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The high cost of dental care and prescription drugs, high heating bills and low wages are among the top concerns of La Crosse and area low-income residents, according to a survey conducted this spring by the Wisconsin Coulee Region Community Action Program.

“The results were very similar county to county,” said Grace Sierer, executive director of the Westby-based agency that serves low-income people in La Crosse, Vernon, Monroe and Crawford counties.

Sierer said the only area that showed a significant difference in responses was one about the need for more training for people to start their own businesses. The respondents in the rural areas were more interested in small business training than people in the metropolitan La Crosse area, she said.

The reason for the difference may be that La Crosse has some training for small businesses available through the University of Wisconsin-La Crosse and other agencies, Sierer said.

The CAP agency distributed 1,516 surveys in the four counties; 318, or 21 percent, were returned. The respondents were asked to rank a list of concerns in the areas of health, employment and job training, child-related problems, housing, education and training, and crisis and emergency services.

The respondents put concerns about health care at the top of the list, with 40.5 percent complaining that the cost of dental care is too high. The high cost for prescription drugs ranked next, with the high cost of medical care ranked third.

Housing issues ranked second, with 47.6 percent listing the high cost of home heating as their biggest concern. Other comments were: “can’t afford the rent, can’t afford to buy a house,” Sierer said.

Concern about wages and job-training issues ranked third, with 41.3 percent of the respondents saying that their wages are too low to cover their living expenses, she said.

Fourth among concerns was a lack of crisis and emergency services, with 21.4 percent saying they need affordable legal help. Other issues in that category included the need for adequate nutritional food.

Child-related problems ranked fifth. Respondents listed among their concerns, the need for affordable/quality child care, obtaining child care for nights and weekends, and the need for help in dealing with teen-age children.

In the sixth- and last-ranked category, education and training, respondents put the need for help starting their own businesses first. The need for more job training or education to get a better job was next. Some respondents also said they were prevented from attending school because of the high cost of transportation or child care.

Sierer said the agency is required to conduct a survey every three years and uses the information to develop programs for the next five years.

“I think the biggest challenge for us is health care, the high costs,” she said. “We haven’t been able to do anything in that area.”

CAP already is heavily involved in energy assistance programs, including fuel assistance and home weatherization, she said. The agency also has programs for jobs and has increased its summer youth employment program this year.

‘Sierer said that due to welfare reforms in the state, CAP is seeing more working people who qualify for assistance because they can’t earn enough to meet all their needs. She said there also is a significant number of lowincome elderly people who need assistance.

Los Angeles, Las Vegas, Salt Lake City, and San Diego recently joined the majority of fluoridated American cities. It took longer to sell the story to the West. More than 70 percent of our nation’s drinking water is medicated to treat the teeth, according to figures released by the U.S. Census Bureau.

Fluoridation, in case your dentist has not drilled it into your head by now, is the process of adding sodium fluoride (NaF) to municipal drinking water. It is nothing new; there is a 50-year history of fluoridation in the U.S.

Fluoride is a binary compound of fluorine with another element. Sodium fluoride is routinely used as an insecticide and as a rodenticide. Although the compound is almost synonymous with rat poison, it represents something else to dentists and most health care advocates. Fluoride is the otherwise disposable by-product of the manufacturing process, and the suppliers of the product are the aluminum and phosphate fertilizer companies.

As early as 1940, Dr. Gerald Cox of the Mellon Institute was aggressively promoting the addition of fluoride to public water systems to reduce tooth decay. The Mellon family, interestingly, owned the Aluminum Company of America (ALCOA), which proceeded to sell fluoride to the municipalities. In the face of the pressure, the American Dental Association (ADA) warned in the Journal of the American Dental Association (October 1, 1944) that

even minuscule amounts of fluoride will cause osteosclerosis,
spondylosis, osteopetrosis, and goiter, and we cannot afford to
run the risk of producing such serious systemic disturbances in
applying what is a doubtful procedure to prevent dental
disfigurements among children. The potentialities for harm far
outweigh those for good.

Three months after issuing its strong warning, the ADA was promoting and participating in the fluoridation projects. The ADA has maintained its continuous support of legislation to fluoridate drinking water.

Maybe fluoride causes truth decay.

