Dental World®		September/October • 2002
	PIERRE FAUCHARD ACADEMY

	Thoughts From the President
	Some years ago, General Mark W. Clark said, “All nations seek it constantly because it is the key to greatness, sometimes to survival—the electric and the elusive quality known as leadership.” Where does juvenile delinquency begin? In the leaderless families! Where do slums fester? In leaderless cities! Which armies falter? Which political parties fail? The answers to all of these is poorly led ones. Contrary to the old saying that leaders are born, not made, the art of leading can be taught and it can be mastered. What we need today, on all fronts, in our homes and communities, in our boardrooms and in our society at large, are leaders. We, as members of the PFA, should recommend colleagues in our sections who have the qualities of leadership for induction to our Section Chairs. On February 27, 1860, Abraham Lincoln, the Republican Presidential candidate, gave one of the more significant speeches of his political career. Among other things, he attacked the pro-slavery position of his opponent, Stephen A. Douglas.		He concluded his presentation with a strong admonition to his Party that they hold fast to the beliefs that they had espoused. “Let neither us be slandered from our duty by false accusations against us, nor frightened from it by menaces of destruction to the government or dungeons to ourselves. Let us have faith, let us, to the end, dare to do our duty as we understand it.” Faith is an irreplaceable virtue for all, particularly those who lead—be it a nation, a company, or a family. I would say that our Academy is a family. There is great loneliness in leadership. We have to live with our consciences. We have to stand up for the values and beliefs that we have embraced, adopted, and woven into our character. If values are not established and adhered to at the top, behavior down the ranks is seriously jeopardized and undermined. Indeed, in any organization where such is the case—be it in a family, a corporation, a society, or a nation—the values being neglected will in time disappear. We do not have the luxury of retreating to our private cloisters and pursuing only our special private interests. Strong voices are needed. The weight of our stance may be enough to tip the scales in the direction of truth and right. May we all stand for what we espouse as members of the Pierre Fauchard Academy.
			Scott M. Welch, DDS President

	Table of Contents- September / October 2002
	Presidents Message		Foundation News
	President-Elect Gordan Stine		Treasurer George Higue
	2002 Calendar		Foundation News - United States
	Awards Banquet		Section News- International
	Dr. Terrance Ward		Section News- United States
	The Value of a Smile		PFA Annual Meeting Schedule
	Dr. Raymond D. Wenn		Editor’s Computer Alert
	The Human Genome
	Congressman Charlie Norwood
	Senate Bill #2650		go to .Page..|. 1..|. 2..

	President-Elect Gordan Stine Honored
	The Greater Charleston Chamber of Commerce, at their 229th annual Gala Meeting on Friday, 28 June 2002, presented the Joseph P. Riley Leadership Award to our PFA President-elect Gordan Stine. Past 2001 recipient Anita Zucker made the presentation of this award, which is given annually to individuals who use their skills to make the Charleston area a better place. Dr. Stine, a retired dentist and civic leader, grew up in Charleston and had spent more than 50 years practicing dentistry there. His volunteer hours number in the thousands to hundreds of local organizations. He is the Founder of the Dental Lifelong Learning Fund at the Medical University of South Carolina and a three-time recipient of the Order of the Palmetto. The Riley Award was named after a very dynamic Mayor of Charleston who revitalized the waterfront area with parks and fountains. Your Editor was there the night Mayor Riley opened the waterfront for the first time with a huge orchestra playing classical water music. My daughter got his autograph on the evening’s program from this gracious man who made time from talking to the elite to sign his name for a little girl. The Award is well named. This year’s recipient is well deserving such company. This exemplifies our own President’s Address, that an organization, city, or a nation is only as great as are its leaders. The some 700 guests at the Charleston Area Convention Center listened to outgoing Chamber of Commerce President Dick Elliott echo our own President Welch and Dr. Stine, that we need more effort at cooperation. “Unfortunately, it all boils down to historic attitudes of fierce independence, political agendas, turf protecting—and the list goes on.”		Dick Elliott continued, “All these challenges that cross multiple boundaries and jurisdictions, these challenges require creative, integrated approaches if we are going to experience real change.” He called for countrywide involvement. “We cannot do that alone. We want to join with the organizations and leaders represented here tonight, as well as others. Only through collaboration on a regional strategy can we maximize our limited financial resources and harness the ingenuity of our people to produce the quantum leaps we need.” There, in the formally attired crowd of South Carolinians sat our President-elect, Dr. Gordan Stine, not just listening, but, having been over a half a century of leadership in the exact areas the Chamber President cited to need more help, Dr. Stine was called to the stage to receive their Leadership Award. Dr. Scott Welch says the same thing from his perspective in Wyoming as Chamber President Dick Elliott says from urban Charleston. Leadership, cooperation, and resolution of the problems facing our society are desperately needed to be awakened. Dr. Gordan Stine comes from exactly that background to launch his year as PFA President.

