Horowitz Oral Health Research and Policy Award

CAPT Rosemary Duffy is the recipient of the 2009 Hershel S. Horowitz Oral Health Research and Policy Award. CAPT Duffy began her distinguished career as an officer in the US Public Health Service Commissioned Corps in 1990 with the Health

Resources and Services and Administration (HRSA) as a dental officer in the Dental Education and Special Initiatives (DESI) Branch, Division of Associated, Dental, and Public Health Professions (DADPHP), Bureau of Health Professions. While in DESI branch, she developed, implemented and conducted the Ryan White HIV/AIDS Dental Reimbursement Program which was then a new legislated program. This Program supported access to oral health care for individuals with HIV infection by reimbursing dental education programs for non-reimbursed costs incurred in providing such care. She also managed the Advanced General Dentistry Grant program which supported the development of new programs and first-year positions in postdoctoral general dentistry education. As Deputy and Acting Director she provided expertise and leadership in planning, developing, coordinating and, evaluating nationwide programs for health professions resource in the dental, allied, chiropractic, medical,


geriatric and public health fields. In 1997, she was assigned to the CDC in Atlanta, GA where she began her training as an Epidemic Intelligence Service Officer (EIS) in the National Center for Infectious Diseases, Division of Healthcare Quality and Promotion. As an EIS Officer, Captain Duffy worked with the Food and Drug Administration (FDA) to identify defective tubing as the cause of a series of serious illnesses and deaths among patients receiving dialysis treatment in three states. The defective tubing was recalled by the FDA and further cases of illness were averted. CAPT Duffy was involved in the Romania hepatitis B study, and the surveillance data suggested that a substantial proportion of acute hepatitis B cases were attributed to dental care. She was asked to work with the CDC Divisions of Oral Health and Hepatitis and the Romania Ministry of Health to evaluate infection control knowledge and practices, to provide training on universal/standard precautions, and to develop strategies to improve infection control knowledge and practices among dental healthcare personnel in Romania. Each of these investigations has had far reaching public health effects not only in the United States but in other countries as well. All these studies have been published and have contributed greatly to decreasing mortality and morbidity. In1999, she was assigned to the Division of Prevention (DOP), Ohio Department of Health (ODH) to assist the state health department in the use of population-based health data to plan and evaluate health promotion and disease prevention efforts, set priorities, and to develop sound public policy while helping to strengthen the state's chronic disease epidemiology capacity in the long term. She has helped develop and implement a plan to train epidemiologists to develop dataset-specific expertise and then share that expertise across chronic categorical (i.e., diabetes, asthma, injury, CV) programs. She assisted with several reports describing the burden of chronic disease on Ohioans. She also has a wide variety of other duties such as assisting the state in preparing for the pandemic flu, working with the Data/Research Committee, and serving on the Director's Advisory Committee on Emerging Infections and supervising Ohio’s EIS officer.

Her career in PHS spans the gamut of management/administration of federal programs, health service research and epidemiology. She has distinguished herself and represented the PHS with the highest standards. She takes pride in her work and continues everyday to try and improve the health of the Nation.

Dental Responder of The Year

CAPT Bob Smith is the recipient of the 2009 Dental Responder of the Year Award. CAPT Smith is the Deputy Area Dental Officer for the Oklahoma Area responsible for the day to day operation of the dental branch in the Office of Health Care Systems.

In addition to his duties, he is the primary consultant for the Medical Imaging Program and Women’s and Children’s Health. CAPT Smith provides consultation services to the federal, tribal and urban dental programs in the Oklahoma area. He is a model PHS officer and has represented the dental category on numerous deployments and has served in the capacity of the Director of Operations for the Gold Team of RDF #4. During his time with the RDF #4 team, he was involved in creating the Standard Operating Procedures for the Planning Section. These documents are still being used by all of the RDF team for deployments. He was deployed to South Florida for Hurricane Wilma in 2005 and was selected to serve as Officer in Charge of a Medical team. The mission of teams is to establish medical units in areas without medical service. He was deployed with the US Navy on the USNS Comfort in 2007 (Partnership of the Americas). During his time on the USNS Comfort, he was selected as the Dental Officer in Charge at the treatment sites and utilized his proficiency in Spanish to enable the US Naval Seabees to contract with a local contractor to drill and build a well to supply a Health Clinic with running water for the first time in 5 years. He was again deployed with the US Navy on the USNS Mercy in 2008 (Pacific Partnership 2008). During this deployment, he was selected to participate in the first Remain Overnight


mission authorized. His team was flown to the Island of Samar in the Republic of the Philippines and stayed for 16 days providing treatment to the people of the Island. CAPT Bob Smith is recognized for his dedication and contribution to further the mission of the U.S. Public Health Service.

Jack D. Robertson Dental Award

CAPT William Bailey is the recipient for the 2009 Jack D. Robertson Dental Award. His distinguished career spans five geographic and programmatically diverse assignments where his superior performance and willingness to assume additional responsibilities

has been recognized. CAPT Bailey’s unwavering commitment to the mission of the PHS is evidenced through his work with four agencies: the Health Resources and Services Administration, Bureau of Prisons, Indian Health Service (IHS) and Centers for Disease Control and Prevention (CDC). These assignments have demonstrated a progression in complexity and scope that should serve as the model for young leaders serving in the PHS. He began at the staff level with local responsibilities and progressed to the position of Area Dental Officer, managing twenty-two dental programs and one hundred fifty personnel across a four state region. His current assignment at CDC’s National Center for Chronic Disease Prevention and Health Promotion affects public health systems serving citizens of every state across the nation, building infrastructure for state oral health programs and extending the reach of community preventive strategies to improve oral health. He earned a

Masters degree in Public Health at the University of North Carolina in 1992 and completed a Dental Public Health Residency in 2003. He completed these programs while continuing to work full time in demanding billets. His thorough mastery of requisite knowledge was demonstrated by attaining Board Certification in 2004. Additionally, his abilities as a leader in the PHS are illustrated in job accomplishments across a wide variety of assignments. Recently, in special assignments to DHHS outside of his regular CDC billet, he has demonstrated great initiative and judgment in difficult circumstances. In 2005, he deployed to Baton Rouge, Louisiana in response to Hurricane Katrina as part of the Secretary’s Emergency Response Team. In 2007, he was hand-picked to serve as a key member of a ten-person pre-deployment site survey team to make arrangements for the USNS Comfort’s 120-day humanitarian mission to 12 Latin American and Caribbean ports. In this role he provided advice directly to the Navy’s Southern Command, and met with local officials in Columbia, Peru, Ecuador, Guyana, Trinidad, and Tobago to assess potential sites and recommend appropriate dental procedures. His excellent planning of this complex endeavor resulted in a very successful mission of “health diplomacy”.