Fluoridation programs are usually implemented by independent municipal choice, although a few states make it mandatory. Indianapolis was the first major city to fluoridate drinking water in 1951. The treatment of drinking water with the precise amounts of fluoride is supposed to prevent dental caries in children, but the record is dubious.

Dr. R. Trendley Dean, a dentist with the U.S. Public Health Service, was widely known as the “father of fluoridation” because he conducted a series of studies of the effects of fluoride on teeth in 1945. His initial findings were favorable, although he later admitted in court that his own statistics were invalid. Health Forum News (August 1992) ran the story as “Doctor Who Advocated Fluoridation Now Calls It a Fraud.”

Dr. Dean’s efforts led to the 1945 project involving Grand Rapids and Muskegon, Michigan. These small cities were assigned as treatment and control areas. Grand Rapids was given the treatment; they got the “poison.” The lucky folks in Muskegon kept right on drinking the same untreated water.

The experiment lasted five years. The results were not surprising, but to most observers the interpretation and reaction were stunning. Tooth decay rates in young people did decline in each of the five years, but there was no distinction between the reduced rates in the two cities. Both outcomes were impressive. Dentists were so pleased with the Grand Rapids figures that they used the information to sell fluoridation all across the land.

The findings from the control city of Muskegon were totally ignored. The only report made public was that the tooth decay rate in Grand Rapids declined after the fluoridation.

In 1974, consumer champion Ralph Nader, in an address at Muhlenberg College in Allentown, Pennsylvania, said:

With the Public Health Service, the fluoride companies and the
dentists on one side, and the consumers on the other
side–fluoridation has been promoted without giving consumers
their free choice. The average dentist goes along because his
dental society passed a resolution about fluoridation decades ago.

Another dentist who was an early leader in the promotion of fluoridation was Dr. Robert Mick of Laurel Springs, New Jersey. He works for the other side now and offers a $100,000 reward to anyone who can prove that fluoridation is beneficial to humans.

Many major cities have been doctoring their water for more than 20 years; these include Chicago, Dallas, Baltimore, St. Louis, Denver, New York, Phoenix, Minneapolis, Washington, D.C., Philadelphia, Houston, Pittsburgh, and San Francisco.

Several states are 100 percent fluoridated; these are Minnesota, South Dakota, Kentucky, Rhode Island, Indiana, North Dakota, Illinois, Wisconsin, Georgia, Tennessee, Iowa, Michigan, and Ohio.

Although most Americans casually accept fluoridation, Europeans are suspicious and wary. Sweden banned fluorides in drinking water, toothpaste, and food. Other countries in Europe (Greece, Italy, Germany, France, The Netherlands, Norway, Denmark, Austria, Luxembourg, Spain, and Belgium) have strict laws against adding fluorides to drinking water supplies. Less than 2% of the drinking water in Europe is fluoridated.

James Sorenson did what the Utah state government refused to do. He gave money to fund dental coverage for the poor. Why didn’t other millionaires in state government help?

Salt Lake City

The United States is not best in the world at much of anything anymore.

Toyotas and Hondas, once derided as “economy cars,” now outsell and outperform Chevrolets and Fords.

A team of NBA All-Star basketball players coached by future Hall of Famer Mike Kryschewski could not win the 2006 World Championship.

And to call the U.S. health care system “best in the world” is a perfect example of living in invincible ignorance. Just ask any American business owner.

Kirk Newhouse, 44, owns and runs Carl’s Cafe. Carl’s annually wins “Best Breakfast” and “Best Lunch Under $5″ polls in the local newspaper. It’s a true family business. Kirk’s mom, 67, makes the pies.

Kirk plans to expand to a second and perhaps even a third location, which would be a significant boost to the local jobs market and economy. That plan is on hold, however, because Kirk doesn’t have the money to make payments on the necessary business loan. He is a good manager, yet struggles just to meet monthly expenses and clear a reasonable profit. One reason is that Kirk pays for everyone’s health care.

Kirk and his wife pay premiums to a managed care health plan. Their sons’ university tuition and fees include a bill for health care coverage. Kirk makes Medicare contributions that pay for his mother’s care. Finally, Kirk provides health care benefits to his employees through the system known as employer-provided health care. Kirk’s plans to expand Carl’s Cafe will remain on hold as long as this health care policy model is in place.

In nearly every other country in the world, health care is a right of citizenship for people of all ages. In contrast, health care in the United States is a right of citizenship only for those over 65 and those with certain named medical conditions.

