May 2019 Volume LIV Number 3


Scientific Program: Friday

January 2018 Volume LIII Number 1

Opening Ceremony & Keynote Address
Kevin Wanzer
Friday, May 25
7:30 – 9 AM

At his lemonade stand when he was just eight years old, Kevin Wanzer offered passersby two types of refreshment: a cold cup of lemonade and hilarious, dead-on stand-up rendi- tions of Steve Martin comedy routines. Decades later, the lemonade and Martin routines are gone. The refreshment, however, is still to be had. As a humorist, motivational comedian and keynote speaker, Wanzer has been earning rave reviews for over thirty years. Inspiring and entertaining audiences in refreshing ways is all he has ever known. He has been noted nationally as one of the most effective and entertaining speakers for inspiring and empower- ing audiences, celebrating Ohana and the Spirit of Aloha. Through stories and humor, he helps people reconnect with hidden passions, embrace diversity, and celebrate community through laughter.

Early in his career, Wanzer served on the staff of and appeared on Late Night with David Letterman. As a result of his early work with First Lady Nancy Reagan, President Ronald Reagan appointed him to serve as a delegate to the White House Conference for a Drug Free America, on behalf of which he spoke at the United Nations. To this day, Wanzer is still one of the youngest presidential appointees in American history.

Please come honor the best pediatric dentist during the awards portion of the morning. And celebrate the spirit of Hawaii with a unique opening.

100. Treatment of Vital and Necrotic Pulps on Immature Permanent Teeth
Friday, May 25
9:30 AM – 12:30 PM
Nestor Cohenca, D.D.S., F.I.A.D.T.

Pulp therapy aims to preserve and protect the inflamed pulp tissue from additional injury and facilitate its healing and repair while maintaining the health status of the tooth. With the advent of new biomaterials, the outcome of vital pulp therapy increased significantly with a high level of predictability. Contrarily, necrotic pulps with apical periodontitis present a clinical challenge, particularly in immature roots with short undeveloped root structures, thin dentinal walls, wide-open foramens and unpredictable disinfection, all of which will affect the long-term treatment outcome. MTA apexification remains a great treatment option for immature necrotic teeth, particularly for cases with advanced root development. Pulp revascularization exploits the full potential for tissue ingrowth toward dentin-like tissue deposition and stronger roots able to withstand fracture, mainly on teeth with poor maturation. This presentation will review the current evidence-based research for vital and non-vital therapy for the young permanent dentition and illustrate the importance of case selection to obtain positive outcome.

Upon completion of this course, attendees will be able to:

• Treat vital pulp exposures using the latest advancements on materials and techniques.
• Understand the concept of pulp revascularization for treat- ment of immature teeth with necrotic pulps.
• Develop the most predictable treatment plan for immature teeth with necrotic pulps to obtain a positive outcome.

Dr. Nestor Cohenca completed the endodontic program at the Hebrew University in Jerusalem cum laude and received the Best Graduate Student Award. He then served 11 years on faculty at the school while maintaining a private practice limited to endodontics. From 2003 to 2005, he served as a clinical assistant professor and coordinator of Trauma and Sports Dentistry at University of Southern California. Thereafter, Cohenca joined the University of Washington where he completed his endodontic certificate in 2008 and served as tenured professor of Endodontics and Pediatric Dentistry from 2005-2014. He served as director of Endodontics and the Multidisciplinary Traumatology Unit at the School of Dentistry, the Center for Pediatric Dentistry, and Seattle Children’s Hospital. Currently he serves as affiliate professor at the University of Washington, professor at Seattle Children’s hospital and maintains a private practice limited to Endodontics in Everett, Wash. He is a Diplomate of the Israel Board of Endodontics and the American Board of Endodontics. Cohenca is a Fellow of the IADT and received an honorary membership to Omicron Kappa Upsilon National Dental Honor Society. He has published more than 75 peer-reviewed articles, 10 chapters and a new book entitled "Disinfection of Root Canal Systems: The Treatment of Apical Periodontitis". Cohenca currently serves as president of the Inter- national Association of Dental Traumatology. Cohenca provided more than 200 lectures around the world and is well known as one of the experts in dental traumatology, Endo-Pedo related topics, vital pulp therapy, CBCT and root canal disinfection.

