Announcements

  • ADA's 10 Under 10 Award

    Nominations are now open for the ADA’s 10 Under 10 Award. The ADA is recognizing 10 amazing dentists who graduated from dental school less than 10 years ago and are already inspiring their colleagues and making a difference in the profession. The 10 Under 10 Award showcases dentistry’s rising stars – dentists who demonstrate excellence and inspire others in science and research, practice excellence, philanthropy or leadership. Winners will be recognized in ADA publications and receive a $1,000 gift card. The nomination process is quick and simple, and the deadline for nominations is December 31, 2018. Visit the 10 Under 10 webpage on ADA.org to learn more.
  • Fake Membership Invoices

    We have recently become aware that about 100 members in one state received fake membership invoices. Members received a fake email that instructed them to ignore the legitimate emailed invoice and instead wire funds to pay for their membership dues. The good news is that only one member is known to have paid the fake invoice. The state is looking into pursuing this as a criminal matter. We are not aware of any problems like this in our state, but wanted to warn you about this problem in case it happens here. If you think you have received an email like this, please contact OCDS staff.  

    • (Where applicable) Consider signing up for auto renew and installment payments, this helps to avoid the issue.
    • If an invoice looks odd to you (misspellings, misuse of words, poor grammar, poor formatting, etc.), by all means give us a call to check on it before paying
    • We will never ask you to wire us funds to pay for membership
    • Teach your dental team to be on the lookout for “phishing emails”. There are some good tips and links to other resources here.
  • CDT 2019: Spend less time on coding, more time with patients.


    Get back your quality time with the new CDT 2019 and Companion Kit! This essential ADA resource helps your team code more accurately – which speeds claim processing, lessens the need for additional information requests, and reduces claim rejections.

    This CDT 2019 Kit includes:

    • CDT 2019: Dental Procedure Codes has all the new and updated codes, including 15 new codes, 5 revised codes and 4 deleted codes, PLUS complete descriptors.
    • CDT 2019 Coding Companion trains staff on how to use the right codes at the right time. The book features four new authors, 35 new coding scenarios, 21 new Q&A, and a new chapter on working with dental benefit plans.
    CDT 2019 and Companion Kit
    Member Price: $85.00 / Retail Price: $127.50
    Free e-Books now included when you order directly from ADA Catalog!

    Order now! Visit ADAcatalog.org or call 800.947.4746 from 7 a.m. to 6 p.m. CT.

    Use promo code 18456BE by 11/23/2018 to Save 15% on all ADA Catalog products.
  • New opioid laws will affect dentistry in 2019 and beyond

    Many bills were introduced over the past year to combat the opioid epidemic in California, as CDA previously reported. Here is an overview of the CDA-supported legislation signed into law by Gov. Jerry Brown in September and how these bills will affect the practice of dentistry.

    AB 2789 (Wood-Healdsburg) E-prescribing

    Beginning Jan. 1, 2022, health care practitioners authorized to issue all controlled and noncontrolled prescriptions are mandated by this law to have the capability to transmit prescriptions electronically. Pharmacies are required by this law to have the ability to receive these electronic transmissions.

    Specified exemptions to this law include temporary technological or electrical failure or when the practitioner reasonably determined that it would be impractical for the patient to obtain the substances prescribed by an e-prescription in a timely manner when the delay would impact the patient’s medical condition. In the case that an electronic transmission to a pharmacy cannot be completed, the prescription must be electronically issued directly to the patient. 

    This new law will help reduce prescription fraud, including the abuse of opioids, and adverse events caused by handwriting errors. The nearly three-year implementation time frame gives dentists and other health care practitioners ample time to obtain adequate e-prescribing systems, to train staff and to update office workflow protocols.

    SB 1109 (Bates-Laguna Niguel) Informed Consent for Minors

    The Dental Board of California is allowed by this law to include the risks of addiction associated with the use of Schedule II drugs in mandatory continuing education requirements. The dental board has already begun discussions about what these continuing education requirements might look like. CDA has been and will continue to be engaged in this stakeholder process.

    Additionally, beginning Jan. 1, 2019, this bill requires a prescriber to discuss the following with a minor or the minor’s parent or guardian before issuing the first opioid prescription in a single course of treatment:

    1. The risks of addiction and overdose associated with the use of opioids.
    2. The increased risk of addiction to an opioid to an individual suffering from both mental and substance-abuse disorders.
    3. The danger of taking an opioid with benzodiazepine, alcohol or another central nervous system depressant.  
    CDA Practice Support and The Dentists Insurance Company are developing for members a resource that consists of a sample discussion script. CDA will publish more details about the script when it becomes available in November.

