THE DALIN EXCHANGE

With the celebration of Children’s Dental Health Month in February, Dr. Jeff Dalin talks with pediatric dentist Dr.

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With the celebration of Children’s Dental Health Month in February, Dr. Jeff Dalin talks with pediatric dentist Dr. Fred Margolis about treating children and the need for dental volunteers.

Dr. Dalin: Well, here it is ... February ... and another National Children’s Dental Health Month! What better way to celebrate this month than to interview one of our profession’s outstanding pediatric dentists. Fred, I began my dental career working with my father. He always told me the way to build a great general dental practice was to take good care of the children in the practice. I have embraced this idea and have found it to be one of the driving forces behind our successful practice. If you make the children happy and comfortable, then their parents come, then the grandparents, and then all of their friends and families follow. How do you feel about this?

Dr. Margolis: First, I would like to thank Dr. Joe Blaes and you for the opportunity to be interviewed. I have been blessed with the love of my vocation, pediatric dentistry, and my avocation of teaching. My mother was a school teacher, and I have an uncle who is a professional actor. I think their genes have certainly helped in my career choice. To answer your question about taking care of the children in my practice, we (our pediatric dental team) have an adage to care for our patients as if they were our family members. This is also what I attempt to instill in my dental residents at Loyola University’s Oral Health Center where I serve as a clinical instructor. I have been involved with two large multispecialty practices during the past 26 years. Our practice philosophy has been: “Take good care of the children and the parents will follow.”

Dr. Dalin: In reading about you and your lectures, I have discovered that you have a great love for the use of lasers in your pediatric practice. How does this clinical tool fit into our dental practices?

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Dr. Margolis
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Dr. Margolis: I began my journey into the world of laser dentistry after reading an article in a dental journal in 2000. I asked three of the pioneers in laser dentistry - Dennis Pietrini, Bob Pick, and Harvey Wigdor - what they thought about using the erbium laser in pediatric dentistry. With their encouragement, I decided to purchase one for my practice. At the following Chicago Dental Society’s Midwinter Meeting, I presented a one-hour lecture on “The ‘Star Wars’ of Dentistry.” The CDS interviewed me and issued a press release about my use of the erbium laser. I received considerable media coverage of this new addition to my practice. I have joined the Academy of Laser Dentistry, and have attended several of their meetings during the past five years. I am proud to tell you that I have achieved Standard and Advanced Certification and, most recently, the Educator Certification granted by the ALD.

Erbium lasers merely give us another “tool” in the practice of dentistry. It is wonderful to make Class I through Class VI preparations that, in most instances, don’t require local anesthetic. Many of my patients are young and/or disabled, and don’t understand they should not bite their lip or tongue when it is numb. With the laser and the absence of local anesthesia, I no longer worry about this. I also can perform multiple quadrants of dentistry in one sitting. I am fortunate to have the Hoya Con/Bio Delight and the Biolase Waterlase MD in my practice.

The erbium laser has revolutionized my practice by:

Providing referrals from dentists who do not have an erbium laser. I even have had referrals from other pediatric dentists with patients who won’t sit still for the “shot” or for the high-speed handpiece.

Providing referrals from parents and physicians because we have an erbium laser.

Performing soft tissue surgery that, prior to our laser use, we had referred out of the office.

Avoiding professional burnout since we now can perform new procedures.

Lowering the stress levels of patients, parents and me.

Dr. Dalin: I am amazed by the work you perform for handicapped and disabled children. You even have written a book about this treatment. Tell me about the passion you have for this type of work.

Dr. Margolis: I am fortunate that, when I was a senior dental student at Ohio State University, I took an elective course and worked at the Nissonger Center for Developmentally Disabled Children in Columbus, Ohio. Ed Sterling, a pediatric dentist and the director of the dental program, was influential in teaching me how wonderful it is to be able to treat disabled individuals. My work with the disabled continued through an internship at Mt. Sinai Hospital in Chicago. During my first year following graduation, David Horberg and Marvin Berman were my mentors. While in my pediatric dental residency program at the University of Illinois College of Dentistry, I had wonderful professors who guided and taught me more about working with children and adults with disabilities. My mentors, Allen Anderson, Indru Punwani, Jin Moon Soh, and many others were so helpful in the educational process of becoming a pediatric dentist. During this two-year residency, we cared for many patients who were mentally, physically, or emotionally challenged.