110. Who Caries?
Friday, May 25
9:30 AM – 12:30 PM
Brian Novy, D.D.S.

Let’s face it, sitting through a lecture about dental caries doesn’t sound appealing (in fact, it sounds downright boring). However, the science of clinical cariology is beginning to have an impact on restorative techniques and technology. Handpieces and burs will remove compromised novy tooth structure, but comprehensive patient care involves addressing the chronic disease that leads to cavitation. Combining the disease management with evidence- based dental materials can take the practice of dentistry to new heights,"and give Streptococcus mutans more to fear than stronger fluoride.

Upon completion of this course, attendees will be able to:

• Explain the mixed bacteria ecological plaque hypothesis.
• Describe bacteria implicated in caries and those that are as- sociated with oral health.
• Implement disease management in practice.

Dr. Brian Novy is the executive director of the DentaQuest Oral Health Center and director of practice Improvement at the DentaQuest Institute in Westborough, Mass. He served on the ADA Council of Scientific Affairs, as chair of the CAMBRA Coalition, and was recently appointed the consumer representative on the FDA dental products panel. In 2009, the American Dental Association awarded Novy and his office the title, "Adult Preventive Care Practice of the Year."

120. Update on the Spectrum
Friday, May 25
9:30 AM – 12:30 PM

Raphael Bernier, Ph.D., Travis M. Nelson, D.D.S., M.S.D., M.P.H., Autism spectrum disorder (ASD) is one of the most com- mon developmental disorders diagnosed worldwide. According to the Centers for Disease Con- trol, one in 68 American children have been diagnosed with ASD. This high prevalence means that every pediatric dentist will encounter children with autism in their practice. Presenters in this session will discuss practical, patient- centered treatment approaches for this population. Bernier will review the medical and behavioral aspects of ASD, and Nelson will cover dental implications and treatment strategies for care of this patient population.

Upon completion, attendees will be able to:

• Identify diagnostic criteria for ASD and the causes of clinical heterogeneity within the diagnosis.
• Understand what the most common comorbid medical con- ditions and associated conditions are and how they impact the clinical presentation of ASD.
• Understand the common behavioral patterns observed in ASD.
• Identify ways to connect with patients and families of chil- dren with ASD.
• Learn clinical tips to facilitate oral examination and connect with patients.

Dr. Raphael Bernier is a professor in the Department of Psychiatry at the University of Washington, the clinical director of the Seattle Children’s Autism Center, associate director of the Center on Human Development and Disability, and a licensed clinical psychologist. He received his Ph.D. at UW, his clinical training at UCLA, and also holds degrees from the University of Wisconsin and Tufts University. As the author of over 100 scientific articles and chapters and the book, "Autism Spectrum Disorders: A Reference Handbook", the principal investigator of several NIH and privately funded studies focused on the etiology and neuroscience of Autism Spectrum Disorders, and an active clinician, Bernier is at the intersection of science and practice of ASD.

Dr. Travis Nelson is a clinical associate professor in the Department of Pediatric Dentistry at the University of Washing- ton. Nelson received his D.D.S., from Loma Linda University and subsequently completed a residency in pediatric dentistry and a Masters of Public Health degree at the University of Washington. He is a board certified Diplomate of the American Board of Pedi- atric Dentistry. Nelson has authored numerous published articles, and has lectured nationally and internationally on a variety of topics. His research interests include providing dental care for children with autism, behavior guidance, and procedural sedation.

