Category Archives: News

Vaping and Oral Health: Not a Compatible Pair

In 2003, what would become the first commercially successful electronic cigarette was created in Beijing, China by Hon Lik, a 52-year-old pharmacist, inventor and smoker. Lik reportedly created the device as a safer alternative to cigarettes after his father, also a heavy smoker, died of lung cancer.

The use of e-cigarettes, referred to as vaping, works by heating a liquid to generate an aerosol that the user inhales. The liquid in the e-cigarette contains propylene glycol, glycerin, flavorings, water, and nicotine.

Ever since Lik’s product went on the market, smokers have been switching from cigarettes to e-cigarettes in an attempt to be healthier.

But is it actually healthier?

In their January Perio-Implant Advisory article “Vaping and oral health: It’s worse than you think,” Scott Froum, DDS, and Alisa Neymark, DDS, write about the dangers of e-cigarette use and the effect it has on oral health. After researching the topic, the two came up with four major dangers posed by vaping.

Danger No. 1: Propylene glycol

Propylene glycol is a viscous, colorless liquid primarily used in the production of polymers and food processing. Because of it’s fairly sweet taste, and can be found in edible items, such as liquid sweetness, ice cream and whipped dairy products.

In the case of e-cigarettes, propylene glycol acts as a carrier for nicotine.

“When used orally, the breakdown products of PG include acetic acid, lactic acid, and propionaldehyde, which are all toxic to enamel and soft tissue,” Froum and Neymark write. “In addition, propylene glycol is a hygroscopic product, which means water molecules in saliva and oral tissue will bond to the PG molecules, leading to tissue desiccation. The result of this is xerostomia, or “dry mouth,” which has been shown to lead to an increase in cavities, gum disease, and other oral health issues.”

Danger No. 2: Vegetable glycerin and flavorings

Vegetable glycerin and flavorings make up the majority of the e-cigarette’s inhalant. Like propylene glycol, vegetable glycerin is a colorless, viscous, sweet-tasting liquid used in the food industry as a sweetener. It is also used in many medical, pharmaceutical and personal care products. Because it’s 40 percent less sweet than sucrose and not metabolized by cariogenic bacteria, it was previously thought to not cause cavities, but studies have shown the combination of vegetable glycerin and flavorings produce an increase in microbial adhesion to enable and an increase in biofilm formation.

“In addition, a 27% decrease in enamel hardness was demonstrated when flavorings were added to e-liquid as compared to unflavored controls,” they write. “The viscosity of the e-liquid also allowed Streptococcus mutans to adhere to pits and fissures. In other words, e-liquid allows more cavity-causing bacteria to stick to a softer tooth and can lead to rampant decay.”

Danger No. 3: Nicotine

While the percentage of nicotine is much lower in e-cigarettes than in traditional tobacco products, one electronic cartridge–200 to 400 puffs–can equal the nicotine of smoking two to three packs of regular cigarettes. And because nicotine is a vasoconstrictor, it affects the gingival blood flow and can have dangerous effects on gum tissue.

“It also affects cytokine production, neutrophil function, and other immune cell function,” Froum and Neymark write. “In addition, nicotine decreases connective tissue turnover. All of this results a much higher chance of developing gum disease and tooth loss.”

Danger No. 4: Lithium batteries

There have been two reported deaths associated with vaping.

In January, a 24-year-old man died after his vape pen exploded and tore his carotid artery, and in May 2018, a 28-year-old Florida mad died when his vape pen exploded, sending projectiles into his head and causing a fire in his house.

“Although these types of sensationalized deaths are rare with e-cigarettes and vaping pens, the explosions of these pens are not,” Froum and Neymark write. “The problem lies within the vape pen and the lithium batteries overheating and exploding. These explosions are usually attributed to improper charging of the device or have been linked to a type of device called a mechanical mod that has no internal safety and can overheat and explode.”

Researchers estimate that there were about 2,035 e-cigarette explosion-related injuries between 2015 and 2017, more than 40 times the initial 195 incidents estimated by the United States government. The injuries caused by these explosions are serious, the pair write, and often lead to disfigurement of oral soft tissue.

Vaping v. Cigarettes

While vaping is thought to be a safer alternative to cigarette smoking. However, Froum and Neymark write, vaping can be just as dangerous, if not more dangerous, when compared with smoking.