For the past year, he has served as acting team lead for CDC’s oral health program services, even as he continues to serve as the agency’s primary official responsible for reviewing scientific reports and translating their findings into information used by health advocates across the nation to promote community water fluoridation. These accomplishments would not be possible without his dedication, compassion, humility, and sense of humor. He has brought great credit upon himself and the U. S. Public Health Service.


AADDITIONALLYDDITIONALLY, , THETHE DENTALDENTAL OFFICERSOFFICERS LISTEDLISTED BELOWBELOW WEREWERE RECOGNIZEDRECOGNIZED FORFOR THEIRTHEIR SERVICESERVICE ANDAND EXEMPLARYEXEMPLARY PERFORMANCEPERFORMANCE BYBY THETHE USPHS, H USPHS, HISPANICISPANIC

OOFFICERSFFICERS A ADVISORYDVISORY C COMMITTEEOMMITTEE ANDAND A ASIANSIAN P PACIFICACIFIC O OFFICERSFFICERS C COMMITTEEOMMITTEE RESPECTIVELYRESPECTIVELY::

USPHS Special Assignment Award

CAPT David LaBadie

CAPT Hsiao Peng

CDR Lynn Van Pelt

Hispanic Officers Advisory Committee Award

CDR Reginald Ballard - Juan Carlos Finlay Award for career dedication to the mission of the Division of Immigration Health Services

CDR Maria-Paz Smith - Juan Carlos Finlay Award for support of humanitarian missions.

Asian Pacific American Officers Committee Award

LCDR Minh Kevin Lee - RADM Kenneth Moritsugu Junior Officer Award

On Behalf of RADM Christopher Halliday and the DePAC - Congratulations to all the 2009 Awards Recipients!

ANNOUNCEMENT OF THE 2010 DENTAL PROFESSIONALANNOUNCEMENT OF THE 2010 DENTAL PROFESSIONAL ADVISORY COMMITTEE AWARDS NOMINATION CYCLEADVISORY COMMITTEE AWARDS NOMINATION CYCLE

The DePAC is pleased to announce the 2010 DePAC Awards Cycle. Nominations for the Dental Category awards are now being accepted. The DePAC requests that you nominate a fellow dentist in the USPHS, either Commissioned Corps or Civil Service. Please pass this information along to colleagues and to supervisors from all agencies so they can recognize deserving candidates.

Detailed nomination information including application, checklist, and example narrative can be found on the Dental Professional Advisory Committee Awards webpage at: http://www.phs-dental.org/depac/newfile30.html

Important points to remember:

Deadline for submission is September 15, 2009

Submit early to ensure all documents have adequate review time

Maintain OFRD readiness status throughout the nomination process

Submit all documents electronically in Microsoft word rich text format

Supervisor’s approval required (e-mail from supervisor with signature block)

If you have questions, contact Awards Workgroup Co-Chairs CDR Darla Whitfield ([email protected] ) or CDR Angie Roach ([email protected] ).

mailto:[email protected]


http://www.phs-dental.org/depac/newfile30.html


Anyone can nominate! Recognize your colleagues!!!CCONTINUINGONTINUING P PROMISEROMISE 2009 – 2009 – CONTINUEDCONTINUED FROMFROM PAGEPAGE 1 1

The Office of Force Readiness and Deployment (OFRD) has provided significant planning input on behalf of the USPHS. The plan is to provide sequential detachments of Corps officers for rotations lasting roughly 28-35 days aboard the ship who will travel to Miami, FL, board a U.S. Navy NALO flight to the ship and remain associated with it for the duration of their rotations. The U.S. Navy is paying all travel costs associated with deploying USPHS Commissioned Corps officers. Thus, Agencies in which Corps officers are assigned will NOT have to pay these travel expenses. As with other uniformed personnel, once embarked on the ship, USPHS commissioned officers will need to turn over their monthly subsistence pay to the ship in order to offset the cost of the meals provided.

OFRD intends to provide 4 successive, pre-configured teams of USPHS officers for this mission. Below is a breakdown of the types of officers needed for each of these teams:

Physicians (Primary Care/Preventive Medicine/Infectious Disease)

Nurse Practitioners/Physician Assistants Health Educators (multi-disciplinary)

including Dietitians, Therapists, Nurses Environmental Health Officers Engineers Dentists Dental Hygienists Pharmacists Veterinarians Epidemiologists

In addition to the pre-configured public health detachments, CAPT Arturo Bravo, a dental officer with the Health Resources and Service Administration is serving as the USPHS Office-in-Charge (OIC) for the duration of the 120-day mission. CAPT Bravo previously deployed as a dentist aboard the USNS Comfort (T-AH20) for Continuing Promise 2007. In addition, each detachment will also include a junior officer (O-2 to O-4) to serve as the executive assistant/public

information officer (EA/PIO) to assist the USPHS OIC. LT Mivoyel Jean Paul, a health services officer with the Administration for Children and Families is currently serving as the EA/PIO for Detachment 1. Both the OIC and the EA/PIO may be from any category within the Commissioned Corps.

Finally, the U.S. Navy may also request additional officers to augment ship personnel for specific mission legs to meet identified needs in certain countries. Officers filling these roles may include optometrists, epidemiologists, physical therapists, dieticians, and scientists.

Each officer selected for Continuing Promise 2009 is expected to meet specific pre-mission requirements, including:

Meeting and maintaining Basic Readiness standards;

Supervisor/Agency consent; Possession of an Official (Maroon) Passport

in time to obtain any required visas; The absence of any current or pending

adverse actions; Submission to OFRD of a full-body digital

photograph in with the officer is standing in Service Khaki uniform, Summer White or BDU’s, and;

CPO concurrence (obtained by OFRD once other requirements are submitted).