Soon thereafter, I started a full-time private practice. I then was informed that Glenkirk Campus, a residential facility for developmentally disabled individuals, was seeking a new staff dentist. I held the position of staff dentist for 14 years. I screened patients and conducted in-service programs for the facility staff and treated patients at my office.

After that, I became staff dentist for the Center on Deafness in Northbrook, Ill. This was one of two residential facilities in the United States for deaf children with behavior problems. For three years, I took care of children’s dental needs at my office.

During this time, I thought there was a need to educate other dental personnel in the care of disabled patients. A parent of one of my autistic patients said, “I think dentists are more afraid of the patient than the patient is of the dentist.” So I wrote a manual, “Beautiful Smiles for Special People” to help dental personnel who wanted to treat disabled patients. Recently, I have taught “Dentistry for the Specially Challenged Patient” at the University of Illinois for the Illinois Academy of General Dentistry, the IFLOSS coalition, and the Illinois Foundation of Dentistry for the Handicapped. I have been asked by the ADA to present this course at its 2006 annual session.

In 2003 and 2004, I was asked by the Sunrise Community, Inc. to present six lectures in Florida. The Florida Disability Council had awarded grants to Sunrise Community to teach dentists and dental hygienists how to be more comfortable in treating developmentally disabled patients.

I am fortunate to have many disabled patients in my private practice, ranging from infants through age 65. I enjoy the challenge of working with them. I have several patients who previously were always given general anesthesia in order to have their teeth professionally cleaned. With the use of pharmacologic and nonpharmacologic means, I have very few patients who need general anesthesia to have their dentistry performed.

Thirteen years ago, I was asked by Steven Perlman to participate in the Special Olympics Special Smiles program that the Boston University School of Dentistry first sponsored. For the past 11 years, I have been chair or co-chair of SOSS’s annual event in Chicago. This year, 75 volunteer dentists, dental hygienists, dental assistants, and laypeople performed dental screenings and dental hygiene instruction for more than 850 special athletes.

In Illinois, the Donated Dental Services program has provided care for patients who are indigent and disabled and/or indigent and elderly. Since 1990, volunteer dentists have provided $5 million in free dental services. This program is a part of the National Foundation of Dentistry for the Handicapped program that is under the guidance and leadership of Larry Coffee and Fred Leviton. Our Illinois program was founded by dentist and visionary Harry Melnick. Under Melnick’s leadership, the Illinois Foundation of Dentistry of the Handicapped has procured a dental van with portable equipment. This van, which serves the Chicago area, helps dentists provide needed dental care at long-term care facilities, residential facilities for the disabled, and private residences for nonambulatory patients. For those dentists who are interested in learning more about becoming involved in this program, please visit the NFDH Web site at www.nfdh.org.

Dr. Dalin: I know you also are involved with the Dental Volunteers for Israel program. One of these days you will be getting a call from me to offer my services in Jerusalem. It is a place I love to visit with my family. It is time that, while visiting, I give something in return.

Dr. Margolis: Twenty-five years ago, Trudi Birger founded a free dental clinic in Jerusalem. This nondenominational clinic treats underprivileged children ages 4 through 18. The dentists, who volunteer to work in the six-chair modern facility, come from 13 countries. Care given includes preventive, restorative, endodontic, minor oral surgery, and preventive orthodontics. Families are referred to the clinic by Jerusalem’s social and welfare departments. This service is provided to children who could not afford any dental or preventive treatment if not for the services offered by the clinic. The Alpha Omega Dental Fraternity’s foundation is one of the primary sponsors of the DVI clinic. Volunteer dentists pay their own way to Israel. Once there, the organization provides dentists with comfortable, centrally located apartments in Jerusalem. DVI always is looking for dentists who are willing to volunteer from one to four weeks.