130. Work Life Balance
Friday, May 25
9:30 AM – 12:30 PM
Uche Odiatu, D.M.D.

Whether you are a dentist, hygienist, dental assistant or front office team member, improving your physical health will enhance everything you do. John F. Kennedy said, "Physical fitness is the basis of all forms of excellence." Did you know two-thirds of the top Fortune 500 executives exercise at least three times a week? And there’s scientific proof on why being fit empowers you to handle the enormous demands of a grueling practice, tight schedules and balance a full personal life. Living a healthy lifestyle can increase your personal productivity up to 25 percent. With the latest research on active living, "peppered with a whole lot of humor,"you will uncover powerful reasons to revamp your health and fitness dreams and goals starting today. This empowering and inspirational session will have you breaking through to the next level at work, rest and play with the newest science of nutrition (gut health), supplementation (probiotics, fish oil, whey protein, etc.), exercise (interval and resistance training) and sleep mastery.

Upon completion of this course, attendees will be able to:

• Gain insights into the three components of a complete exer- cise program and how to get the best sleep for recovery.
• Discover how stress negatively impacts digestion, the im- mune system and aging and 10 new ways to slay the stress dragon.
• Understand the new science of nutrition with respect to gut health, probiotics, nutraceuticals and dieting.

Dr. Uche Odiatu is the author of The Miracle of Health, a professional member of The American College of Sports Medi- cine, an NSCA Certifed Personal Trainer and a busy practice dentist in Toronto. This busy dad of four young children has been the invited guest on over 400 TV and radio shows and has lec- tured 400 times in Canada, the USA, England, Norway, Jamaica, Denmark, Bahamas and Bermuda.

140. Managing the Caries Continuum
Friday, May 25
1:30 PM – 3:30 PM
Kevin J. Donly, D.D.S., M.S., Rebecca L. Slayton, D.D.S., Ph.D.

This presentation will discuss the prevention and manage- ment of caries in children including risk assessment, caries classification systems, non-surgi- cal management strategies and restorative options. Evidence for each strategy will be discussed with consideration for age and behavior of the patient.

Upon completion, attendees will be able to:

• Understand the caries process and factors that contribute to increased risk of disease.
• Be familiar with non-surgical strategies to manage caries in children and adolescents.
• Understand the best restorative options for cavitated lesions in children based on current evidence.

Dr. Kevin Donly is a professor and chair in the Department of Developmental Dentistry and professor in the Department of Pediatrics at the University of Texas Health Science Center at San Antonio. Previous positions include professor and associate director of the Center for Clinical Studies at the University of Iowa, associate professor, Pediatric Dentistry at the University of Texas Dental Branch at Houston and Associate Professor, The University of Texas Medical School. He received his D.D.S. in 1984, certificate in pediatric dentistry in 1986, and M.S., in 1986 from the University of Iowa. Donly is a diplomate of the Ameri- can Board of Pediatric Dentistry, is past president of the Ameri- can Society of Dentistry for Children and past chair of the Public Information Committee for the American Academy of Pediatric Dentistry. He served as the AAPD chair of the Council on Post- doctoral Education and was also on the Board of the American Academy of Pediatric Dentistry Foundation and the American Dental Association Foundation. He also served as the American Academy of Pediatric Dentistry academic trustee-at-large,and was the Pediatric Dentistry Commissioner for the Commission on Dental Accreditation. Currently, he is the secretary-treasurer of the American Academy of Pediatric Dentistry. He has published over 350 chapters, manuscripts and abstracts associated with pediatric dentistry and dental restorative materials research and clinical utilization. He has received grants or research support from NIH/NIDCR, HRSA, as well as the 3M ESPE, Premier, Bisco, GC, NuSmile, Dentsply, Ivoclar, Kerr, Procter and Gamble, Church and Dwight, Optiva, Oral-B, Enamelon, Atrix Laborato- ries, Inc. and Guidor companies.