In addition to the above requirements, officers selected for these missions will have to complete some additional web-based modules specific for ship-based missions in international environments. The uniforms for this mission are based on the operational needs of the mission.

The countries involved require visiting health care providers to submit credentials for in-country review prior to an intended visit. Some of the countries require this to be done 45 days in advance. Other countries are less stringent.


After reviewing appropriately cleared officers and consulting with their respective CPOs, OFRD will make the final decision regarding which of the selected officers will participate in these training deployments.

If you have are interested in deploying for Continuing Promise 2009, please send questions or concerns to the OFRD Response Operations mailbox at [email protected].

NNOMINATIONSOMINATIONS FORFOR THETHE 2010 USPHS D 2010 USPHS DENTALENTAL PPROFESSIONALROFESSIONAL A ADVISORYDVISORY C COMMITTEEOMMITTEE (D (DEEPAC)PAC)

Approximately four slots for voting members (3-year terms) are available. Those not selected to voting membership will be encouraged to participate in one of the DePAC subcommittees or workgroups.

The Dental Professional Advisory Committee (DePAC) provides advice and consultation to the Surgeon General and the Chief Dental Officer on professional and personnel issues related to the Dental Category. Members are required to attend the scheduled meetings during the three-year term. Meetings are typically held in Rockville, Maryland, and members in the field connect via teleconference if they are unable to travel to attend. Qualified candidates will be identified primarily through nominations by the DePAC, the Chief Dental Officer, and self-nominations. Candidates may be Commissioned Corps officers (CC) and Civil Service (CS) Dentists working within DHHS/DHS/DOJ. Candidates must receive initial approval and subsequent support from their immediate supervisor and agency liaison. DePAC members are selected to represent Public Health Service agencies, field and headquarters locations, CS employees and CC, and based upon the nominee's commitment to public health activities. The Surgeon General makes final approval for DePAC membership. All CC candidates must meet current Corps policies to include, but not limited to, Corps-wide readiness requirements from the time of the application deadline through appointment and subsequent three-year DePAC term. DePAC may request OFRD to check member basic readiness status at any time during a term. Nominees, by virtue of their application, agree to attend monthly DePAC meetings (in person or by phone) and actively participate in ongoing DePAC activities, including membership and leadership of one or more subcommittees or workgroups.

For more information visit the DePAC Website: http://www.phs-dental.org/depac/newfile27.html . Officers are encouraged to self-nominate using the application form found at the following link: http://www.phs-dental.org/depac/DePAC%20Self%20nomination%20form2009%203-yr.doc

PHS DPHS DENTALENTAL O OFFICERSFFICERS ATAT THETHE NNATIONALATIONAL I INSTITUTESNSTITUTES OFOF H HEALTHEALTHBBYY C CAPTAINAPTAIN K KATHYATHY L. H L. HAYESAYES, DMD, MPH , DMD, MPH OOFFICEFFICE OFOF S SCIENCECIENCE P POLICYOLICY ANDAND A ANALYSISNALYSIS, NIDCR, NIDCR

OverviewThe National Institutes of Health (NIH) together make up the nation’s premier health research agency. Comprised of 27 Institutes and Centers, the NIH supports research grants to many organizations. The agency also pursues basic and clinical research through intramural programs on NIH campuses. The main NIH campus is located in

Bethesda, Maryland. The NIH community includes PHS commissioned officers, civil servants, and visiting scientists from the US and abroad. The

http://www.nih.gov/icd/index.html

http://www.nih.gov/

http://www.phs-dental.org/depac/DePAC%20Self%20nomination%20form2009%203-yr.doc




National Institute of Dental and Craniofacial Research (NIDCR) leads the nation’s ongoing effort to improve oral, dental, and craniofacial health. The NIDCR pursues its mission through research, research training, and dissemination of health information to the public and health care professionals. Since 1948 NIDCR leadership has helped establish prevention as a cornerstone of American oral health. The founding director of the (then) NIDR was H. Trendley Dean, a PHS commissioned officer who led early investigations regarding the effect of fluoride on both the development of fluorosis and protection against dental decay.

Roles of Dental OfficersAs of April 3, 2009, the majority of the 355 PHS commissioned officers assigned to the NIH are physicians or nurses. Currently five dental officers serve at the NIH performing a variety of duties. Four are trained in dental public health, and one in oral medicine.

Four of the officers are assigned to the NIDCR:---RADM Isabel Garcia is the Deputy Director of the NIDCR. Dr. Garcia provides both administrative and policy leadership. She spearheaded the development of the last two NIDCR Strategic Plans. Dr. Garcia also is President of the American Board of Dental Public Health, and directs the NIDCR Residency Program in Dental Public Health, an accredited dental specialty training program. One current resident, CDR Michael Johnson, is a PHS officer sponsored for training by the Federal Bureau of Prisons. Prior to joining NIH RADM Garcia served at the AHRQ and in state and local government dental public health.

---CAPT Kevin Hardwick is Chief of NIDCR’s Research Training and Career Development Branch. As such, he leads NIDCR’s extramural research career training efforts. Several NIDCR training

grant programs provide infrastructure and resources to developing oral health researchers and the institutions that train them. Dr. Hardwick is a critical lynchpin communicating to young researchers and their mentors the different types of training grants and loan repayment opportunities available through the Institute. He travels to schools and conferences and works closely with professional associations. His prior career experiences include assignments to the Health Resources and Services Administration (HRSA) and the World Health Organization in Geneva. ---As the NIDCR Planning Officer, CAPT Kathy Hayes helps coordinate the annual NIDCR budget planning cycle. These policy and planning activities communicate the Institute’s accomplishments and future plans to NIH, HHS, and other offices within the executive branch. She also co-directs the dental public health residency

mentioned above. Dr. Hayes entered the PHS through the IHS, and served with HRSA working in health training, rural health, and policy. ---LCDR Demetrio Domingo is the most recent NIH dental officer to come aboard. As the Acting Clinical Director in the Clinical Research Core of the Division of Intramural Research, he conducts

patient evaluation and treatment in the NIH Clinical Center, collaborates in protocols within the NIDCR and in other Institute Centers, directs the Clinical Research Fellowship Program, advises the NIDCR Intramural Review Board, and represents NIDCR in the Medical Executive Committee. Prior to coming to NIDCR, Dr. Domingo served as a dental officer in the U.S. Navy.