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			Calendar 2002
	1-5 October 17 October 18–20 October 19–23 October		90th FDI Congress, Vienna, Austria AADE Conference at the New Orleans Marriott PFA Academy and Board Meetings, New Orleans, Louisiana 143rd ADA Annual Meeting, New Orleans, Louisiana (Have your PFA Event date put here. E-mail Editor Brophy at PFADWJMB@aol.com)

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	Awards Banquet
	As of this writing, the Awards Banquet will be held on Saturday, 19 October 2002, at the New Orleans Riverside Hilton Hotel. The last issue of Dental World highlighted the Awards and those receiving them. A more in-depth picture of the event will be reported in the next issue. Past PFA International President Minori Horiuchi, and current ICD International President, received the PFA Gold Medal, our top honor award. The International Elmer Best Award was presented to Dr. Rufino Achacoso of the Philippines. The Certificate of Merit was presented to past Uruguay Section Chair Walter Lieber Bielli. Honorary Fellowship was conferred on Iowa Dental Executive Director Robert Harpster. The President’s Award was presented to Dr. Joseph Devine, past President of the Wyoming Dental Association. Degussa President Gerd Schulte The Dental Trade and Industry Award was mentioned as going to Gerd Schulte, President of Degussa AG of Germany.		The profile they have sent us notes that Degussa Dental stands for progressive and successful products and systems solutions in the area of dental technology. Their modern Dental Centre and headquarters is located in Hanau, just outside of Frankfurt, Germany. Degussa Dental melds the medical and functional requirements to the esthetic demands of the patients, such as ensuring the compatibility and tolerance of their products with clinical studies lasting several years and consultations with dentists and dental laboratories throughout the world. This ensures that they stay in the forefront of developing technology. They are the largest dental company of its kind in Europe and are a part of the USA Dentsply International network. Degussa Headquarters in Hanau, Germany