They go on to write that while vaping has helped many people quit smoking, it has also upped their oral health problems. Dentists across the country have seen rampant decay, smooth-surface and interproximal lesions, tooth loss, and cervical enamel demineralization. And, unfortunately, the vaping fad is making its way down to the youth.

“The problem is that vaping is thought to be a safer alternative to traditional tobacco products, and companies are adding flavoring products to attract younger generations,” they write. “According to a 2013–2014 survey, 81% of current youth e-cigarette users cited the availability of appealing flavors as the primary reason for use.”

Froum and Neymark write that middle- and high-school-age children is the group in which e-cigarette use percentage is increasing the most.

“Because of the known dangerous effects of traditional tobacco methods, use among middle and high school students has been steadily decreasing since 2014,” they write. “However, since the introduction of the e-cigarette, that number is now increasing, and it is estimated that one in five high school students may now be using tobacco products. E-cigarette use from 2017 to 2018 increased 78% among high school students and 48% among middle school students.”

With the amount of young vapers now out there, Froum and Neymark think things are about to get worse.

“Because of this, a tidal wave of oral health problems is heading our way.”





Best Mobile Apps for Your Dentistry in 2019

Mobile apps make our lives so much easier.

There are apps that tell us the weather, apps that let us pay our bills, apps that help us find our significant others, and there are now apps that allow medical professionals to better communicate with their patients.

Because we now live in a technology-based world, it’s smart for dentistries to keep up with the times when it comes to best serving the patient. Below are five apps can help your practice help its patients through more efficient and effective communication.

dcStory

Available on Android, iOs and Blackberry devices, dcStory is a free tool used by dentists to educate and motivate their patients with easy explanations of complex dental procedures and multi-step treatments. With the app on an iPad, dentists and hygienists can sit right next to their patients an narrate a customized treatment plan with the help of high-quality 3D animations. The included X-Ray Plan module allows easy tab and touch functionality to select and move illustrated objects onto a patient x-ray. It also provides explanations of treatments and alternative treatments according to each patient’s dental needs. This information can easily be stored in individual patient folders for future use.

DDS GP

DDS GP (Dental Demo Suite General Practice) is an app that helps dentists communicate dental conditions and treatment plans more effectively to their patients. With more than 200 illustrated demonstrations, dentists can show their patients the progression of conditions and diseases and treatment steps. The app, which is $399.99, allows dentists to add their own photos, draw on the screen with their finger, and create customized treatment plans for their patients, which can be printed and emailed. It is available on Android, iOS and Blackberry devices.

Dental Manager

Dental Manager focuses more on the business side of the dentist/patient relationship. This free app has a cost calculator and treatment plan construction, and a way to send that information to the patient via email or text. Dentists can use this app to create a database of all their patients and share it with their co-workers to get everyone on the same page.

Dental Anywhere

Dental Anywhere works with individual dentistries to create customized apps for their specific needs. The app is available for general dentists, orthodontists, pediatric dentists and oral surgeons, and is comes in three versions: lite, premier and rewards. Lite, the most basic version, comes with a way for patients to contact the dentistry, a map, an appointment request button, sharing pre/post op notes, an emergency screener and a PayPal integration. Pricing starts at $69 a month.

Mavro

Mavro allows dentists to communicate technical and medical terms and concepts with their Spanish-speaking patients. This free app has audio capabilities that clearly and deliberately pronounces Spanish, which dentists can either use to communicate to the patient or they can repeat the phrase themselves. The app comes with a bookmarking, so dentists can save frequently used information and questions for easy access. It also has flashcards with an audio pronunciation component for dentists to practice and learn Spanish.





Are They An Independent Contractor or an Employee?

Updated: 3/25/2019

1099 is more than a number, and we’re going to talk about why.

First, do you own or manage a dental practice?

If so: 1. Do you have a separate bank account to manage your income? 2. Do you invoice the dentist for your services as an independent contractor? 3. Do you classify dental professionals who come to work in your office as independent contractors?

And second, are you an independent contractor?

If you fall into one of the two categories mentioned above, this blog is for you.

Familiarize yourself with Form 1099

dental-1099

It’s in the best interest of both the business owner and the independent contractor–dentist, dental hygienist, dental assistant, business assistant and receptionist–to be informed and take ownership of the facts as they relate to the employment relationship when it comes to payments and taxes. Form 1099 is an IRS tax form that is used to report payments to independent contractors, the category in which temp workers fall under.