The fifth, CAPT Renée Joskow, works in the National Center for Research Resources (NCRR). She is a program official who manages Clinical and Translational Science Awards, which provide funds to accelerate the development of “bench” or basic science discoveries and translate them into clinical applications for the “bedside” and in turn, the

L-R: CAPT Kevin Hardwick, CAPT Renee Joskow, RADM Isabel Garcia, CAPT Kathy Hayes, LCDR Demetrio Domingo, and CDR Michael Johnson

(DPH Resident)

L-R: CAPT Kevin Hardwick, CAPT Renee Joskow, RADM Isabel Garcia, CAPT Kathy Hayes, LCDR Demetrio Domingo, and CDR Michael Johnson

(DPH Resident)

http://www.ncrr.nih.gov/clinical_research_resources/clinical_and_translational_science_awards/

http://www.ncrr.nih.gov/clinical_research_resources/clinical_and_translational_science_awards/

http://www.ncrr.nih.gov/

http://clinicalcenter.nih.gov/about.shtml

http://clinicalcenter.nih.gov/about.shtml

http://www.nidcr.nih.gov/Research/NIDCRLaboratories/ResearchSupportCores/ClinicalResearchCore.htm

http://www.nidcr.nih.gov/AboutUs/BudgetCongressionalStatements/

http://www.nidcr.nih.gov/CareersAndTraining/

http://www.nidcr.nih.gov/CareersAndTraining/

http://www.nidcr.nih.gov/CareersAndTraining/Fellowships/DentistsandPhysicians/ResidencyDentalPublicHealth/default.htm

http://www.nidcr.nih.gov/CareersAndTraining/Fellowships/DentistsandPhysicians/ResidencyDentalPublicHealth/default.htm

http://www.nidcr.nih.gov/AboutUs/MissionandStrategicPlan/

http://dcp.psc.gov/rpt_agency_by_category.asp

http://dcp.psc.gov/rpt_agency_by_category.asp

http://www.nidcr.nih.gov/AboutUs/MissionandStrategicPlan/MissionStatement/

http://www.nidcr.nih.gov/

http://www.nidcr.nih.gov/


community to improve public health. She serves as the dental liaison for her program to the NIDCR and makes a special effort to encourage dental school and dental researcher participation in NCRR funded programs. Dr. Joskow has served in the CDC’s Epidemic Intelligence Service, the Department of Homeland Security, and in the OFRD.

This synopsis of current officers provides only a snapshot of the variety of assignments available at the NIH. In recent years dental officers have also served in the NIH Office of the Director, in the Center for Scientific Review, and as intramural Scientists and Scientific Directors.

Officership at the NIHNIH dental officers carry a history of service to the category and a sound sense of officership. All current NIH dental officers have a record of service to the DePAC and/or its subcommittees. At least five of the NIH dental officers who are active duty or retired within the last three years have served as DePAC chair, an impressive proportion considering the relatively small number of officers. All are readiness qualified, and LCDR Domingo helps lead the quarterly fitness tests for NIH office.

BBRINGINGRINGING ITIT BACKBACK TOTO THETHE CHAIRCHAIR - T - THISHIS ISSUEISSUE’’SS C CLINICLINIC C CONTRIBUTIONONTRIBUTION

GGUIDELINESUIDELINES FORFOR THETHE MANAGEMENTMANAGEMENT OFOF PATIENTSPATIENTS WITHWITH PERIODONTALPERIODONTAL DISEASEDISEASELLIEUTENANTIEUTENANT C COMMANDEROMMANDER R RAYNESEAYNESE S. F S. FIKESIKES, DC, USN, C, DC, USN, CAPTAINAPTAIN T THUHU P. G P. GETKAETKA, DC, , DC, USN USN ANDAND C CAPTAINAPTAIN M MARYARY E. N E. NEILLEILL, DC, USN , DC, USN RREFERENCEEFERENCE: C: CLINICALLINICAL U UPDATEPDATE - N - NAVALAVAL P POSTGRADUATEOSTGRADUATE D DENTALENTAL S SCHOOLCHOOL, , NNATIONALATIONAL N NAVALAVAL D DENTALENTAL C CENTERENTER, B, BETHESDAETHESDA, M, MARYLANDARYLAND, V, VOLOL. 30, N. 30, NOO. 1, 2008. 1, 2008

IntroductionRecently the American Academy of Periodontology published guidelines for the co management of patients with periodontal disease.1 These guidelines are intended to facilitate communication and serve as recommendations for the identification of patients who would benefit from co-management by the referring dentist and the periodontist. Risk assessment and risk management have become an increasingly important component of dental examination and treatment. Periodontal disease can be a challenge to manage and is a major cause of tooth loss in adults. By using the guidelines as a communication tool, a dentist can make an earlier identification of patients who would benefit from specialty care.

The guidelines are divided into four main sections: narrative introduction, three levels of patient conditions, definitions of terms, and frequently

asked questions. Clinical, medical and behavioral conditions are used to identify and triage a patient according to the level of risk and the severity of disease. The recommendations are intended to improve communication between the general practitioner and the specialist; not limit the scope of practice of experienced practitioners.

An explanation of terms may enable a better understanding of the stratification of the level of care. “Should” merely means the recommendation is a highly desirable direction, but not mandatory. “May” provides a choice to act or not, giving the practitioner the freedom to follow a suggested alternative. The general dentist remains the primary care provider.

Level 3: Patients who should be treated by a periodontistAny patient with:


Severe chronic periodontitis Furcation involvement Vertical/angular bony defect(s) Aggressive periodontitis (formerly known as

juvenile, early-onset, or rapidly progressive periodontitis

Periodontal abscess and other acute periodontal conditions

Significant root surface exposure and/or progressive gingival recession

Peri-implant disease

Any patient with periodontal disease, regardless of severity, whom the referring dentist prefers not to treat.