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	Dr. Terrance Ward, Hall of Famer
	PFA nominated Dr. Terrance G. Ward for installation several years ago but has been searching for the proper venue to install him. Dr. Ward earned his professional degrees from the University of Edinborough, and received many honours from Great Britain (FDS, RCS), Scotland (LRCP, LRCS, LRFPS), Ireland (FFD, RCS), and Australia (DDSc-Melbourne). In 1969, the ADA House of Delegates honoured him with Honorary Membership for his outstanding achievements in dentistry and for organized dentistry. He was an international leader in oral and maxillofacial surgery. He served as President of the International Association of Oral Surgeons and became their first Secretary-General. He also was past President of the British Society of Oral Surgeons and Chief of the renowned Maxillo-Facial Unit of Queen Victoria Hospital at East Grinstead in Sussex, England. He was Consultant Oral Surgeon to the British Army, to the Royal Navy and to the Royal Air Force in which he had served as a Squadron-Leader. Dean Terrance Ward served the Faculty of Dental Surgery for the Royal College of Surgeons of England and was on the Council of Faculty of Dentistry for the Royal College of Surgeons of Ireland.		Dr. Ward served as Vice President of the Odontological Section of the Royal Society of Medicine and President of the British Association of Oral Surgeons. He was a frequent contributor to the literature of oral surgery and lectured in many countries on this topic. As educator he was in the leadership forefront in advancing the standards for graduate and post graduate training in oral surgery throughout the world. What today we call continuing education courses, Dr. Ward was an essential part of advancing dentistry and oral surgery worldwide on topics of cancer in the mouth, oral surgery, facial injuries, radiology, first aid for oral trauma, facial pain—all topics ahead of their time. He was never named “Father” of any dental facet, but he certainly was an aggressive apostle in spreading the most recent developments in oral surgery to the various corners of the world. (Dental World wishes to thank Ruth Schultz of the ADA Library for her contributions to this article when the British and Irish Dental Societies failed.)