For 160 million people (62 percent of Americans under age 65), health care is a right of employment. (1) Even so, some of the nation’s 50 million uninsured citizens are employed. As Social Darwinism (lack of concern for the human condition) became the norm in American business culture, employers became as comfortable with ignoring employees’ health care needs as they are with spending pension plan money now.

Until recently, criticisms of U.S. health care policy focused primarily on Medicare’s shortcomings and the plight of the uninsured. Now, suddenly, some critics shine a glaring spotlight on the employer-provided health care insurance policy model. Among stakeholders abused by this model is Kirk Newhouse, representative of young men and women trying to grow America against tremendous odds.

How did health care benefits come to join vacation time and pension plans as job perks? How can Kirk and other American business owners be relieved of that burden?

Where it began

Employer-provided health care was born in the 1930s after Franklin Roosevelt decided not to try for universal socialized medicine. In a move that seemed ingenious then because health care was comparatively cheap, the federal government passed laws offering economic incentives to businesses that provided health care to employees.

As a result, two objectives were met at once. Many Americans in the prime of life would now have health care coverage, and business owners and executives could spend less money to satisfy union demands. (2)

This employer-provided health care model is now being called an “accident of history.” Renowned medical economist Uwe Reinhardt of Princeton University says, “If we had to do it over again, no policy analyst would recommend this model. (3) Criticisms of employer-provided health care are hitting the public press. (4)

Ironically, health care organizations suffer a double hit because they are squeezed between providing health care for employees and stingy third-party payment formulas. As awareness of unfairness increases, don’t be surprised if health care businesses lead an effort to breathe new life into business/community/government coalitions.

Once simply bargain-seeking groups, these coalitions would put pressure on the politicians and insurers to scrap the employer-provided health care model and replace it with something better.

Ah, but there’s the rub. So far, no one has come up with a feasible replacement plan. The reason is that nobody’s looking very hard. Quick fixes that are comfortable, convenient and conventional are only rearranging the deck chairs on the Titanic. Such solutions offer hope and make us feel good in the short term, but only lead to disappointment and delay genuine lasting solutions.

[ILLUSTRATION OMITTED]

Consider these eight tough questions and answers about my proposed new system.

A new U.S. health care system

Q: Will the new uniform national health care system more closely resemble Canada’s, England’s, or Germany’s? (5)

A: There would be no uniform national health care system. Following federal guidelines they help create, each state would develop and implement a system.

Hawaii would be allowed to continue the effective working model that has evolved there.

Hospitals are notorious for nosocomial infections. Both the outpatient clinics and wards attract and accumulate ailing people, many with infectious diseases. Crowding and cross-infections are quite common in hospitals. Three groups are at risk of hospital-acquired infections. One, hospital clients themselves - they may come with one problem and acquire another in the hospital. second, the attendants of the patients - bystanders and visitors - who may get infected in the hospital premises. Third, health care workers themselves - who are constantly at risk of exposure to a myriad of microbes. Hospital Infection Control Committee (HICC) is required in all hospitals, to monitor and minimize the risk of hospital-acquired infections. It usually pays attention to post-surgery wound infections and to sharp-tool-injury to staff, but tend to ignore risk of infections through other modes of transmission such as droplets, aerosol or touch. Immunization against vaccine-preventable diseases is also neglected often by HICCs.

When health care workers get exposed to pathogens in the work place, the repercussions may be many. Those who are not immune to the agent may develop disease, and are forced to be absent from duty. Some hospital-acquired infectious diseases may be severe and even life-threatening. Anecdotally, I know of doctors or nurses who developed human immunodeficiency virus (HIV) infection, fulminant hepatitis B, progressive primary tuberculosis, varicella, measles or rubella as hospital-acquired infectious diseases. Prevention is always better than cure. Awareness, alertness and systematic procedures guided by hospital policy are essential for prevention.