Dr. Rebecca Slayton is professor emeritus of the Depart- ment of Pediatric Dentistry at the University of Washington School of Dentistry and former director of the Dental Depart- ment for Seattle Children’s Hospital. Prior to her retirement, she served as the chair of the Department of Pediatric Dentistry at the University of Washington and before that, she was profes- sor and chair of the Department of Pediatric Dentistry at the University of Iowa. Slayton received her D.D.S., certificate in pediatric dentistry and Ph.D. in Genetics all at the University of Iowa. She is a board certified pediatric dentist and a diplomate of the American Board of Pediatric Dentistry. She serves as the chair of the Scientific Program Committee of the American Academy of Pediatric Dentistry and a member of the ADA Council on Scientific Affairs. She has been an examiner for the American Board of Pediatric Dentistry oral clinical exam since its inception. She has published numerous articles in peer-reviewed journals and textbook chapters. She is the co-editor of a textbook entitled, "Early Childhood Oral Health". Her research focuses on caries risk assessment tools and genetic factors that contribute to dental caries susceptibility.

150. Current Principles and Management of Anterior Supernumerary, Impacted, Ectopic and Missing Teeth
Friday, May 25
1:30 PM – 3:30 PM
Patricia H. Medland, D.D.S., M.S.

Ideal treatment of anterior tooth impaction (secondary to supernumerary teeth, trauma or ectopic development) and missing teeth (due to agenesis or trauma) aims to minimize long-term maintenance and maximize long-term esthet- ics. Temporary anchorage devices (TADs) and CBCT imaging now allow more teeth to be suc- medland cessfully disimpacted and spaces (left by missing teeth) to be closed to maintain alveolar bone and avoid prostheses. Realizing the potential of these new treatments requires directed treatment planning by pediatric dentists from the time of initial diagnosis. Clinical cases will be presented demonstrating the cur- rent interdisciplinary management of these challenging clinical problems in young patients.

Upon completion, attendees will be able to:

• List causes of anterior tooth eruption disturbances and their incidence/prevalence.
• Identify the diagnostic methods for assessment of anterior supernumerary, impacted, ectopic and missing teeth.
• Discuss the treatment options and ideal treatment timing for anterior supernumerary teeth and missing or impacted anterior teeth.
• Recognize factors associated with successful temporary an- chorage device (TAD) protraction of posterior teeth to close space where teeth are lost or missing.

Dr. Patricia Medland has a D.D.S. degree from West Virginia University (1977) and M.S. degrees in pediatric dentistry and orthodontics from the University of North Carolina (1982, 1988) and currently is an adjunct associate professor in orthodon- tics at the University of Queensland. She has combined private orthodontic practice in Surfer’s Paradise, Australia, with teaching in pediatric dentistry and orthodontic graduate programs since 1990. Her practice and teaching focuses on age-appropriate orthodontics. She has a particular interest in the early diagnosis and treatment of anterior tooth impactions and missing teeth and the application of new technologies to improve outcomes for this challenging group of young patients.

160. Dental Benefits Symposium
Friday, May 25
1:30 – 3:30 PM
1:30 – 2:15 PM
2019 CDT Codes
The coding workshop will cover all of the CDT-2018 addi- tions, revisions and deletions that pertain to pediatric dentists and general dentists who see children. In addition, the course will offer advice for submitting efficient and clean claims, medi- as their strategic solutions partner. Schaak brings to his posi- tion extensive leadership experience in matters of business and cal claims submissions, cross coding dental procedures to medical procedure and diagnosis codes, developing meaningful narratives, Medicaid policies on reimbursement issues and tips for appealing claim denials

Mary Essling is dental benefits director for the American Academy of Pediatric Dentistry. Essling has previous experience working on dental and medical procedure coding and third-party insurance matters for both the American Dental Association (from 1994 - 2002) and the American Society of Plastic Surgeons. She earned her Bachelor of Science degree from Marquette Univer- sity and an M.S. in Health Law Policy from DePaul University. In addition, Essling is a licensed registered dental hygienist in Illinois, Indiana and Texas.