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	The Value of a Smile National Health Service vs. Private Practice Debate in the UK by Dr. Amarjit Gill
	(Dr. Amarjit Gill is a United Kingdom PFA Fellow who serves as Chairman of the British Dental Association Private Practice Committee and is Director on the BDA Executive Board. The opinions expressed are his own and do not necessarily represent PFA policy.) Just how much is a tooth worth? When it comes to that, how much is it worth to have a fabulous smile? As professionals, we have seen our value eroded by successive governments. I have never once paid thousands to an architect (or a lawyer) and thought, “Well, that was worth the cost.” Does that mean that when we charge only a few pounds (dollars) that our work is any the less important? Is this a true reflection of our respective worth to society? When this topic concerning the value of a smile was raised, we wondered how to place a value on it. The real value comes to the individual when they have lost it. Is it the cost of a partial denture? A bridge? Implants? How can you place a monetary figure on not having your very own teeth? Another model might be what is it worth over a lifetime of use? The National Health Service (NHS) averages this at £54 per year. That is £540 over 10 years. Is this the real value of a smile? The real value lies somewhere between those two concepts. The younger practitioners think to want a salary. Others sit on the fence mulling over the idea of getting into NHS or not. What future are they being guided to in their professional careers? Recent reports reveal that we are being stressed as a profession. Over the years, the government makes claims about providing dental care, but it does not compensate for the care they expect us to deliver. Professionals are trained to provide the best care possible for their patients, yet what type of care can they provide on a limited reimbursement schedule? In some countries, third-party programs are trying to squeeze the profession into a business that they can deal with on a monetary basis, rather than on a patient service basis. Are we a profession or a business? The answer is both. The answer is not one or the other. Government insurance programs see it only as a commodity with a price tag. Professionals see it as a human service for their fellow man. Reality dictates that to provide a service to patients, we need to stay in business. Our education, skills, and experience put us on a level way above an architect or a lawyer. But all third parties, abstract from owning the smile, deal with us as discount warehouses. We are trained in the science and art of our profession. Few have any leadership skills. The profession needs this talent more so than ever before. And our democratic process just does not lend itself toward this goal. Weak politicians pay lip service to the public with a dental service program and then fail to fund it to the extent that it is needed to save budget costs for the public. Reformers get elected, but the situation does not change. Where is the dental leadership to step up and demand the government keep their promises? Over the last decade (or more in other countries), the only way to balance the books and be progressive—add newer technology to the office, replace outdated equipment—was to do so on a personal basis. Or not, as the economic situation dictated. As independent contractors, colleagues began to choose to limit their work for ungrateful third parties. Depending on the rankled professional, this takes the form of overdiagnosis, underdiagnosis, shortcuts, referring out work they could perform but not at what they are being paid, limited access, and selective treatment to name a few options. In the United Kingdom, NHS has been around for a few generations. In America, government and third-party insurers have a stranglehold on the profession. Thus begins the fearful future choice for all practitioners to initiate a transition to private, fee-for-service dentistry. Is survival possible with your creditors standing at the door?		The decision is not the dentist’s alone. Will the public be aware enough to appreciate the better treatment if they must pay for it? Some will, but is that enough to survive as a business? And how many of us will the marketplace be able to sustain? We need the support of our professional organizations, the support and confidence of the public, and the courage to take the steps leading to private practice. The Financial Times reported the “business” of dentistry in the UK was worth more than 12 times the current reimbursement levels when compared with other per capita costs of a patient. Even if the government doubles their current spending, that does not mean an optimistic future for us all. We are seeing a move on the public’s part, reflected in the government, to go from “required dentistry” to “desired dentistry.” That means the partial denture that is placed for required dentistry could be replaced with the patient’s demand for bridgework—at about the same government reimbursement! The cost of maintaining a practice rises, but the income does not. And we have still not addressed the issue of increased staff salaries, rising utility costs, investing in newer technology, or replacing older equipment to be more efficient. We have not faced the issue of time away from the practice to gather new information or be educated on the latest research. Once we understand our value as a profession, only then can we determine our role in society, only then can we plan a future. NHS is not inspiring any of us by their actions. Our future is dependent on understanding the financial concepts that relate to our society—value and pricing. What is the value of a dentist compared with other professionals? Other services? What is the value of a smile financially and psychologically? What is the image of dentistry in today’s image-obsessed world? Businesses meet the changes in supply and demand with “fluid pricing.” For example, supermarkets charge different prices for the same item at different times of the day. Soda pop machines will charge more for pop on hot days than colder ones. Airlines charge more for day flights than night ones. Following this business practice, should we be charging more for the occasional patient who comes in with a toothache than our regular patients? This rewards our regular patients in terms of comfort and money. But try to argue that with the government or insurance companies. The same situation occurs if we need to interrupt our schedule of regular patients to see an emergency that puts us behind for the rest of the day, and costs overtime for our office. Do we need to be reminded how much people spend on hairdressers, alcohol, and other lifestyle choices over fixing their teeth? The BDA Private Practice Committee believes our priorities must be to provide the best care for our patients and move away from trying to satisfy the government of the day! Editor’s Note: We welcome all such articles from various parts of the world so we can better understand the problems facing our profession. These problems are not unique to just one country. The United States has been thinking about a national health system for some time. Russia has just gotten rid of theirs. The United Kingdom is trying to do the same. Guatemala’s is severely underfunded to have any real effect. Many countries have none at all. PFA is a world dental service organization. Together, we might be able to build support for a recommended system that serves all participants fairly. Is a baseball player or lawyer worth $1,000,000 and we are not? We need all the physical skills of a top athlete and the mental prowess of a good attorney to perform an intimate human service. What is our value really worth in humanity? Dr. Amarjit is exploring just such concepts to open debate for us all.

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	Correction
	Dr. Raymond D. Wenn
	Ray Wenn, born in 1943 in Charlottetown, Prince Edward Island, earned undergraduate degrees from Prince of Wales College (1962), the University of Prince Edward Island (1971), and his dental degree from Dalhousie University (1975). He maintains a general dentistry practice in Charlottetown. He is a member of CDA (many Chairs and committees, President 1993-1994), FDI (national Treasurer 1995-1996), the Dental Association of Prince Edward Island (President 1984-1985), Dental Council of P.E.I. (Registrar 1995-1996), Instructor at Holland College, and served for a decade on the Village Council of Cornwall.		He holds Fellowships in PFA, ICD, ACD, AGD, and ADI. Dr. Wenn is married with three children. He enjoys canoeing, fishing, skiing, biking, and squash. (Publisher’s Note: Because of an error, the photo of PFA Outstanding Service Award recipient Raymond D. Wenn, above, was omitted from the July/August 2002 issue of Dental World. The photo that ran in error was of Trustee for Region 1 [Europe] Pierre Marois.)

