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The Root, April 2016

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The Root, March 2016

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Jonathon Kimes 5-13

Editor’s Report March 2016

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The Root, February 2016

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The Root, October 2015

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Click here to see the October issue of The Root, your source for Dental Legislation, Regulation, and Advocacy published by the TDA.

Jonathon Kimes 5-13

Editor’s Corner October 2015

Jonathon Kimes 5-13

 

 

The Austin Fluoride Fight: City Council Gets It

I know water fluoridation is a controversial topic, especially in Austin.  The amount of data, both for and against water fluoridation, can make your head explode.  The ADA remains a pro-fluoridation group, and as the local level of the tripartite, the Capital Area Dental Society remains a pro-fluoride group.  This doesn’t mean that you must agree or disagree with the position of the Society, however.  Personally, I think debate, if handled in a professional manner, is healthy to our knowledge of all topics.  If we never challenged the status-quo, then we would still live in the Dark Ages.  Above all else, I encourage you to create your own opinions based on your interpretation of science and fact, and continue to treat your patients with their well-being in mind; fluoride or no fluoride, amalgam or no amalgam, BPA or no BPA, and our profession will continue to be the best there is.  So yes, I am writing as a pro-fluoride CADS member…if you disagree with me, letters to the Editor are always welcome!

A very special Thank You is due to all of the CADS members and other pro-fluoride proponents that attended the recent City Council Committee hearing on community water fluoridation.  It speaks volumes for our profession when we take time off from our busy practices to fight for the health of our community.  Well Done!

This time, it all began at the June meeting of the Austin City Council Public Utilities Committee, where Councilman Don Zimmerman brought forth a resolution that would remove fluoride from the community water supply.  Whether by his intention or not, the resolution almost flew under our (CADS’) radar while the anti-fluoridation crowd was well aware and well prepared.  During the meeting, invited testimony included the assistant director of the water and wastewater treatment program with Austin Water Utility, and the chief epidemiologist with the Austin/Travis County Health and Human Services Department (Thank You, ladies!) giving some basic facts about water fluoridation and speaking in favor of continued water fluoridation.  Testimony in favor of the resolution was then given the majority of the floor time, with several local anti-fluoridation activists giving well thought-out presentations.  All sides were allowed non-biased representation by the Council, but pro-fluoride speakers were simply outnumbered.  I’ve read the meeting manuscript and watched the recorded meeting twice, and it is my (editorial) opinion that Councilman Zimmerman came with a hope of getting the resolution passed before anyone really knew what was happening.  He, along with the anti-fluoridation camp, was hoping to slide this resolution past the committee without much representation from the dental community.  Thankfully, Councilwomen Troxclair and Kitchen recognized the importance of the decision and requested that the resolution be tabled to allow time for a more thorough investigation.  This gave us time to organize our troops and circle the wagons.

Another hearing on the resolution was held in August at a joint session of the Public Utilities Committee and the Health and Human Services Committee.  By now, the pro-fluoride team had been assembled and was ready.  Philip Huang, MD, MPH, medical director and health authority of the Department of Health and Human Services, gave a wonderful presentation, followed by CADS President Elect Dr. Matthew Heck, CADS President Dr. Elyse Cronin Barron, and CADS member Dr. James McLane.  The anti-fluoridation group presented their side, and also did a good job illustrating their points.  In the end, Councilman Zimmerman made a motion to send the resolution forward to the full City Council, but was unable to get a second, and the resolution died.  Game over, for now.  There will be another round…there always is.

Preparation for a fluoride fight in City Council takes weeks, and in this case was just for a few minutes of testimony and a no-vote from the Council.  Fluoride fights are always difficult and mentally challenging, but once again, CADS rose to the occasion.

Jonathon R. Kimes, DDS
Editor, CADS

 

Jonathon Kimes 5-13

Editor’s Corner September 2015

Jonathon Kimes 5-13

Ride Off Into the Sunset

Beginning this month, the Texas State Board of Dental Examiners will begin a lengthy and often arduous process knows as a Sunset Review.  The Texas Sunset Act, passed in 1977, allows for the Sunset Advisory Commission to review the purpose and effectiveness of about 130 different state agencies.  Anything from the Texas Commission on the Arts to the Texas Low-Level Radioactive Waste Disposal Compact Commission (which meets next month in Montpelier, Vermont…you can’t make this stuff up).  The purpose of the Sunset Review process is to keep the government accountable to the constituents and prevent any agency from becoming a useless budget drain.  In its most basic sense, the Sunset Commission simply asks, “Is this agency needed any longer?”  Any state agency subject to Sunset Review can be automatically abolished unless a new legislative bill is passed that “renews” the agency.  If the Commission feels the agency is still needed, then they will introduce a new bill, often with recommended changes to the operating policies of the agency, which must pass through the Legislature in order for the agency to continue to exist.  If an agency is abolished, either by recommendation from the Commission or failure of a renewal bill, then that agency has one year to conclude its business.

The Sunset Commission consists of twelve people: five Senators, five Representatives, and two public members, one appointed by each the Speaker of the House and the Lieutenant Governor.  The Commission also maintains a Director and staff.  Beginning this September, the process begins with agencies submitting self-evaluation reports to the Sunset staff.  The staff then spends the next year working closely with agency representatives and conducting their own evaluations.  Public hearings will be held and the staff will prepare its final report to submit to the Commission.  Final recommendations and Sunset Bills will not be introduced until the next Legislative session, in 2017.

