Pro-Fluoride Resolution Victory in Austin, December 15, 2011

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In a 7-0 vote, the Austin City Council approved a resolution that makes the following recommendations:

  • Continue to keep Austin water fluoridated because fluoridation of public drinking water is a good population based public health practice according to the Centers for Disease Control and the City’s Health and Human Services Department.
  • Post information about fluoride and infants on the City’s website and at the City’s Health and Human Services Department Neighborhood Centers and WIC Stations, in both English and Spanish.
  • Mail information to Austin Water Utility customers highlighting fluoride and infant information from the City’s website.

According to the website of the Austin Anti-Fluoride group, http://fluoridefreeaustin.com/, “On July 3, 2010, celebrated health journalist Dr. Joseph Mercola, honored us by declaring Austin – along with San Diego and Waterloo, Canada – one of North America’s three most important cities in the ongoing battle against water fluoridation”.

Cassidy Neal, Program Manager, Department of Member Services & Administration of the Texas Dental Association said that, “Capital Area Dental Society sent Dr. Jeffery Brunson and Dr. Barry Rouch who presented very well and lent a great deal of credibility to the pro-fluoride side. A big thanks goes to them for making this a successful vote for fluoride, patients, and organized dentistry!”

Also instrumental in the hearing process were Dr. Mark Peppard and Dr. David Slaughter. Other local dentist were present in support of CADS.

Capital Area Dental Society President, Dr. Jeff Brunson remarked that Ms. Neal was most helpful in making resource materials available and that she is the unsung hero in this victory. He also said that, “Dr. Slaughter made a most impressive and passionate presentation”.

Looking Back, Looking Forward

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It’s always exciting to start another year. I hope that in 2012 you, your family, and your dental career can build on the successes and challenges that were 2011.

Last year was many things for the Capital Area Dental Society. It was another year of growth in overall membership for CADS. We welcomed 74 dentists to our society. We also had several current members nominated for awards. Special congratulations again to Don Taylor and Eric Hollander for their nominations for Texas Dentist of the Year. Also, we were fortunate to have Ensy Atarod receive the Texas New Dentist of the Year Award, and Elyse Cronin took home the CADS New Dentist of the Year Award.

Financially, CADS has positioned itself very well. This good fortune has come our way because of the support of our members. Thanks to all of you who attended a CADS General Meeting or our John Kois Lecture last year. We are also positioning ourself for the future. While there is no immediate need or date set for a CADS central office, measures are being made to insure that we are fiscally ready when CADS’ growth dictates its necessity.

In 2011, the issue of water fluoridation arose in Austin. As the local dental society, we felt that it was important to take facts regarding this important dental public health measure to Austin’s City Hall. I would personally like to thank Barry Rouch, David Slaughter, Mark Peppard and Frank Bonasso for joining me and taking time from their practice to speak on benefits of water fluoridation. I am happy to report that we were successful and that your Austin City Council values our opinion as healthcare professionals. Even though we have been successful to this point, we know that water fluoridation could remain a topic of discussion locally. I would ask all of you to make yourself knowledgeable on the subject, not only for your patients, but also for your family, friends and fellow citizens of Austin.

Please make plans to attend the Capital Area Dental Foundation Gala on February 18th at the Four Seasons Hotel. Donations are still being accepted and raffle tickets are for sale for this great event. For further details please visit capitalareadentalfoundation.org. Hope to see you there.

Here are some dates to be aware of as you are planning your continuing education for 2012. Registration is currently open for the TDA Annual Session in San Antonio scheduled to be held May 3-6. Additionally, the Southwest Dental Conference in Dallas is set for January 12-14th and the Star of the South Dental Meeting in Houston is March 29-31st.

As we look forward into this year, I wish all of you the best.

You can all be Reporters!

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With more than 700 members, it is difficult for one person (your editor) to keep up with all of the happenings of our members month after month. Past President, Dr. Barry Rouch recently had a great idea of having a section in the Capital Star devoted to news involving individual members such as the birth of their children, awards earned, whether dental or non-dental. We have always been a tight-knit group and this will help get the word out about what everyone is doing. I am really envisioning one or two lines at most for each entry.