Level 2: Patients who would likely benefit from comanagement by the referring dentist and the periodontist*Any patient with periodontitis who demonstrates at reevaluation or any dental examination one or more of the following risk factors/indicators* known to contribute to the progression of periodontal disease:

Periodontal Risk Factors/Indicators Early onset of periodontal disease (prior to

the age of 35 years) Unresolved inflammation at any site (e.g.,

bleeding upon probing, pus, and/or redness) Pocket depths > 5 mm Vertical bone defects Radiographic evidence of progressive bone

loss Progressive tooth mobility Progressive attachment loss Anatomic gingival deformities Exposed root surfaces A deteriorating risk profile

Medical or Behavioral Risk Factors/Indicators Smoking/tobacco use Diabetes Osteoporosis/osteopenia Drug-induced gingival conditions (e.g.,

phenytoins, calcium channel blockers, immunosuppressants, and long-term systemic steroids)

Compromised immune system, either acquired or drug induced

A deteriorating risk profile

Level 1: Patients who may benefit from comanagement by the referring dentist and the periodontistAny patient with periodontal inflammation/infection and the following systemic conditions:

Diabetes Pregnancy Cardiovascular disease Chronic respiratory disease

Any patient who is a candidate for the following therapies who might be exposed to risk from periodontal infection, including but not limited to the following treatments:

Cancer therapy Cardiovascular surgery Joint-replacement surgery Organ transplantation

As prefaced in the ninth edition of the text book “Carranza’s Clinical Periodontology” by Newman, Takei, and Carranza, “The periodontal care of the public is primarily the concern of the general dentist, who cannot disregard his or her responsibility to examine, treat, or refer all periodontal problems. The high incidence of periodontal problems and the close relationship between periodontal and restorative dental therapies make this an incontrovertible point. A well-trained group of periodontists who specialize in the diagnosis and treatment of severe or unusual problems should serve to supplement the general dental care available to our population.”2

In cases where the presentation is so severe or unusual or cases where optimal results occur after initial periodontal therapy, the decision to refer or not to refer may be less ambiguous.2 For the patients who do not fall into either of these categories, the guidelines should serve as an aid in making the determination when a referral or co-management would be beneficial for the patient.

These recommendations are intended to serve as guidelines for the dental team in managing patients with periodontal diseases and serve to facilitate effective communication between referring dentists and periodontists. They are intended to assist the


general practitioner in quickly identifying patients who are at greatest risk and most appropriately suited for specialty care. These guidelines are not intended to serve as a medico-legal standard of care and do not replace the knowledge, skill, and abilities of the practitioner.3 Ultimately, it is the patient who will benefit the most through risk assessment and appropriate management.

For more information and updates please visit the American Academy of Periodontics website, www.perio.org.

* It should be noted that a combination of two or more of these risk factors/indicators may make even slight to moderate periodontitis particularly challenging to manage (e.g., patient under 35 years of age who smokes).

References:

1. Academy Report. Guidelines for the management of patients with periodontal diseases. J Periodontol 2006; 77(9):1-3.2. Newman MG, Takei HH, Carranza FA. Clinical Periodontology, ed 9. Philadelphia, Saunders, 2002.3. AAP clarifies the guidelines for the management of patients with periodontal disease. Media/Press Release Nov 28, 2006.

Lieutenant Commander Fikes is a resident in the Periodontal Department. Captain Getka is the Periodontics Department Residency Director and Captain Neill is Chairman of the Periodontics Department at the Naval Postgraduate Dental School.

The opinions or assertions contained in this article are those of the authors and should not be construed as official or as reflecting the views of the Department of the Navy or the USPHS.

SSPECIALPECIAL THANKSTHANKS TOTO THETHE N NAVALAVAL P POSTOST G GRADUATERADUATE D DENTALENTAL S SCHOOLCHOOL FORFOR USEUSE OFOF THEIRTHEIR “C “CLINICLINIC U UPDATEPDATE” ” PUBLICATIONPUBLICATION THISTHIS ISSUEISSUE!!

USPHS DUSPHS DENTALENTAL O OFFICERSFFICERS INTERESTEDINTERESTED ININ SUBMITTINGSUBMITTING CINICALCINICAL PUBLICAITONSPUBLICAITONS AREARE ENCOURAGEDENCOURAGED TOTO CONTACTCONTACT ONEONE OFOF THETHE NEWSLETTERNEWSLETTER’’SS COCO--EDITORSEDITORS: C: CAPTAINAPTAIN T TODDODD T TOVAREKOVAREK ATAT TTODDODD.T.TOVAREKOVAREK@[email protected] OROR LCDR S LCDR SHANIHANI L LEWINSEWINS A ATT LEWINSSLEWINSS@@USMMAUSMMA..EDUEDU

WWELCOMEELCOME C CAPTAINAPTAIN D DONALDONALD B BELCHERELCHER!!U.S. CU.S. COASTOAST G GUARDUARD’’SS N NEWEW C CHIEFHIEF D DENTALENTAL O OFFICERFFICERBBYY C COO-E-EDITORDITOR CDR S CDR SHANIHANI N. L N. LEWINSEWINS

Captain Belcher will be assuming the position of Chief Dental Officer (CDO) for the U.S. Coast Guard (USCG) at Headquarters in Washington, DC on 22 June 2009. We wish Captain Suzanne Saville, the outgoing USCG CDO, the best as she assumes her new duties as the D11 Field Office Senior Dental Executive and Senior Health Services Officer in Alameda, California.

We are quite privileged to have an Officer with Captain Belcher’s diverse background and professional demeanor assume command of the CG dental corps. He received his DMD in 1984 and subsequently completed a 1 year AEGD Certificate program in 1985 from the University of Pennsylvania. After working eight years in private practice Captain Belcher accepted a commission into the US Public Health Service. He has served across the nation both clinically and administratively. In Kodiak, Alaska he was a staff dental officer and in Petaluma, California the Health Services Dental Technician Liaison and Clinical Instructor at the training center. Captain Belcher has served as Senior Dental Officer at Integrated Support Command in Portsmouth, Virginia and following that Chief, Health Services Division at Air Station Clearwater, Florida. He




brings additional training to the position with a Master’s degree in Quality Assurance from California State University and was recently selected as the CDO for USCG.

In addition to his lengthy professional qualifications Captain Belcher presents himself as approachable to junior Officers and has the utmost respect for his piers. We very much look forward to working with him!