    AB 2086 (Gallagher-Yuba City) CURES Prescriber Report

    This law allows a prescriber to access the CURES database and generate a report that lists patients for whom he or she is listed as a prescriber in the CURES database. Once the system upgrades allow reports to be generated, prescribers will be able to more easily review their prescribing history and to detect potential red flags or prescriptions for which they have been falsely named the prescriber. While no official timeline has been set, CDA will keep members updated as to when the CURES database functionality is updated to reflect this new feature.

    AB 1751 (Low-Campbell) Interstate CURES Access Agreement

    This law authorizes the Department of Justice to put in place regulations by July 1, 2020, for the purpose of entering into agreements with other states to share prescription drug monitoring program information in compliance with California laws relating to patient privacy and data security standards.
    Once implemented, the new law will help provide prescribers with a more complete prescription history if patients receive prescriptions in multiple states and will help curb “doctor shopping” in communities near California’s borders. 

    AB 1753 (Low-Campbell) Controlled-Substance Prescription Pad Requirements

    This law requires controlled-substance prescription-pad manufacturers approved by the Department of Justice to have uniquely serialized numbers in a manner prescribed by the department. This new law will help curb controlled-substance prescription fraud. CDA will keep members updated on changes to the approved controlled-substance prescription-pad vendor list.

    For more news and resources on opioids and CURES, visit cda.org/opioid. CDA will continue to inform members about the requirements of these new laws as they take effect.
  • Legislative victory: Dental Plan Transparency Act passes

    Gov. Brown also signs bill that adds training requirements for pediatric dental sedation

    CDA’s sponsored legislation calling for more value and transparency from dental plans passed the California Legislature with bipartisan support and was signed by Gov. Jerry Brown on Sept. 29. CDA and the author of SB 1008, Sen. Nancy Skinner (D-Berkeley), worked closely with stakeholders to ensure the best outcome for CDA members and consumers in California — increased transparency, accountability and value from dental benefit plans.

    “Signing this bill into law is an unqualified victory for dental plan patients in California. Patients deserve to have clear, understandable information about their dental plans,” said CDA President Natasha Lee, DDS. “As providers, we all too often see patients in our offices struggle to understand what procedures are and are not covered. We aim to stop that and ensure patients get the care they need with SB 1008.”

    Dr. Lee continued: “I want to thank Gov. Brown for signing SB 1008 and state Sen. Skinner for working with her colleagues to pass this important reform.”

    SB 1008 builds off CDA-sponsored legislation that passed in 2014, AB 1962 (Skinner), which created a mandate for dental plans to annually disclose to state regulators and the public their “loss ratio,” or how much of premium dollars are spent on patient care. Three years of reporting shows a wide variation in dental loss ratios (DLR) by product type and market, with some plans falling as low as 4 percent. This variation raises significant questions about the consistency and value of many dental plans. The plan-reported data validates the concern that too much of dental plan premiums are spent on administrative overhead costs and not enough are spent on patient care.

    The lack of standardization among dental plans and a regulatory “Wild West” lead to questionable plan value and consumer frustration when needed services are not covered. To help combat this, SB 1008 will require all dental plans to use a uniform matrix to disclose their benefits, similar to the matrix used by medical plans. The matrix will provide plan beneficiaries with a uniform summary of benefits and coverage template to include plan details, including: deductible; annual benefit limit; coverage of the following categories: preventive and diagnostic services, basic and major services, and orthodontia; reimbursement levels and estimated enrollee cost share; waiting periods; and examples to illustrate coverage of commonly used benefits. The uniform matrix will be designed through a stakeholder process to be available starting in 2021 or 12 months after regulations are adopted.

    Sen. Skinner said, “No one should have to drill into 80 pages of legalese to understand their dental plan. SB 1008 requires dental insurers to provide details on what their plans cover in a simple, easy to understand format, so consumers understand what services are covered and what services they may have to pay for out of pocket.” 

    SB 1008 will help level the playing field for consumers and providers by holding plans accountable to comparable disclosure standards as medical plans. While amendments were taken along the way, CDA is pleased that the new law continues the association’s efforts to increase dental plan transparency and accountability.

    SB 501 passes, adds training, monitoring requirements for pediatric dental sedation

    Gov. Brown also signed into law SB 501, authored by Sen. Steve Glazer (D-Orinda), which updates the regulatory structure for pediatric dental sedation and ensures that children have access to safe, effective pediatric sedation services when needed.

    SB 501 reflects three years of work, starting with a 2016 report from the Dental Board of California that studied recent pediatric deaths and made recommendations to improve safety. SB 501 updates definitions for levels of sedation to reflect those recognized by the American Dental Association, acknowledging that level of sedation is independent from route of administration.

    Developed through substantial stakeholder involvement, SB 501 provides for additional training and monitoring requirements targeted to ensure that during the provision of pediatric dental sedation, the right people are in the room with the training and ability to respond quickly and expertly to emergencies should they arise.