This will be a place for you to brag on a colleague by simply giving me a call or sending an email. As of now, I have not decided on a name for the section but for now it will be something like WE HEARD…CADS members in the news. The success of such an endeavor will depend upon members actually providing the information. I say we give it a try and see how it goes.

On that note, CADS members who have recently earned Fellowships in the Academy of General Dentistry are Dr. Henry Truong of Austin, Dr. John McEntire of Hutto, Dr. Wayne Radwanski of Austin, and Dr. Patrick Bell of Georgetown. Dr. Kelly Hale of Buda was awarded the Masters of the Academy of General Dentistry. Congratulations to each of you on these professional milestones!

Do not forget the Gala on February 18, 2012! This year there will be a Casino portion that is always fun! For more details and to purchase raffle tickets to win a trip to Hawaii, check the newly updated website of your Foundation at www.capitalareadentalfoundation.org.

Falling Through the Cracks

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Imagine the horror of discovering that a patient with a suspicious lesion on the tongue was sent to your surgeon for a biopsy and it was discovered more than a year later that the specimen had not been sent to the lab for examination. According to the June 2011 OMSNIC Monitor, a newsletter of OMS National Insurance Co. this actually occurred with catastrophic consequences.

It turns out that the surgeons’ office did have a log book for tracking specimens and pathology reports but it appeared that the staff person responsible for documenting and sending the report never did either. The patient never received a follow-up visit or a consultation of the laboratory findings and returned to her general dentist 13 months later because the lesion had worsened. Upon investigation, the oral surgeon realized that there was no record of the specimen being sent and consequently, no report. She was asked to return for a second biopsy that revealed that the lesion was in fact a squamous cell carcinoma that had progressed to the mandible and the cervical lymph nodes.

To make matters worse for the well-meaning surgeon, the patients’ record was never found. An investigation revealed that the person tasked for tracking the pathology cases had several patient records in her car, but not the one in question.

I cite this very unfortunate incident as a reminder to us all how important our internal systems are and that critical tracking systems should be monitored frequently and by more than one person. Additionally, the referring dentist should also follow the case to make sure the pathology report is received in a timely manner as an additional safeguard to assure that critical and timely information does not fall through the cracks.

Executing Plans

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The Capital Area Dental Society has never been more active than it is now. Over the past several years your colleagues have committed substantial time and effort to make our organization the best dental society in Texas. The success of this group is no mistake. It came about through planning, organizing and ultimately, executing plans.

Many years ago a strategic plan was developed. Some of the highlights of that plan included increasing our charitable contributions, improving the quality of CE for our members, and increasing the visibility of CADS to the local community.

I am happy to say that we have met and exceeded the challenges set forth.

  • CADS now proudly has an active and growing charitable organization, the Capital Area Dental Foundation. The foundation has done many great things in a short period of time. They are currently raising money and looking for grants to help local citizens receive dental care they otherwise couldn’t afford. The presence of the foundation increases our exposure throughout the community and sends a message to the public that, as organized dentists, we care.
  • Most members are aware of the quality of CE that CADS consistently brings to Austin. Our General Meetings are the best attended local dental society meetings in the state, and possibly the country. We regularly have more than 100 dentists in attendance, and recently had almost 300 in attendance at our Kois all day seminar.
  • For multiple reasons, our visibility has increased in the community. I would like to spotlight the Dentists on Campus (DOCS) program. As part of this program, our member dentists are going into elementary schools to educate students on healthy living and dental hygiene. This year, the program was able to reach 3,900 children, making a difference locally.
  • An additional facet is our new Member Benefits program. This program is similar to TDA Perks but has a local flair to it. The companies participating in this program are: Peoples Pharmacy, ABC Home and Commercial Services, Russell Korman Jewelry, Austin Area Computers, Blue Sky Scrubs, The Steam Team. Every time you patronize one of these companies, there is a benefit for CADS and a direct benefit to you in the form of a discount.

We will be setting new goals this summer to reach even greater heights in the future. If you would like to be a part of our new strategic plan, now is the time to be heard.