A very recent report on an outbreak of hepatitis A in and around a medical college in Kerala had the following statement in passing. “Two deaths among the doctors were reported. However, the serum samples were not stored for further analysis”1. This episode illustrates the risk of life-threatening infectious diseases as an occupational hazard to health care staff. The lack of scientific attitude for preserving samples to identify the infectious agent that caused death of doctors is appalling. If nurses or other hospital staff died of hepatitis A at home or in other hospitals or even in the same medical college hospital, the investigators would probably not have been told about them. According to the report, among those who developed hepatitis A “170 were from the members of the medical community” including residents of medical college hostels for men and women students, nurses, house surgeons and postgraduate students, and “a substantial proportion of viral hepatitis patients were care-taking relatives of patients hospitalized for other causes”1. Hospitals should be havens of healing, not departments of disease dissemination.

Hepatitis A virus is unlikely to be transmitted directly from health care worker to others. However, there are several pathogens that may be passed on unknowingly, even before the worker himself/herself develops symptoms or signs of illness. Varicella, measles and rubella come under this category. Thanapal and co-authors draw our attention to the potential of rubella in health care workers in an eye hospital setting in Tamil Nadu, in this issue of the journal2. Although rubella virus infection is very common in children, all adults may not be immune. In the eye hospital, some 11 per cent of staff were non-immune and susceptible to infection and infectiousness2. Among female staff (nurses and counselors) 39 per cent and among physicians 16 per cent were non-immune. Some staff had evidence of recent infection - predominantly among nurses. When non-immune personnel were immunized with rubella vaccine, all developed antibody response2. In adults rubella itself may be mild or inconsequential. The importance of rubella is not the disease itself, but infection during pregnancy and the consequent risk of congenital rubella syndrome (CRS). By the time a baby is born with CRS, who will remember where or from whom the mother got the infection3. For those who do not realize how frequent CRS may be in India, an earlier report from the same eye hospital on rubella as a major cause of cataract in children is an eyeopener4. Among infants with suspected congenital infections in another Tamil Nadu hospital, 10 per cent had CRS5.

The rubella susceptibility of sizable proportions of women of child-bearing age is not confined to south India, but is a recognized problem in north India as well6. In Delhi, some 13 per cent were recently reported to be without detectable rubella antibody6.

Continued rubella susceptibility among health care staff is both risky for themselves and hazardous to ‘innocent bystanders’, particularly women in the child-bearing age groups. All hospital staff deserve to have rubella antibody screening and non immune staff deserve to be vaccinated. Alternatively, as Thanapal and colleagues2 recommend, prescreening for antibody need not be mandatory and health care workers could be vaccinated as they begin employment. Vaccination will protect them and also prevent hospital-based outbreaks2. Perhaps the best time to introduce rubella vaccination is when trainees enter institutions of health care profession. As students they may be more likely to be receptive to the concept than established professionals who tend to neglect such ideas. In many overseas universities, rubella vaccination is mandatory for admission of students. In India we could begin with institutions of training of health care professionals - medical, nursing, dental, pharmacy or paramedical.

ADAA offers a record number of new and revised courses in our roster of home study opportunities.

Just look at the list presented here and see the six new courses and then check out the revised courses as well–there are five!

If you haven’t received your current copy of the Professional Development Catalog from ADAA’s Continuing Education Council, you’ll want to order one right away. Call, write, fax or drop us an e-mail.

And there are other good ideas for professional growth too. You can get a package of materials to prepare for all three national exam topics–chairside, infection control and radiation–and you can order ADAA’s popular career video “Your Future in Dental Assisting,” a 7-minute capsule to aid in career planning presentations.

35 E. Wacker Dr., #1730, Chicago 60601 Phone: 312-541-1550 Fax: 312-541-1496 e-mail: srobles@adaal.com

Newly Revised Courses:

* Dental Assistant’s Management of Medical Emergencies

* Alginate Impressions and Diagnostic Study Model Techniques

* Prevention of Disease Transmission in the Dental Office

* Introduction to Computerized Dental Systems

* Designing a Comprehensive Health History

Package Pricing:

Purchase all three national exam prep courses and save:

#0109 (Chairside)

#0008 (Infection Control)

#9806 (Radiology)

If bought separately, cost $205; as a package, only $150; Non-member: $225

Code Number: 3-pack

Management of HIV/AIDS Patients in Dental Practice

(NEW) Since the first reported outbreaks of HIV/AIDS, great strides
have been made in the treatment of disease-related opportunistic
infections, neoplasms and neurological disorders. Combined use of
multiple anti-viral agents and preventive treatment for pregnant
women has increased the number of infected persons living longer and
seeking regular dental care. This disease continues to devastate
countries in Africa and Southeastern Asia and has increased
significantly in China and Russia. In the United States high-risk
groups have started to reject prevention schemes. Learn the
consequences for today’s modern dental practice.