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	The Human Genome Revisited
	Last year, in this month’s issue, we reported an article from the Academy of General Dentistry’s Impact magazine, which described the dental ramifications of defining the human genome. With the events over the last year, not much has been noted about this progress. But an article in the Food Insight magazine has raised some interesting questions. The publication is put out by the International Food Information Council Foundation in Washington, DC. It covers a wide range of health issues particularly concerning nutrition. Their article, “The Human Genome: A Double-Edged Helix,” touted the “revolutionary, unprecedented, unsurpassed” potential to benefit society that this research will have in leading to breakthroughs in medicine (and dentistry) that may ultimately eradicate many of today’s diseases (and grow new teeth). Genetic screening could be a help to detect one’s potential, for example, to cancer. It could aid individuals in planning a career, having children, deciding about insurance coverage, travel, or education. But all the advantages that result from this discovery come with moral implications as well, such as those about stem cell research, or legal implications as scientists learn which chromosomes establish certain behavioral conditions that may cause deviant behavior.		The world stands on the threshold of a new age in biology that will bring us enormous hopes for cures, but enormous concerns as well. There is no going back from here. But… Can an insurance company demand a pre-enrollment genetic screening to determine their risk in insuring you, or not? Can society pass judgment in advance on those with potential deviant behavior genes? Can we tweak a few genes for a healthy male baby as the parents’ desire? Will genetic screening determine whether a child goes to technical school or professional school? Where does personality, work ethic, and culture overlay the weakness in a person’s gene patterning? We need to be wary that such information may determine a change in attitudes and life styles, when in fact, the genetic patterning may not be the only determining factor in a person’s life as it unfolds. A pattern is just that. You cut out the dress according to the pattern and sew it together, but you add the ornaments. You choose the color. You fill the insides. You give it shape, form, and personality. Let us not jump to the conclusion of using it as a yardstick for everyone. History is filled with special people whose physical handicaps might have dictated sending them to work in the fields, when they rose above those deficiencies with much effort to create great art and science that benefited us all.

	Table of Contents- September / October 2002
	Presidents Message		Foundation News
	President-Elect Gordan Stine		Treasurer George Higue
	2002 Calendar		Foundation News - United States
	Awards Banquet		Section News- International
	Dr. Terrance Ward		Section News- United States
	The Value of a Smile		PFA Annual Meeting Schedule
	Dr. Raymond D. Wenn		Editor’s Computer Alert
	The Human Genome
	Congressman Charlie Norwood
	Senate Bill #2650		go to .Page..|. 1..|. 2..

	From the Desk of Congressman Charlie Norwood…
	I want to thank all my colleagues for their financial support, as well as their time and effort on my behalf in promoting the interests of dentistry on Capitol Hill. I appreciate everything you have done for me more than words can express. The best way I can return your interest is to keep you updated on what is going on in Washington, DC. In June, the House again repealed the Death tax forever. The President has agreed to sign this bill if the Senate will ever vote on it. The Patients Bill of Rights is still in play. The White House is discussing it with Senators Ted Kennedy and John Edwards and Republican John McCain. They are at 99% agreement. The sticking point is the limit on HMO liability. Can lawyers live on $1,000,000 per case? This is up to Democrats Kennedy, Daschle, and Edwards to agree to. “I negotiated with the President unlimited economic damages, a limit of $1.5 million for non-economic damages (pain and suffering), and $1.5 million punitive damages. We have a tight definition of serious injury that would be capped at $4 million. This is fair and proper for all concerned. Senator Edwards, a trial lawyer, has not accepted this. Considering all the other important provisions in the bill that patients need, this is inexcusable.” If you have a Democrat Senator in your State, call them, get your family and friends to call them, and have them tell Senator Daschle to get this worked out.		The Medicare Administrative Reform Bill passed in the House. This bill has important reforms for dentists. But it is being held up in the Senate. My many thanks to HHS Secretary Tommy Thompson (former Wisconsin Governor) for saving the day on the new medical privacy regulation. The old rules would have been very disruptive for the dental office. Fortunately, Secretary Thompson changed those rules and injected some common sense into the regulations. I will finally get home sometime in August to campaign for my August 20th Primary. I need to ask for your help again for a friend of mine in Congress, a medical professional, Dr. Greg Ganske of Iowa. He has been an invaluable ally in the fight for a Patients’ Bill of Rights. He is running against Iowa Senator Tom Harkin, an original co-sponsor of the Hillary Clinton health care system takeover. Harkin is relying on his national network of trial lawyers to fund his campaign since Dr. Greg supports medical malpractice reform. And, of course, Harkin does not. You do not need to live in Iowa to send Dr. Ganske a contribution at P.O. Box 65340, West Des Moines, Iowa, 50265-9914. Next time you are in DC, give me a call and come by. My number is 706/738-8400 or email me at campaign@NorwoodforCongress.com to make arrangements. And thank you to the Academy for all the good you do in your efforts for our profession. Sincerely, PFA Fellow Charlie Norwood