2:15 – 3 PM
Big Data, Little Teeth: How Technology Enables Happier, More Engaged Pediatric Dental Networks
John Schaak, J.D., President, Scion Dental

John Schaak will present on building a happier, more engaged pediatric dental network. This is a critical contributor to meet- ing the Quadruple Aim’s goal of enhancing the patient experi- ence, improving population health, reducing costs, and engaging providers in both commercial and government-sponsored dental programs. Getting there can be a challenge, however, especially in the world of budgeted health care, i.e., Medicaid. Since money is limited, the only option is to develop better programs and tech- nology strategies that reduce administrative burdens for providers while also encouraging appropriate and cost-effective care. In his address, Schaak will highlight how the industry can leverage data analytics, automation, and digital tools to create efficiencies, increase provider satisfaction, recognize good providers, drive higher levels of access, and encourage more preventative care – all in an effort to stretch limited dollars to provide more and better care.

Upon completion, attendees will be able to:

• Discuss how the right technology strategy, built on a founda- tion of analytics, access, and automation, can transform Medicaid administration.
• Describe the effects that formally recognizing good pediatric dental providers have in delivering a higher standard of care while stretching budgeted dollars further.
• Identify common causes of fraud, waste, and abuse and the effects they have on pediatric patients as well as Medicaid dental programs overall.

John Schaak and his team are responsible for driving growth, operational performance, and customer satisfaction across SKYGEN USA’s suite of solutions. He leads efforts to improve effectiveness and efficiencies in the company’s benefits administration solutions, advance business services including client implementations, and increase customer responsiveness, making it easier for clients to do business with SKYGEN USA as their strategic solutions partner. Schaak brings to his posi- tion extensive leadership experience in matters of business and in child advocacy. Prior to joining SKYGEN USA, he was a partner with the national law firm Quarles & Brady. He is an experienced speaker who, among other things, has addressed the national conference of The National Association of Dental Plans, providing his vision of "The Insurance Company of the Future." He further takes every opportunity to speak about the need to protect children from pediatric dental abuse, including a recent presentation to the National Health Care Anti-Fraud Association on "Pediatric Restorative Benefits: Potential for Fraud & Abuse." Schaak formerly served on the board of directors for Wells Street Academy, a school for children with special needs. During his time as a practicing attorney, he also created and oversaw an award-winning truancy court program that continues to provide pro bono legal assistance to students. Schaak has been listed on the Wisconsin Super Lawyers, Rising Stars list multiple times. He holds a Juris Doctorate from Marquette University Law School. He earned a Bachelor of Science Degree in Political Science and Criminal Justice with a minor in Sociology from the University of Wisconsin Oshkosh.

3 – 3:30 PM
Questions from the Audience

170. Mini Clinics I
Friday, May 25
1:30 – 3:30 PM
1:30 – 2:15 pm
The Diagnostic Challenge in Pediatric Dentistry Part IV
Juan F. Yepes, D.D.S., M.D., M.P.H., M.S., Dr.P.H.

After three successful Annual Session presentations, the case discussion is coming for the fourth time. This fast to-the-point session will bring to the audience three patients with an interesting challenge. Differential diag- nosis is the center-point of the discussion together with a brief review of the final diagnosis.

2:15 – 3 pm
Odontogenic Infections and Antibiotic Use
Keri Discepolo, D.D.S., M.P.H.

Best practices for antibiotic use are discussed. Spreading odontogentic infections are important to diagnose early and manage appropriately; discussion regarding ineffec- tive category/dosage of antibiotics are described. Due to the growing body of evidence regarding antibiotic resistance, it is important to reduce overuse and misuse of systemic antibiotics.

3 – 3:45 pm
New Guidelines on SDF
Timothy Wright, D.D.S.

Caries lesions continue to be managed most often using surgical approaches. While the use of silver products is not a new concept for caries management, the introduction of silver diamine fluoride (SDF) to the US marketplace in 2015 provided a new non-surgical caries management tool. The mechanism of action is thought to be a result of the compounds combined antimicrobial and remineralization properties. Based on systematic reviews of clinical trials the AAPD developed a guideline recommending the use of 38% SDF as part of a comprehensive caries management approach. This presentation will review the scientific evidence that informs this guideline for the use of silver diamine fluoride as a caries management tool.

Click here for a PDF version of this article.