#0204   4 Credit Hours   $36 Member   $50 Non-member

Carbonated Beverages–The Pouring Rights Dilemma

(NEW) Learn why we are seeing an increase in soda drinking with
children and how it is affecting dentistry today. Includes the
harmful effects of soft drinks to enamel and supplies alternatives
to soft drink consumption. Describes the “pouring rights” concepts,
why schools are using it, and ways to combat the marketing methods
used by soft drink companies on and off school grounds.

#0207   1 Credit Hour    $15 Member   $22 Non-member

Gingival Health–Periodontal Assessment

(NEW) An introduction to finding, locating, and assessing periodontal
diseases. Included is the importance of the initial examination, the
recording of in-depth information in the patient record, and types of
clinical evidence that can be found on radiographs. Also covered are
the pitfalls involved with inaccurate sulcus depth readings, mobility
and furcation classifications.

#0208   2 Credit Hours   $22 Member   $32 Non-member

Radiation Biology, Safety and Protection for Today’s Dental Assistant

(NEW) This summary demonstrates how the study of radiation biology
began and how radiation safety and protection measures evolved from
early research efforts to formally established organizations that
examine leading scientific thought and provide guidance and
recommendations on radiation protection and measurement. The
subsequent information will provide an overview of radiation biology
and the safety and protection measures that the dental assistant can
implement to reduce radiation exposure to dental patients as well as
minimize occupational exposure.

#0209   5 Credit Hours   $45 Member   $56 Non-member

Medications as Risk Factors for Periodontal Disease

(NEW) As our population ages, increased numbers of patients will
be using a variety of medications. These medications may benefit
the general health of a patient, but consideration must also be
given to the impact of these agents, both prescription and
over-the-counter, on gingivitis and periodontitis. The risk factors
associated with the use of various types of medication and
periodontal disease are discussed.

#0210   2 Credit Hours   $22 Member   $32 Non-member

Hepatitis: What Every Healthcare Worker Needs to Know

(NEW) This course provides an overview of Hepatitis A, B, C, D,
and E with a special emphasis on the bloodborne viruses. An
explanation of modes of transmission, epidemiology and prevention
of these potentially life-threatening infections is presented in a
clear and informative manner. Know which hepatitis viruses may pose
a risk in the dental healthcare setting and important precautions
for prevention of the spread of hepatitis, including the latest
vaccine recommendations, infection control precautions, and post
exposure management.

With the focus of the world on the U.S. military, it is more than coincidental that this year’s DARW entries included more military input than ever before. An entire category in the competition was created and identified as “Other Organizations” and included both Army and Air Force entries and will in the future feature the work of dental associations, government agencies such as Veterans Administration clinics and any other large institutional practice not included in the traditional groupings of schools, dental assisting associations and dental offices.

We are pleased to acknowledge the enthusiasm of this sector of participants and welcome them along with the new and returning entries from all other categories.

As usual, in addition to thanking the entrants, we are grateful to the panel of judges from the ADAA and the ADA who gave their time to the review and selection of materials. The competition covered in this issue reflects only the work of U.S. individuals and groups, with the Canadian groups conducting their own competition.

A note about the headline. DARW themes are chosen by joint action of the sponsors of the event: the American Dental Association, the American Dental Assistants Association, The Canadian Dental Assistants’ Association and the Canadian Dental Association. The theme is generally retained for three or four years. The outgoing theme, “United by Excellence, Linked by Pride,” was in effect from 2000 through this year, 2003.

The new theme that will take effect for the 2004 Week is based on an idea from Nancy Callaway of Overland Park, KS, an ADAA member. Ms. Callaway will receive one year’s free national dues from the ADAA. We thank everyone who provided input and ideas for this project.

… on to the competition. And the winners are:

DENTAL ASSISTING SCHOOLS

FIRST PLACE

THE MEDIAN SCHOOL DENTAL ASSISTANT/EFDA PROGRAM Pittsburgh, PA

How’s this for starters? The entire class joined ADAA! Then they reached out to the public by acquiring three proclamations, two radio spots, two TV spots and making and selling tooth fairy dolls for charity. They asked local dentists to nominate their dental assistants for “#1 Assistant in Pittsburgh” and gave the winner a pizza party for their practice. DARW posters adorned 800 telephone poles in the area and a newspaper ad ran for a week. The instructors hosted a dinner for the students and the school president purchased an intra-oral camera as a gift. In all, a terrific multilevel tribute to DARW.