It’s in the Water

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Over the course of a dental career, our patients are capable of asking some interesting questions.  Most of the time the questions are appropriate and give us valuable teaching moments with our patients, while at other times you might get something that makes you scratch your head.  One day it is mercury in amalgam, and the next it is BPA’s in composite.

The question that Austin might be asking you today is about water fluoridation.  Is it good, is it bad, or is it too much of a good thing?  Historically, recommended fluoridation levels for drinking water ranged from 1.2-0.7 milligrams of fluoride per liter of water.  The range was based on temperature, with lower levels recommended in hotter climates with the expectation that more water will be consumed in those areas.  Earlier this year The US Department of Health and Human Services (HHS) lowered their recommended fluoridation level to 0.7 milligrams of fluoride per liter of water.  This updated recommendation is based on recent EPA and HHS scientific assessments that balance prevention of tooth decay while limiting unwanted health effects.  Locally, our levels did not change and remain at 0.7mg/L.

You might be aware that recently, Austin and more specifically the City of Austin’s drinking water has been targeted by a group known as the Fluoride Action Network (FAN).  The group is better known locally as Fluoride Free Austin (FFA).  These groups have a stated goal of eliminating fluoride from public water supplies.  The test markets for getting this movement started are Austin and San Francisco.

As you might expect the debate on water fluoridation can be a passionate endeavor.  According to the FFA’s website they believe that fluoride is a, “health-damaging hazardous waste toxin” and should never be added to water.   While on the other hand, the Centers for Disease Control (CDC) list water fluoridation as one of the top 10 public health measures of the 20th century.

There are dentists and other well-educated individuals on both sides of this debate.  The ADA has a position on water fluoridation and encourages members to advocate fluoridation of water supplies.  This statement is the umbrella that carries the Association’s views of the topic, “The American Dental Association unreservedly endorses the fluoridation of community water supplies as safe, effective and necessary in preventing tooth decay. This support has been the Association’s position since policy was first adopted in 1950.”

As I write this, the City of Austin is reviewing its policy and standards on this matter.  Locally, there has been a great deal of debate at City Hall.  As the talks move forward, expect more media coverage locally and nationally.  Austin has become the battleground that could change the way cities view fluoridation of drinking water.  A quick internet search is all it takes to find more information on the topic.  There is a wealth of information available, however it often seems misleading and conflicting.  That is where you as a dental professional are invaluable.  Educate yourself so that you can educate your patients.

Change is Good

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In May of 2002, Dr. Peppard, then CADS President, called me and asked me if I would consider becoming Editor of the Capital Star, I paused and told him that I would have to get back to him. I thought it over and decided to give it a whirl. That means that I have served as your Editor almost as long as Rick Perry has been Governor of Texas! Well, not really, he became Governor December 21, 2000, but it does seem like I’ve been Editor forever. I believe that it is time for a change – for Editor that is.

With the expertise of Nancy Nisbett as Managing Editor, the Star has continually improved. When I began there was only black-and-white. Now we are full color. I am now committed to another year as Editor, ending May 2012. That will be 120 issues of the Star that I have been responsible for.

We have been blessed with strong advertiser support during my tenure and Nancy has done a marvelous job making sure that this publication is not just a service to CADS members but making sure that we have always been published without a loss.

The job has been much more rewarding than I imagined. I get to report on awards won by many of our members. I get to report on Galas and the always popular, New Dentists socials. Sometimes the news that I need to report is not so good but for the most part it is positive news.  I have tried to keep everyone up to date on rule and law changes as well as upcoming events. I hope all of you have enjoyed the Star. As Editor, I have sat on the CADS Executive Board for eleven years. This is significant in that as officers rotate through the board, I remain the one that has been there the whole time.

It is time for a change. I am asking you to consider becoming Editor. If you have an interest or have questions about the duties of the Editor, please call me. If you wish to be placed into consideration, I will pass the nomination to the Nominating Committee.

Thank you for allowing me the privilege of serving you as Editor of your newsletter, the Capital Star.

Installation of New Leaders and Board Members

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Each year in May, the Capital Area Dental Society installs new leaders and board members to serve this great organization. This year I have the honor of serving as your CADS President. The leaders that have preceded my time in this role have been excellent mentors to me, and have provided a road map to continued success for this organization. Each year brings new faces to the organization and a new breath of enthusiasm, and this year is no different as we continue to welcome new dentists to Austin.