Correctly using this form continues to be a big issue in the dentistry profession.

To cut costs, many dentists pay hygienists and dental assistants via conditions of the 1099 so they don’t have claim them as employees. For employees, the employers must withhold taxes, withhold and pay Social Security and Medicare taxes, and pay unemployment tax on the wages paid to an employee. If the worker is an independent contractor, employers generally do not have to comply with any of these regulations, which saves the practice time and money.

Because this issue spans across all profession, the IRS developed specific criteria to determine whether or not a person is a true independent contractor. 

The following 20 questions to determine whether you have an independent contractor or an employee working for you (the responses an employer would have for an independent contractor appear in parenthesis following each question).

    1. Are you required to comply with instructions about the details of your job tasks? (No.)
    2. Does the dentist provide you with training specific to his or her practice? (No.)
    3. Are the services you provide integrated into the owners business operation? (No.)
    4. Must the services be rendered by you personally? (No.)
    5. Do you have the capability to hire others to help you perform the services you’re contracted to do? (Yes.)
    6. Is the relationship between you and the business owner a continuing relationship? (No.)
    7. Who sets the hours of work? (You do.)
    8. Are you required to devote your full time to this business? (No.)
    9. Do you perform the work at the place of business of the potential employer? (No.)
    10. Who directs the order or sequence in which you work? (You do.)
    11. Are you required to regularly report your progress to your employer? (No.)
    12. What is the method of payment — hourly, commission or by the job? (A fixed price, a not-to-exceed (NTE), and/or milestone payments are standard for independent contractors.)
    13. Does the client reimburse your business and/or traveling expenses? (No.)
    14. Who furnishes tools and materials used in providing services (You do.)
    15. Do you have a significant investment in facilities used to perform services? (Yes. Key here is “significant.”)
    16. Can you realize both a profit and a loss from your work? (Yes–very important–you must assume risk based on client satisfaction with your work.)
    17. Can you work for a number of dentists at the same time? (Yes.)
    18. Do you make your services available to the general public? (Yes. You should have business cards, stationery, invoices and a business listing in the phone book and/or online.)
    19. Are you subject to dismissal for reasons other than nonperformance of contract specifications? (No.)
    20. Can you terminate your relationship without incurring a liability for failure to complete a job? (No. If you work on a project or milestone basis, you must deliver to receive payment for your efforts.)

What independent contractors should know

While it’s true that 1099s are not required if you are paid less than $600 by the business owner in a year, you should know that $600 is not a magic number and has nothing to do with whether or not you are classified as an independent contractor.

If you are operating as an independent contractor you have to remember you are self-employed and responsible for all tax withholding and payments yourself. Keep on top of these things. Don’t set yourself up for a big surprise and caught at the end of the year with a large tax bill to pay when April 15th rolls around.

For more information on employees vs. independent contractors, visit the IRS website.

DISCLAIMER: This is not intended or offered as legal or professional advice. These materials have been prepared for educational and information purposes only. If you have questions about the status of your staff, please consult with your legal adviser or CPA.





Managing The Employee You Hate

First, let me say this: I feel like this is kind of a controversial or taboo topic to tackle because no one wants to admit they hate one of their employees. But more than that, they don’t to come off as if they hate one of their employees, so that’s why this blog is important.

In her Dental Practice Management Article “How to manage the employee you hate,” Lisa Newburger recognizes that it’s not politically correct to be honest about hating an employee, but, she writes, it’s a reality that you’re not going to like every single one of those you manage. 

Newburger goes on to list things you should do and things you definitely should never ever do when it comes to managing that particular employee.

What you might want to do but should NEVER do when managing the employee you hate:
  1. Sabotage him/her.
  2. Gossip about him/her.
  3. Push his/her buttons and make him/her explode.
  4. Humiliate him/her.
  5. Make him/her quit.

The above list are all things Newburger felt about employees she’s managed that she hated. “Sometimes someone just irritates the heck out of me and I want (revenge badly,” she writes. “It comes from a deep place inside me that is purely evil. It’s so hard to believe I could really revel in wanting to hurt someone else, but it happens.” 

But, she goes on to write, that bosses who are have these thoughts need to snap out of it. “You don’t want to do these things to someone. Or, you shouldn’t,” she writes. “What can you do? How can you get your employee to behave and perform their job? How can you get them to just show up for work on time? You are sick and tired of this nonsense. The rest of the staff should not be subjected to this kind of behavior over and over again. What can you do without sinking to such a low level?”