SECOND PLACE

NDSCS DENTAL ASSISTING STUDENTS: 2003 Wahpeton, ND

Presented by Lucinda Johnson

This school decorated its clinic and library to draw attention to DARW and then laid out a table (staffed by Ms. Tooth Fairy and Ms. Molar) to give away toothpaste to campus students and collect money for families in need. A total of $226 was collected–which was matched by the instructor–and Crest Spinbrushes were purchased and distributed. A contest for the area’s #1 dental assistant was conducted and the winner received a gift basket. Additionally, a dental assistant in active guard duty was recognized through e-mail and presented with a “care package” and ribbon. The dental assisting supervisor presented the class with lunch to round out DARW and to recognize them for their efforts.

HONORABLE MENTION

LINN-BENTON COMMUNITY COLLEGE Albany, OR

Every day there was something new: Monday: 30- and 60-second radio spots on five local stations; a large banner in the hall, and words of appreciation from the Vice President of Instruction. Tuesday: Students delivered flowers, food and goodie baskets to the offices where they had done their observations. These were directed to the offices’ assistants, many of whom didn’t know it was DARW. Wednesday: Each instructor received flowers, cookies and a scroll of thanks for their time and expertise. Thursday: Words of encouragement from the Director of Health and Human Services, and a student-faculty quiz game with students receiving a gold pin bearing a tooth emblem. Friday: A visit from ADAA National President Karen S. Waide, CDA, EFDA, who presented each student with a pink rosebud and an ADAA souvenir. Two officers of the Capital City DAS also came and gave greetings … and every day there were refreshments for all.

ALSO NOTED

DENTAL ASSISTING CLASS OF BERDAN INSTITUTE Totowa, NJ

Presented by Helene A. Pizzuta, CDA

Berdan students wore blue ribbons to draw attention to DARW and made dental-related posters to hang on the walls. The posters were a competition with staff voting for the best three. Going outside the school, visits were made to an elementary school to instruct in dental hygiene while during the week, speakers were invited to present a variety of subjects including oral health care products, personal care products and PANDA.

ELI WHITNEY DENTAL ASSISTING PROGRAM Hamden, CT

Presented by Janice F. McMorran

During DARW, students visited elementary schools with dental hygiene instructions. Back at the school itself, a breakfast for dental assisting students was hosted by d.a. faculty and included members of the adult education faculty.

One of the best things about the holidays is the abundance of delicacies to satisfy your sweet tooth.

But indulging in all those cakes, cobblers and candies can take a toll on your teeth if you aren’t careful.

“As soon as we take our first bite into something sugary, the bacteria in plaque begin to produce acids,” explains Dr. Richard Price, a dentist and consumer advisor for the American Dental Association (ADA). “While the acid is being produced, it starts to rob the tooth of minerals and that’s how decay starts.”

While all sweets are potential cavity time bombs, treats that stick to teeth like caramel, gummy candies, licorice and fruit cakes are especially harmful because saliva–nature’s cleansing agent–can’t wash them away as easily.

But sugary foods aren’t the only producers of decay-causing plaque. Starches like bread, crackers and cereal also cause harmful acids to form in the mouth.

To keep holiday goodies from ruining your healthy smile, the American Dental Society offers the following teeth-friendly tips:

* Limit snacking between meals. Every time you snack, tooth-damaging acids build up in your mouth. The more you snack, especially if you eat sweets, the more acid is produced, increasing your chances of tooth decay.

Dentists say eat sweets after your main meal, when they cause the least damage. “If you don’t want to eat the sweets as a dessert, then pick some other time of day,” Dr. Price suggests. “Try to eat all your sweets in one sitting rather than eating sweets all day long.”

* Eat a balanced diet. A diet rich in fruits and vegetables helps prevent tooth decay and gum disease–the main cause of tooth loss in adults. Instead of snacking on sweets and other junk foods, opt for raw veggies, plain yogurt, cheese or fruit.