SSENIORENIOR O OFFICERFFICER S SPOTLIGHTPOTLIGHT: : CCAPTAINAPTAIN D DANIELANIEL H HICKEYICKEYCCHIEFHIEF D DENTALENTAL O OFFICERFFICER, B, BUFFALOUFFALO F FEDERALEDERAL D DETENTIONETENTION F FACILITYACILITY,,DDIVISIONIVISION OFOF I IMMIGRATIONMMIGRATION H HEALTHEALTH S SERVICESERVICES

1) Can you please provide a brief summary of your training and education?I attended the University of Pittsburgh School of Dental Medicine on a National Health Service Corps (NHSC) scholarship. After graduation, the NHSC provided me ample opportunities to further my education through CE both within and outside PHS. I became hooked on CE, and joined the Academy of General

Dentistry to expand my knowledge base. Perhaps my best move was signing on with the Pennsylvania AGD PEAK program. In PEAK we have meetings twice a year; have cutting-edge speakers present on 18 different dental disciplines; present cases which are peer reviewed; and are prepared for Fellowship and Mastership in the Academy. I also take full advantage of the many opportunities federal service offers. For example, when I was in the BOP I was able to take the three-tiered Spanish Immersion language program, which I have put to good use many times.2) Can you tell our readers how long you have been a USPHS officer and what agency (agencies) you

have been assigned to during your tenure? I started out in the NHSC in 1982 in the Upper Peninsula of Michigan, where I also helped out at the Indian Health Service site at Kincheloe, MI. I transferred to the BOP and did service at facilities in Central Pennsylvania and West Virginia. Currently I am with the Division of Immigration Health Services (Department of Homeland Security) in Batavia, NY.3) What led you to consider a career in the PHS dental program?Prior to Dental School I was looking at various options available to students and came across the NHSC scholarship program. PHS was in the background during my student years at Pitt, but upon my call to active duty my first commanding officer, CAPT William Hall, was a huge influence on my professional outlook. He mentored me into the PHS and became a great friend. His positive insights and guidance sold me on a PHS career.4) What do feel has been the most significant change in the evolution of the Corps during your

Commission?Two events come to mind. First, in the 1980s the elevation of Dr. C. Everett Koop to Surgeon General gave immense credibility and visibility to the Commissioned Corps. This event cannot be underestimated. Second, the announcement on July 1, 2003 by HHS Secretary Tommy Thompson regarding the Transformation of the Corps was the necessary driving force to guide and modernize the Corps into the 21st century. Hopefully we will continue to see the Corps expand and more opportunities arise for our officers as the Transformation evolves.

5) What have you found to be the most rewarding part of your career with PHS (personal or professional)?

The most rewarding aspects of a PHS career are the many talented and extraordinary people you meet on the way and the deep friendships PHS engenders. I truly have met some exceptional and brilliant clinicians, as well as some truly creative and adventurous individuals who have influenced me and provided many memorable moments. Let the good times continue to roll!


6) What have you found to been the most challenging part of your career with PHS (personal or professional)?

Perhaps the most challenging professional aspect in PHS dentistry is dealing with individuals who do not understand dentistry! Non-dental personnel do not always have an appreciation of the rules and regulations we have to deal with, no do they understand other issues such as adequate staffing, scheduling patterns, invasive procedures, etc. I am extremely confident every PHS dental officer has dealt with these frustrations at one time or other in their career.


7) If a new Dental Officer asked you “why should I make PHS my career” what would you tell him/her?

I would suggest if the new officer has a sense of adventure, is flexible in outlook and willing to accept new challenges, desires to have the opportunity to custom-tailor your career, wants to see the country and the world, and does not want to be stuck in the same office for the next 30 years, then perhaps the PHS is for you! It certainly has been a fruitful and fulfilling career for me.8) What motivates you to stay in the Public Health Service?Years ago, in my NHSC days, I was called to Chicago to attend an awards ceremony. At that event I received my first PHS medal. The director of the NHSC, a PHS Captain, presented it to me and, after the ceremony, took the time to speak and engage in a dialogue about what I wanted out of my career and of life. I was most impressed with his bearing and professionalism; obviously he was greatly concerned about the officers under his watch. His name was Kenneth Moritsugu. He said something to me I have never forgotten and every new officer should hear. "The Public Health Service" he said, "offers you a career rich in opportunity and challenge." His words continue to motivate me to this day and still ring true.

Xxxx DePAC ‘click’ FAQsHaving trouble finding something on a Commissioned Corps or PHS website?Found that page once but can’t seem to find it again?Just not enough hours in the day to surf the PHS web?Let our editors provide you with the one click solution!

Send your inquiries to one of our co-editors at [email protected] or [email protected] ; we’ll email you back the link and may even include your FAQ in the next DePAC Newsletter.

Ctrl+click on the mouse

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in DePAC?





Dental PAC Coin Order Form

Price: $10

Name: _____________________________________________________________

Address (for shipment):_______________________________________________

City/State/Zip Code: _________________________________________________

Quantity:_________

Total Enclosed:__________ (including S&H)(Please make the check payable to: Commissioned Officers Foundation

Send your check and this form to: Mary Beth Kinney – Dental Coins5125 Alberta NE Ave.Rio Rancho, NM 87144

QUESTIONS: Contact Mary Beth Kinney at phone number: 602-364-7747 or email [email protected]

Shipping and Handling:Less than 5 coins = $2.505 to 10 coins = $3.50More than 10 coins = $5.00



JJUNIORUNIOR O OFFICERFFICER S SPOTLIGHTPOTLIGHT: : LLIEUTENANTIEUTENANT C COMMANDEROMMANDER V VICKYICKY O OTTMERSTTMERSCCHIEFHIEF D DENTALENTAL O OFFICERFFICER, P, PEARSALLEARSALL, , DDIVISIONIVISION OFOF I IMMIGRATIONMMIGRATION H HEALTHEALTH S SERVICESERVICES