Newburger writes that there are expectations of this employee and he or she should do them or leave. “I know it sounds a little bit harsh, but is it?” she writes. “If both management and the emploee are unhappy, sometimes there is only one answer.”

Managers should take the high road on this one, she writes, and take the legal, ethical and common-sense approach to dealing with this by adhering to the five tips below.

What you should do when managing the employee you hate:
  1. Document. Document. Document. Keep track of specific incidents and start a paper trail. 
  2. Let the person know there is an issue. After all, the employee can’t change the behavior until he or she knows there is one. 
  3. Have a plan of action with the employee. Address the specific issues and let them know what’s expected. “If they don’t want to come to work on time, let them know they don’t have to,” Newburger writes. “Have them sign and agree to the plan of action.
  4. Do not gossip about this person with anyone in the practice.  Go through the chain of command and do it behind closed doors. “Make sure no one hears conversations about this employee,” she writes. “You shoot yourself in the foot when you manage employees and forget you are not one of them. You are management. Management does not gossip.
  5. Do not sabotage or live in a distorted reality of wanting to fire someone. “Keep your eyes on the prize,” she writes. “The prize is not firing  . . . it is finding a solution.” Newburger said you should exhaust all possibilities to resolve problems, as firing has an impact on practices. Even if the employee wasn’t liked, managers still send a message that anyone could be fired. 

Newburger writes that managers should never forget that being a boss means having to deal wit problems every day. “How you deal with those situations really marks what kind of a leader you are,” she writes. 





Don’t Do These Things if You’re the Boss of a Dental Practice

Here at Dental Temps Professional Services we spend a lot of time discussing what you should do in a professional capacity. But today, I’m here to discuss what you shouldn’t do. 

The list below is from Lisa Newburger, LISWS and appears the DentistryIQ article “What NOT to do as a boss of a dental practice.” Newburger is a licensed social worker who is known for tacking difficult topics for dental practices with boldness and honesty. Her tips might seem like common sense, but remember: if someone had to write this list, there was likely a boss somewhere who was doing one or more of the following.

Five Tips a Boss Should Always Remember
  1. Do NOT try to be friends with your employees. Newburger writes that being a boss is like raising children. “You will never be one of us,” she writes. “Even if you were one of us and have been promoted, you are no longer part of our group. That is reality.” Bosses have subordinates, and they cannot be friends with people who report to them. There are times that managers have to deal with disciplinary issues, which is obviously unpleasant, but it becomes even worse for both you and your employee if you are friends.  
  2. Do NOT ask your employees on a date. As Newburger puts it, not only could this lead to an extremely uncomfortable situation, it could also open you up to harassment. “You will put everyone in a terrible position if you ask any of us out or give us any signals you’re interested in any of us,” she writes. “That doesn’t mean we want you to fire anyone. What it means is we don’t want to ruin our professional relationship!”
  3. Do NOT talk about your problems with your employees.  Newburger writes that even though a boss might think their employees might want to hear about office gossip from them, they’re wrong. “If you need to talk to someone, find a friend or a coach outside of the practice,” she writes. “We don’t need to know about coworkers’s issues or the financial problems going on in the practice.” It’s important that bosses protect their employees from unnecessary stress that they don’t need in their lives, and a way to do that is to keep gossip to themselves.
  4. Do NOT pretend your employees are deaf. Some bosses think that if they aren’t talking to staff members, their staff members aren’t listening. But she said that absolutely isn’t the case. “Close the door when you’re on the phone with your personal issues,” she writes. “All you’re doing is giving us something to gossip about, and we will! This takes away from our ability to respect you. You need our respect, but you have to earn it and act like a boss. If you don’t have our respect, this isn’t going to work.”
  5. Do NOT ignore us or treat us with disrespect. Your employees work hard for you, and they should get the same respect they give you. “Do not make us afraid to tell you about something important,” she writes. “Make time for us. The issues we bring to you are relevant either to us as team members or to the practice. Find out what the issues are so we can solve them and get back to business.”

Let’s get something clear real quick. I am in no way saying you can’t be friendly with your employees because who doesn’t like a friendly boss? But you can very easily blur or cross some of these lines without even realizing it. The key, I think, is this: When it doubt, keep it professional.