* Brush and floss every day. Brushing cleans cavity-causing plaque from the surfaces of teeth and flossing removes plaque the toothbrush can’t reach–in the spaces between teeth.

The ADA recommends brushing teeth twice a day with fluoride toothpaste and flossing once a day to prevent decay and gum disease, and making visits to the dentist every 6 months for a checkup.

When you brush, use one with soft bristles to avoid injuring gums and also gently brush your tongue to remove bacteria and keep your breath fresh.

* Drink plenty of water. Water is good for your body and your teeth in that it keeps the saliva working to wash away excess bacteria.

It has been a memorable year for me as your ADAA President … a year of celebrating, New Beginnings and the culmination of a 12 month journey. Throughout the year we have had revitalization, new connections, historic events, participation with other organizations, and building the vision for all dental assistants.

The Board of Trustees, Council Chairmen and ADAA staff, all contributed to produce another year of accomplishments and progress. Our thanks go to all those who played an important role in the achievements.

Good news includes the progress that has been made over the last five years in bringing the Association to a more healthy financial level. Emphasis has been and will continue to be to monitor expenses, but at the same time to focus heavily on increasing membership.

New connections and educational opportunities began with our Executive Director, Larry Sepin and Director of Education, Jennifer K. Blake, CDA, EFDA, FADAA, who met with Linda L. Miles of Linda L. Miles and Associates. A subsequent contract with Linda L. Miles was accomplished for her new book, Dynamic Dentistry, in which she is offering membership in ADAA.

The U.S. Army provides ADAA access to dental assistants globally and greatly increases our visibility. This past year the U.S. Army has contributed several articles and news through our ADAA journal. We look forward to continued participation with them. I wish to thank our U.S. Army for enabling us to continue business as usual on the home front while they were taking care of business in Iraq.

New relationships have been developed and existing relationships enhanced with other dental organizations such as the ADA, American College of Prosthodontists, the Hinman Dental Meeting in Georgia, the California Dental Association, Greater New York Dental Society, Yankee Dental Congress and the Chicago Dental Society, by providing education as requested. Special focus in March was on DARW activities. ADAA and ADA Presidents co-signed a DARW Proclamation, signifying that dental assistants, working with the dental profession, play an important part in maintaining the dental health of the citizens of the United States.

The first International Dental Assistant and Nursing Symposium is being co-hosted by ADAA and the Canadian Dental Assistants’ Association one day prior to Annual Conference in Nashville. The theme will focus on the globalization of dental assisting. This will be an opportunity for an exchange of information and practical knowledge.

Another first this year is the Educators Newsletter. The newsletter presented the latest student dues structure and more. And speaking of students, 10 scholarships were made possible again this year by Oral-B Laboratories. Thank you. Two Student Newsletters were mailed featuring dental assistants in business and industry. Plus, at annual conference this year there will be a student poster contest … with thanks to Procter & Gamble for this event.

Further success has been noted with the relocation of ADAA Central Office. Executive Director Larry Sepin successfully negotiated the lease at considerable savings to ADAA. A more detailed report will be given at annual conference. Staff morale has increased tremendously since the move into the new office space.

Next my thanks to our ADAA staff. Thank you to our Executive Director Larry Sepin who has provided the opportunity for this organization to grow. And for being watchful of our organization so that it could become financially stable. Also, he has assisted in his staff’s development and growth, providing new titles and more responsibilities.

For me this year has been a world of electronic transmission, and much of it with our staff. Any source, any question, the staff provides necessary data and is always asking: “can I do anything more for you”. The communication keeps flowing. Thank you. Several of the ADAA staff will be attending the Nashville meeting. Please stop and say thank you.

To our Board of Trustees, thank you. The composition of the Board changes yearly, as well as new delegable duties and directives. They have been hard at work to communicate ways to assist the states within their districts and share ways that individual states can help each other. This year, the Councils to which Board Members are assigned have overlapped in ways to help achieve results and complete directives. The diligence, productivity, support and hard work of Board Members has been appreciated.

ADAA is very grateful for its corporate contributors who have largely made education at Annual Conference possible as well as underwriting many of our organization’s worthwhile activities and programs.

ADAA is very grateful for our Sponsors this past year. Acknowledgement of them and thanks to them is ongoing and featured on a convention program page in this Journal.