1) Can you please provide a brief summary of your training and education? Texas A&M University, BS, 1995 San Antonio Dental School, DDS, 2000 Houston Dental School, Two-Year General Practice Residency, 2002 Clinical research 2001-2003 Conducted clinical care and research at the Bering Dental Center, Houston focusing on HIV patients and

related care, 2002-20072) Can you tell our readers how long you’ve been a PHS officer and describe your duties at your

present site? I was called to active duty in September 2008 and I’m stationed at the South Texas Detention Complex in Pearsall, TX. This is a Division of Immigration Health Services site and I provide supportive dental care for approximately 1600 detained illegal immigrants awaiting adjudication of their immigration cases. This is a solo, two chair clinic and the focus of my practice is emergency dental services.3) What led you to consider a career in the PHS dental program? I’ve always leaned towards community service and the Public Health Service seemed like a good fit for me. Public Health allowed me to be a part of something bigger, and I was attracted by the mission and wide array of opportunities available with a Public Health Service career.4) What did you find to be the most challenging aspect of your transition into the Public Health

Service?The transition from private practice mode to the more structured uniformed service protocols has been an interesting change. I’m always vigilant to respect the chain of command and I’m learning new acronyms on a daily basis. Getting used to daily uniform wear and proper military protocols has been a big change for me as well and I really enjoyed the opportunity to attend the BOTC training. Clinically the transition has been less challenging as my previous experience and training prepared me for this type of practice.5) What has been the most rewarding aspect of your service thus far?I enjoy the opportunity to help those in need who otherwise wouldn’t have access to dental care. Many of my patients have had little or no access to dental care and I feel as though I’m having a positive impact on their oral health. I’m also pleased to have the opportunity to work with such committed and focused health care providers.6) Describe some of your hobbies and activities outside of the PHS?I like to travel and I’m an avid reader. Family is very important to me and I spend as much quality time with them as possible. This includes my three faithful companions, a sheep dog, black lab and Jack Russell terrier.7) Has your experience in the PHS thus far lived up to your expectations?I expected that this career track would be challenging and the daily, frenetic pace of my clinic has not disappointed. I’m very happy with the decision I made and I’m looking forward to a rewarding career with the Public Health Service. The quality of individuals that I’ve encountered thus far has impressed me and I have a new appreciation for the PHS dental officer after serving in the Corps for about a year.


AASSOCIATESSOCIATE R RECRUITERECRUITER P PROGRAMROGRAMBBYY C CAPTAINAPTAIN S SUZANNEUZANNE S SAVILLEAVILLE, C, CHIEFHIEF D DENTALENTAL O OFFICERFFICER, US C, US COASTOAST G GUARDUARD

Call it modernization or transformation, either way the Associate Recruiter Program (ARP) will be experiencing some exciting new changes in the near future. Stay tuned for more detailed information as it becomes available. The current dental category leads, CAPT Renée Joskow, CAPT Tim Owen and myself, CAPT Suzanne Saville would like to acknowledge and personally thank every dental category Associate Recruiter past and present for the time, energy and contribution to this valuable program.

Current proposals in works for the ARP include reducing each category to two leads and providing two designated Associate Recruiters for each of the ten (10) federal districts. The current dental category leads are working closely with the Recruitment work group of the DePAC to ensure a smooth transition.

As a reminder to all Associate Recruiters: please make sure you submit all required documentation to DCCR and the Associate Recruiter Leads** to remain active in the Associate Recruiter Program. You must have completed at least two qualifying events during your qualifying period and the annual training; as an officer it is your responsibility to track your status.

Materials Available to Support You in Your Recruitment Activities!

A New Look for Corps MaterialsAs you may be aware, several years ago the Corps engaged the services of a communications contractor to develop a new “look” for our recruitment materials. Through this contract, a suite of materials was created that serve a variety of purposes and that complement one another to create a new “brand identity” for the Corps. The new brand debuted with the launch of the revamped Web site last spring: http://www.usphs.gov/RecruitmentMaterials/

The brand includes a new recruitment campaign logo that features the tagline “America’s Health

Responders,” which is based on extensive audience research conducted with potential recruits. This logo does not replace the HHS logo or the PHS seal.

Presenting a Unified ImageCorps officers are encouraged to use the new materials whenever possible to ensure that we present a cohesive, consistent image to the outside world, including our future officers. The materials include a recruitment PowerPoint presentation, category-specific fact sheets and/or flyers and posters for the following professions: Physician, Nurse, Dentist, Pharmacist, Mental Health, Scientist, Engineer, Veterinarian, Public Health (multi-category), and Student Opportunities. To request materials, please contact CAPT Tim Owen a minimum of four to six weeks prior to your event at [email protected]

Reminder to send activities to Leads and ARP

**Please send qualified recruitment activities on the correct form to: CAPT Renee Joskow, CAPT Tim Owen or CAPT Suzanne Saville AND also send to: [email protected], one event per form. Go to CCMIS main page, click on Services, Official Forms, scroll down to Recruitment and use PHS 7052. A fillable PDF version is available: http://dcp.psc.gov/PDF_docs/FillablePHS-7052.pdf as well as a fillable word document: http://dcp.psc.gov/cc_forms.asp (see “recruitment” section). If you have changed duty stations and we may not have your current address, please up-date it with one of the Associate Recruiter Leads.

CAPT Suzanne Saville [email protected] Renée [email protected] CAPT Tim [email protected]




http://dcp.psc.gov/cc_forms.asp

http://dcp.psc.gov/PDF_docs/FillablePHS-7052.pdf







http://www.usphs.gov/RecruitmentMaterials/


EDUCATIONAL RESOURCES & ONLINE CE OPPORTUNITIESEDUCATIONAL RESOURCES & ONLINE CE OPPORTUNITIES

Description/Topics Link CDE Hours FeesADA/CERP Recognized

Series of online courses in dental ethics and professionalism

https://www.dentalethics.org/index.shtml

15(1 hr per course)

No Yes

Organization for Safety and Asepsis Procedures(OSAP) interactive guide to CDC infection control guidelines

http://osaplms.ts.karta.com/

10Available for free study or fee for

online CDE credits

Yes for CDE credits:

$85 members/$100 non-members

Yes

Practical oral health care for patients w/ developmental disabilities

http://www.nidcr.nih.gov/EducationalResources/HealthCareProviders/POCPDD.htm

2 No Yes

Home study courses available from Henry Schein on variety of topics

http://www.henryschein.com/us-en/dental/services/cehp/HomeStudy.aspx

15+Yes for CDE creditAvailable free for

reference useYes

Dental Providers Oncology pocket guide. Quick reference on treating pts before, during and after cancer treatment

http://www.nidcr.nih.gov/NR/rdonlyres/AA5DF3DD-5DB7-47D4-9F09-461F242C471F/0/DentalPocketGuide.pdf