I encourage all of you to give something back to your profession. Dentistry allows us several methods for giving back, whether through time or money. I think you will find your reward is greater than your gift. If you would like to become more involved with CADS leadership, please contact me or any other board member and we would be happy to welcome you.

May was also a month of awards for the dental society. The CADS “Dentist of the Year” has been awarded to Dr. Eric Hollander. Dr. Hollander is a previous recipient of the “New Dentist of the Year” award and has served in a leadership role for CADS for almost 10 years, including being our Immediate Past President. Dr. Elyse Cronin has been awarded the CADS “New Dentist of the Year”, for her dedication and commitment to making our new dentist group the best one in the state.

I would also like to congratulate Dr. Lance Sanders who was elected by the SE Caucus at the Texas Meeting to serve as an ADA Alternate Delegate. Dr. Sanders is no longer the “man behind the man,” he is now the man to go to if you have questions about what’s going on at the ADA level.

Lastly, I want to thank our Executive Committee (Dr. Tom Wicheta—President Elect, Dr. Misti James—Secretary, Dr. Don Taylor—Treasurer, Dr. Kavin Kelp—Editor, and Ms. Nancy Nisbett—Executive Director).  As you can see, you have a great team leading the way. As Henry Ford said, “If everyone is moving forward together, then success takes care of itself.”

Toothpaste Abrasion

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For years, it was thought that the toothbrush was the main culprit in cervical tooth abrasion but it turns out that the problem lies in the toothpastes. We all have patients with cervical wear in the teeth and several speakers I have heard recently have addressed this problem. The ADA has adopted a standardized test for rating the relative abrasiveness of toothpastes. Extracted teeth are inserted into a brushing machine and brushed at a constant pressure and stroke speed. There is no wearing noted when no dentifrice is used. The abrasive component is toothpaste itself.
A Relative Dentin Abrasion (RDA) score or index is given to the toothpaste. Any value over 100 is considered to be abrasive. The ADA recommended limit is 250, whereas the FDA limit is 200. You may find this list from the ADA helpful in your practice.

The RDA Table:
0-70 = low abrasive
70-100 = medium abrasive
100-150 = highly abrasive
150-250 = regarded as harmful limit

Toothpastes / RDA Value

FDA Recommended Limit 200. ADA Recommended Limit 250


Straight Baking Soda 7
Arm & Hammer Tooth Powder 8
Arm & Hammer Dental Care 35
Oxyfresh 45
Tom’s of Maine Sensitive 49
Arm & Hammer Peroxicare 49
Rembrandt Original 53
CloSYS 53
Tom’s of Maine Children’s 57
Colgate Regular 68
Colgate Total 70
Sensodyne 79
Aim 80
Colgate Sensitive Max Strength 83
Aquafresh Sensitive 91
Tom’s of Maine Regular 93
Crest Regular 95
Mentadent 103
Sensodyne Extra Whitening 104
Colgate Platinum 106
Crest Sensitivity 107
Colgate Herbal 110
Aquafresh Whitening 113
Arm & Hammer Tarter Control 117
Arm & Hammer Advance White Gel 117
Close-up with Baking Soda 120
Colgate Whitening 124
Crest Extra Whitening 130
Ultra Brite 133
Crest MultiCare Whitening 144
Colgate Baking Soda Whitening 145
Pepsodent 150
Colgate Tarter Control 165
Colgate 2-in-1 Tarter Control/White 200

Something to Think About

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Dr. Griffin Cole, a CADS member, was seen on World News Tonight with Diane Sawyer on Friday, January 7th discussing the new recommendations on maximum concentrations of fluoride. The Environmental Protection Agency and the Human Health Service has lowered the maximum concentration to 0.7 mg/L.

Dr. Cole has submitted an opinion article discussing his thoughts on the use of fluoride in dentistry that appears in this issue of the Capital Star. While the opinion of Dr. Cole is in conflict with the ADA position and the great majority of its members, it is healthy to consider the issue. There have been numerous studies and political discourse for many decades concerning the benefits and perceived harm of fluoride use.