The ADAA Foundation has developed and implemented a new ADAA Contribution Packet. Each foundation member will recruit three new companies that are not yet contributors. In addition, the Foundation underwrote funding for an ADAA/Army commemorative coin for the Foundation fundraiser at annual conference. Through Foundation funding, new courses have been added to the continuing education catalog and many existing courses have been updated; research and scholarships have been underwritten as well.

Since September 11, much has been said of the challenge “you are either for us or against us.” Although choices are rarely so black and white, those of us responsible for health care are faced with a similar challenge: Either we provide the best patient care possible or we choose not to. Either the patients’ best interests are paramount or they are not. Any compromise of patient care is the choice of the practitioner; therefore “you are either for us or against us” is an appropriate challenge to you, the dentist, and to me, the dental assistant. The “us” in this challenge represents our patients. They believe that you have their best interests and health at heart when they visit your office. They also believe that the person working beside you is formally trained and feels the same way. They are right to expect this of us.

I believe that most dentists value their assistants and agree that they play a critical role in the delivery of excellent dental care. Modern materials are technique-sensitive. Sterilization, which occurs away from dentists’ direct supervision, is critical. Employing an assistant who can apply proper techniques to ensure the safety of patients is a must. Formal training for dental assistants, proper testing and licensure are clearly in the public’s interest.

Let me be absolutely clear and firm about this–the health of the public is too important to be left in the hands of untrained people. The nearly 20,000 members of the Canadian Dental Assistants’ Association (CDAA) are committed to professionalism and to promoting national occupational standards, formal training and continuing education for all dental assistants. The CDAA will validate the title ‘Professional Dental Assistant.’

In the November 1, 2001 edition of The Economist, an article entitled “The New Workforce” describes workplace employees as knowledge workers. It states: “Knowledge has become the key resource, and the only scarce one. This means that knowledge workers collectively own the means of production.” According to The Economist, effective knowledge is now specialized. For example, the greatest software designers need hardware specialists, manufacturers need experts on product development, surgeons need nurses and dentists need dental assistants.

The article also states that the most important thing about these knowledge workers is that they “see themselves as equal to those who retain their services, as ‘professionals’ rather than as ‘employees.’ The knowledge society is a society of seniors and juniors rather than of bosses and subordinates. (…) Knowledge workers, whatever their sex, are professionals applying the same knowledge, doing the same work, governed by the same standards and judged by the same results.”

Although these professionals spend much of their time doing unskilled work–such as placing bibs on patients, answering the telephone or filing–they identify with the specialized knowledge aspect of their job, and this identification gives them a sense that they are full-fledged knowledge workers.

Knowledge workers possess a formal education and continue that education throughout their career in an ongoing effort to remain up-to-date. Knowledge workers are very mobile within their area of specialization, a result of the increasingly transitory nature of work. In the knowledge society, education must never stop.

There is no hierarchy to knowledge. Either it is relevant to a particular situation or it is not. For example, proper application of surgical and sterilization techniques are equally important to patient safety. Formally educated dental assistants have the knowledge required to recognize this. Our expertise allows us to understand the difference between sterilization and disinfection, and the relative importance of both. These tasks are nearly always performed by dental assistants, without direct supervision. In the era of Walkerton and the recent $27.5-million settlement in the Ontario EEG-Hepatitis B class action lawsuit against Dr. Ronald Wilson, public safety demands that those responsible for sterilization be knowledge experts.

Ultimately, the dentist is responsible. It is your profession and it is your job to make sure that patients receive proper dental health care in your office. The public looks to you to do the right thing. For the sake of your community, I urge you to do the right thing. Support formal education and registration for dental assistants. The public trusts you and would be outraged if it were to find out that you were permitting someone without a formal education to guard them from infection and communicable diseases.

The argument that there are not enough formally trained dental assistants to meet current demand in various parts of Canada is spurious. The answer is not to lower the standards of care but to increase the supply of knowledge workers. It should be mandatory that every dental assistant in every dental practice be formally educated and have recognized licensure. Properly trained people are those who have received a recognized formal education. This is the only way we can ensure that dental standards are maintained and that dental patients across Canada receive safe health care. As president of CDAA, I urge you to insist that your regulatory body work with us to make it mandatory that every dental assistant and chairside or office auxiliary in every dental practice be formally educated and have recognized licensure. I also urge you to work with CDAA to endorse national dental assisting practice standards.