No No -

Presentation explaining the clinical trial process

http://www.nidcr.nih.gov/EducationalResources/DentalHealthProf/ClinicalTrialsSlideShow.htm

No No -

Naval Postgraduate Dental SchoolCorrespondence Course Program

http://www.bethesda.med.navy.mil/Careers/Postgraduate_Dental_School/Educational_Resources/Corres_Brochure_Jan09.doc

Numerous No Yes

Dental Evaluation and Consultation Service(DECS): Continuing education lectures and handouts and a wide variety of topics

Air Force/DECS/CDE Numerous No Yes

Oral Pathology Image database http://www.uiowa.edu/~oprm/AtlasHome.html No No -

Naval post –graduate dental school continuing education clinical updates archives. Vast array of topics.

http://www.bethesda.med.navy.mil/Careers/Postgraduate_Dental_School/Research/Clinical_Updates/

No No -

Inside Dentistry online continuing education opportunities. Many topics

http://www.insidedentistry.net/continuingeducation.php

Multiple No AGD/PACE

Clinical guide to occlusal splint therapyhttp://www.insidedentistry.net/article.php?id=2726

No No -

http://www.insidedentistry.net/article.php?id=2726









http://www.uiowa.edu/~oprm/AtlasHome.html

http://www.uiowa.edu/~oprm/AtlasHome.html

http://airforcemedicine.afms.mil/idc/groups/public/documents/webcontent/knowledgejunction.hcst?functionalarea=DentalEvalConsultation&doctype=subpage&docname=CTB_108267






















Clinical article highlighting remineralization w/ unique delivery system

http://www.dentalaegis.com/Publications/Inside_Dentistry/article.aspx?id=34787

No No -

UPCOMING EVENTS FOR 2009-2010UPCOMING EVENTS FOR 2009-2010

Organization Information Meeting dateMeeting Location

Reserve Officers Association Annual Convention http://www.roa.org/site/Calendar?view=Detail&id=101501 July 8-11,2009 Orlando, FL

Academy of General Dentistry Annual Meeting http://www.agd.org/baltimore09/ July 8-12,2009 Baltimore, MD

Pacific Northwest Dental Conference http://www.wsda.org/pndc/pndc.view July 23-24, 2009 Seattle, WA

National Dental Association Annual Convention http://www.ndaonline.org/NDAconvention.asp July 24-29,2009 Jacksonville, FL

Indian Health Service Dental Updates

http://www.ihs.gov/MedicalPrograms/DentalCDE/index.cfm?fuseaction=course.display&year=2009&cat=general&sort=course&order=asc&c=1155

July 27-30, 2009 Albuquerque, NM

American Academy of Esthetic Dentistry http://www.estheticacademy.org/Annual_Meeting.html August 2-5,2009 Las Vegas, NV

California Dental Association Fall Sessionhttp://www.cda.org/popup/2008_Fall_Scientific_Session_Attendee_Information

Sept. 11-13,2009 San Francisco, CA

American Academy of Periodontologyhttp://www.perio.org/meetings/am/index.html Sept. 12-15,2009 Boston, MA

Mid-Continent Dental Congresshttp://www.gslds.org/congress.phtml Sept. 24-26, 2009 St. Louis, MI

American Dental Association Annual Meetinghttp://www.ada.org/prof/events/session/index.asp Sept.30-Oct.4,2009 Honolulu, HI

American Association of Oral and Maxillofacial SurgeonsAnnual Meeting

http://www.aaoms.org/annual_meeting/2009/ Oct. 12-17, 2009 Toronto, Canada

Hispanic Dental Association Annual Meetinghttp://www.hdassoc.org/site/epage/25547_351.htm Oct. 23-24, 2009 Houston, TX

American College of Prosthodonticshttp://www.prosthodontics.org/professionals/AnnualSession.asp Nov. 4-7, 2009 San Diego, CA

American Public Health Association Annual Meetinghttp://www.apha.org/meetings/highlights/ Nov.7-11, 2009 Philadelphia, PA

Association of Military Surgeons(AMSUS) Annual Meetinghttp://www.amsus.org/convention/attendees/ Nov. 15-20,2009 St. Louis, MO

http://www.amsus.org/convention/attendees/

http://www.amsus.org/convention/attendees/

http://www.apha.org/meetings/highlights/

http://www.apha.org/meetings/highlights/

http://www.prosthodontics.org/professionals/AnnualSession.asp

http://www.prosthodontics.org/professionals/AnnualSession.asp

http://www.hdassoc.org/site/epage/25547_351.htm

http://www.hdassoc.org/site/epage/25547_351.htm

http://www.aaoms.org/annual_meeting/2009/

http://www.aaoms.org/annual_meeting/2009/

http://www.ada.org/prof/events/session/index.asp

http://www.ada.org/prof/events/session/index.asp

http://www.gslds.org/congress.phtml

http://www.gslds.org/congress.phtml

http://www.perio.org/meetings/am/index.html

http://www.perio.org/meetings/am/index.html

http://www.cda.org/popup/2008_Fall_Scientific_Session_Attendee_Information



http://www.estheticacademy.org/Annual_Meeting.html

http://www.estheticacademy.org/Annual_Meeting.html




http://www.ndaonline.org/NDAconvention.asp

http://www.ndaonline.org/NDAconvention.asp

http://www.wsda.org/pndc/pndc.view

http://www.wsda.org/pndc/pndc.view

http://www.agd.org/baltimore09/

http://www.roa.org/site/Calendar?view=Detail&id=101501

http://www.roa.org/site/Calendar?view=Detail&id=101501





Greater New York Dental Meeting http://www.gnydm.com/index.html Nov. 27-Dec 2,2009 New York, NY

Note from the EditorsThe DePAC Communications Work Group would like to thank all who have contributed to this edition of

the DePAC Newsletter. We would encourage each officer to contribute information for publication through their DePAC work groups to help improve our newsletter and communication to all dental officers.

http://www.gnydm.com/index.html

Documents

Additionally, the dental officers listed below were ....doc