Having spent several weeks in the clinic during my last two visits to Israel, I can attest to the fine work this organization does. Children and parents are appreciative of the care that is given them in the clean, modern dental clinic. There are two rewarding aspects that I experienced while working at the clinic. First, there is the satisfaction of being able to do something truly altruistic - donating time, effort, and the skills that I have been blessed with to help these needy children. Those weeks spent at DVI have been the most professionally rewarding weeks I have spent in my 31 years as a dentist. A second rewarding aspect was the camaraderie and willingness to share treatment skills and techniques with dentists from around the world. The dentists I have worked with at DVI hail from the United States, Israel, France, New Zealand, and Norway. There will be a benefit dinner in New York City on behalf of DVI this spring. The organization’s Web site is www.dental-dvi.co.il.

Dr. Dalin: I do not know if you realize that I am one of the founders of the Give Kids a Smile program that began in St. Louis, and has been adopted as the National Children’s Access Day by the American Dental Association. What types of access problems exist in our country, particularly when it comes to children? What can we do to help?

Dr. Margolis: Congratulations and thank you for being one of the founders of the GKAS program. This program has been active in private dental practices and at local dental schools. Indru Punwani and Shahrbanoo Fadavi at the University of Illinois College of Dentistry have had a very successful program since the inception of the GKAS.

There are other programs available that achieve similar goals:

The “Take Two” program was started in Illinois by past ISDS president Peter Paulson. In this program, each dentist is asked to provide free dental services for two foster children per year.

Each year, more than 3,000 children visit the Children’s Health Museum in Barrington, Ill., during Children’s Dental Health Month. An educational and entertaining program is provided by Chicago Dental Society members and the auxiliary of the CDS. This program serves to educate children about good dental and nutritional health.

The governor of Illinois recently signed a law in which children entering kindergarten, second, and sixth grades must have dental examinations. Since this law went into effect, I have seen several children - ages seven and older - who have never been to a dentist.

There are several programs in Illinois that have mobile dental vans which are used to provide services to underprivileged children and, in some cases, adults. They include:

Illinois Masonic Dental Center, under the direction of Harvey Wigdor. Dental staff and general practice residents provide services.

Colgate Dental Vans provide educational programs and preventive services for underprivileged children.

The Northwest Community Hospital’s mobile dental van is co-sponsored by three townships in the Arlington Heights, Ill., area.

Dental Housecalls program, sponsored by the Illinois Foundation of Dentistry for the Handicapped, has Boris Trukman as the van’s driver and dental assistant.

Advocate Mobile dental van.

Illinois Department of Dental Health’s mobile van.

Christina’s Smile Dental Van, sponsored by the Senior Professional Golfers Association.

These programs attempt to address the access problems that occurred in 2005.

Dr. Dalin: Thank you, Fred. You are an inspiration for every dentist and staff member who reads Dental Economics®. All of us need to “give back” to those who are in need of the services we offer. You provide a great role model for others to emulate. I hope others are now inspired to become dental volunteers.

Dr. Margolis: Thank you, Jeff, for the pleasure of being interviewed. I am proud to be the recipient of the Access to Care Award from the ADA, and to be named the Distinguished Dentist of 2005 by the Illinois State Dental Society for my work with the SOSS program and with disabled patients. If readers would like to contact me, they can do so by calling my office at (847) 537-7695, or via e-mail at kidzdr@comcast.net.

Jeffrey B. Dalin, DDS, FACD, FAGD, FICD, practices general dentistry in St. Louis. He also is the editor of St. Louis Dentistry magazine, and spokesman and critical-issue-response-team chairman for the Greater St. Louis Dental Society. Contact him by e-mail at jeff@dfdasmiles.com, by phone at (314) 567-5612, or by fax at (314) 567-9047.

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