For the TSBDE, the last Sunset Review was finalized in 2003.  As you know, because you have been paying them to renew your dental license, they passed and were renewed for 12 more years.  Changes that were made to the Board policy and operations then included a reduction in the size of the Board, reduction in experience required for licensure by credentials, and a strengthened enforcement process.  Interestingly enough, as recent as last year, the Board was still making policy changes to unburden the violation enforcement process.  The Board was established in 1911, and it is unlikely that it will be abolished in 2017, but there could be some major changes made that could affect us.  Any TSBDE Sunset Bill for the 85th session will certainly be on our radar, so we will keep you informed of any changes that would affect your practice.

Jonathon R. Kimes, DDS
Editor, CADS

 

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Regulatory Updates

A reminder that the Opt-In/Opt-Out dates for Medicare have changed.  The Centers for Medicare and Medicaid Services have announced an extension for the deadline to either enroll or opt-out of Medicare for providers prescribing Medicare Part-D drugs.  The new deadline is June 1, 2016, but the CMS encourages you to take action by January 1, 2016 to allow time for paperwork to clear.

The Texas State Board of Dental Examiners recently held Stakeholder Meetings to discuss possible changes to current rules pertaining to the advertising of a “specialty.”  Check the CADS website (www.capitalareadental.org) for the most up to date information on this topic.

The Austin City Council Public Utilities Committee met recently to decide the fate of a proposal to remove fluoride from the community’s water supply.  A full report will be made available on the CADS website and in the October issue of The Capital Star.

The EPA’s final rule on minimizing environmental mercury in the dental office is due next summer.  The rule will have an effective date of three years after it is finalized (summer 2019).  Under the proposed rule, dental offices (some specialty practices not included) will be required to install amalgam separators if their waste water is discharged to public treatment facilities.

Infographic on Fluoridation (June 2013)

Community Water Fluoridation Update

Undeserved-Reputations-Fluoride

Congratulations to the Austin Community, you can keep your fluoridated water. Special thanks to all who spoke on behalf of continued community water fluoridation at the recent joint committee hearing of the Austin City Council Public Utilities and Health and Human Services Committees. Councilman Zimmerman’s motion to pass his anti-fluoridation resolution on to the full City Council did not receive a “second” from any other committee members, and therefore the resolution will not go any further.

Elyse-Cronin-Barron-Pic-1

President’s Message August 2015

Elyse-Cronin-Barron-Pic-1

Are you an activist?

 

Are you an activist?  Does the word activism have a positive or negative connotation when you hear the word?  Maybe it depends on your direct experience with activism, or your generational mindfulness.  Looking at the definitions of activism and traditionalist, I’m not sure I would consider myself in either category.  I do however love evidence and love research.

I pride myself on being a non-traditionalist, a non-conformist, on not following the masses in blind obedience.  Austin has a reputation for being a liberal hotbed here in Texas.  In fact, Austin prides itself on being progressive.  I attended the University of Washington in Seattle for my dental education and so I am a “transplant” here to Texas soil.  Over the years I’ve cultivated a great respect for the religious, political and cultural differences represented in Austin.  I may not always agree with people at church or a dinner party or even at a football game, but the wonderful thing is, we all have a voice.  It’s just a matter of if and how we choose to use it.

So what is the most controversial topic as a dentist in Austin?  Fluoride!  Yes, you get 10 bonus points for guessing it on your first try.  As a dental community we have been discussing, organizing, fighting and laboring over this topic for years.  Last year when it arose again I started to question all that I had been taught.  It seemed juvenile to repeat everything I was told 10 years ago.  What good is it to know quotes from a study 50 years ago?  Digging deep and becoming entrenched in the recent literature and research with an open mind, I found myself being led back to the evidence, good evidence, supporting fluoridation.  We all want to practice evidence-based dentistry, right?

There is education and there is experience.  We have all had experiences where you know fluoride has been central to the diagnosis.  It could have been a halt in the rampant deterioration of crown margins or the sad effect of living where fluoride wasn’t readily or available.  The other month I had to extract several baby teeth on an otherwise healthy seven year old.  Some of her baby molars were already beyond repair and she was in pain.  The mom doesn’t hold fluoride in high regard.  Respecting her right to parent didn’t mean I had to give up the obligation to let her know that her daughter’s cavities could have been prevented.  We had an open and frank discussion of what I thought led to her daughter’s condition.  As an individual’s doctor that’s what we can do, diagnose and try to prevent oral disease.  As a healthcare provider do we have an obligation to try and prevent it on a larger scale?

The extremists’ arguments are targeted at projecting fluoride as evil, poison, and detrimental at any level.  Let’s keep in mind that many things considered healthy in moderation are harmful in excess.  Vitamin C can cause kidney stones, headaches, insomnia, vomiting, and nausea.  Iron overdoses can cause cirrhosis, heart failure and diabetes yet it is still recommended, especially for pregnant women.  Yes fluoride in excess can cause some adverse effects but those effects are only seen in research with extreme cases of overt toxicity.  We all have sound scientific backgrounds even if we come from different parts of the country, different parts of the world.  Let us read and analyze the research to the best of our ability.  How do we want to care for our families, how do we want to care for our patients, our neighbors, our friends?  As a doctor, what would you recommend?  Let us stand up so that others may hear what our education and what our experiences lend us.  Let us be activists in that we ACT.

If you are inspired to get involved, the next City Council session hearing discussion points on fluoridation is on August 19th at 3pm at Austin City Hall.  There is a very real possibility of fluoride being taken out of Austin’s water supply.  One of the city council members, Don Zimmerman, brought the resolution himself to the Public Utilities Committee as a way to get the issue in front of the city council again.  Proponents of fluoride were not notified of the past meeting in June but will plan to be there at the August meeting.  Please contact Matt Heck or Elyse Cronin if you would like to speak or show solidarity in protecting our community.

By Elyse Cronin Barron, DDS
CADS President, 2015-2016

 

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