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	PFA endorses Senate Bill #2650
	Our Academy joined 18 other dental organizations including the ADA, ICD, ACD, AADE, and the NDA in endorsing Senate Bill #2650 sponsored by Senator Mary Landrieu. This bill is called the Consolidation Student Loan Flexibility Act of 2002, which is identical to House Representative Regula’s bill, which we all endorsed. The bill is simple enough in repealing the Higher Education Act’s provision for the “single holder rule,” which prevented student loan borrowers from consolidating their student loans at the lowest possible cost. Currently, these loans may only be consolidated at the loaning institution. This bill provides for consolidation at the best rate at any banking institution. This bill will effect about 25% of the students representing 14 million individuals. This allows borrowers to effectively manage their debt, estimated to be about $100,000 on the average for dental students, and is expected to reduce defaults on the loans. Dental students graduating with a $100,000 debt face another $125,000 to $200,000 amount for establishing a dental practice, particularly in rural and in underserved areas. Opponents of this bill note that the loaning institutions supplied the students the funds when the students needed them at the prevailing rate at the time. Relief of this contractional arrangement allows a student to open his own office in competition with other dentists seeking associates for their own. This situation deprives the student of a dental business preceptorship with an established mentoring dentist, the possibility of purchasing existing practices at better rates, and in no way guarantees that any dental graduate will practice in rural or underserved areas based on debt consolidation. In fact, it probably will have the opposite effect, allowing the dental graduate flush with debt consolidation, to open in already established areas.		Lower rates and/or debt consolidation ought to be tied to the expected end goals—that they be available to graduates who practice in rural or underserved areas, or enter a preceptorship association with an established dentist for at least two years. When the country is faced with a glaring shortage of dentists, and the government fails to support the economically strapped dental schools allowing them to close their doors, the answer is that of the Kennedy Era—provide debt relief to the student at the dental school level, through capitation to the schools or reduced loans rates. This would better encourage the more disadvantaged student to enter dental school, and these students are more likely to practice in underserved areas of their city neighborhood or rural home area. This bill applies to all students, not just dental students. So the reasons for our support are parochial and short-sighted. The support is too based on faulty sine non quid reasoning. If the reasoning were correct, it defeats the traditional learning business practices in associateships, and the limits the possibility of purchasing a known entity from a retiring dentist owner who will help the new owner succeed in transferring the patients he served and the business that he built and loved. This also allows time for the graduate to reduce his obligation to the loaning institution and get a better purchasing price on a known product with an experienced mentor. We seem to be concentrating on the graduate, when our emphasis would be better placed on recruitment and easing the school year burdens so the graduate is not faced with debt load after the dental school struggle.