    Gov. Brown vetoes SDF legislation

    Lastly, another CDA-sponsored bill, SB 1148 authored by Sen. Richard Pan, MD, (D-Sacramento) was vetoed. This bill would have made silver diamine fluoride a covered benefit in the Medi-Cal dental program for young children, the developmentally delayed, and adults residing in living facilities. Gov. Brown issued a message on this bill saying that because it would have required new ongoing state funding, he believes it should be considered as part of the budget.

    CDA will update members about the provisions of SB 1008, including the new uniform matrix to be used by dental plans, once they are developed.
  • FDA Approves HPV Vaccine For Men And Women Aged 27 To 45

    The New York Times (10/5, Grady, Hoffman) reported that the Food and Drug Administration has approved the HPV vaccine “for men and women from 27 to 45-years-old.” The article noted that the vaccine “had been previously approved for minors and people up to age 26.” The HPV vaccine “works against the human papillomavirus, HPV, which can also cause genital warts and cancers” including “tumors affecting part of the throat – called oropharyngeal cancers” which are on the rise.

    CNN (10/5, Lamotte) reported that Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said, “HPV vaccination prior to becoming infected with the HPV types covered by the vaccine has the potential to prevent more than 90 percent of these cancers, or 31,200 cases every year, from ever developing.”

    The Washington Post (10/5, McGinley) reported that the approval “represents an important opportunity to help prevent HPV-related diseases and cancers in a broader age range,” said Dr. Marks.

    Dentists can refer patients to MouthHealthy.org for information on oral cancer and HPV and oropharyngeal cancer, and JADA For the Patient includes the article Oral cancer: What to do if something unusual shows up. The ADA also offers the brochure “Get The Facts About Mouth and Throat Cancer.”
  • CURES and Opioid Pain Management

    All dentists who are authorized to prescribe, order, administer, furnish or dispense controlled substances were required to register in the Controlled Substance Utilization Review and Evaluation System (CURES) by July 1, 2016, and must now have updated browsers to access the system. Dispensed controlled substance prescriptions are recorded in CURES, which allows prescribers to look up a patient's controlled substance current usage and past history.
  • Controlled Substance Utilization Review and Evaluation System

    California’s Prescription Drug Monitoring Program
    CURES 2.0 (Controlled Substance Utilization Review and Evaluation System) is a database of Schedule II, III and IV controlled substance prescriptions dispensed in California serving the public health, regulatory oversight agencies, and law enforcement. CURES 2.0 is committed to the reduction of prescription drug abuse and diversion without affecting legitimate medical practice or patient care.

    The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and confidentiality and disclosure provisions of California law cover the information contained in CURES 2.0.

    Access to CURES 2.0 is limited to licensed prescribers and licensed pharmacists strictly for patients in their direct care; and regulatory board staff and law enforcement personnel for official oversight or investigatory purposes.

    CURES Registration Requirements
    California law (Health and Safety Code Section 11165.1) requires all California licensed prescribers authorized to prescribe scheduled drugs to register for access to CURES 2.0 by July 1, 2016 or upon issuance of a Drug Enforcement Administration Controlled Substance Registration Certificate, whichever occurs later. California licensed pharmacists must register for access to CURES 2.0 by July 1, 2016, or upon issuance of a Board of Pharmacy Pharmacist License, whichever occurs later.

    Prescriber and dispenser registration to access CURES 2.0 is simple and fully automated. Prescribers and dispensers can register to access CURES by clicking here.
  • CURES 2.0 WEBINAR HOSTED BY CDA

  • Volunteers still needed for CDA Cares Modesto

    Volunteers are still needed for the following positions:
    Sterilization, Central Supply and for Dental Team members needed for treatment
    Orthodontists to help in the lab with stay plates and wire bending
    Oral Surgeons
    Medical personnel to help with screening
    Community volunteers to help as patient guides (friends, family, neighbors, etc.) including those that can interpret (all languages including sign)
    Pre-event orientation will start next week and they are hoping to get everyone registered soon to avoid the congestion orientation process at the event.

    Register to volunteer by end of day Sunday, Oct. 21, at http://www.cdafoundation.org/modesto. Advance online registration is highly encouraged to ensure first-choice placement, but walk-in volunteers are also welcome. Also visit cdacares.org for volunteer FAQ, maps, parking information and more.​​
  • Join us for the ADA’s first Twitter chat!

    The ADA is hosting its first Twitter chat at 6:30 p.m. CDT Wednesday, September 12! The ADA and special guest VCU Health will discuss gender gaps in health care, preceding Dr. Kathy O'Loughlin's September 17 speech on the subject at Virginia Commonwealth University.

    Spread the word!  You and your members can participate by searching for the hashtag #DentistryChat on Twitter and then tweet with the hashtag to chime in! You can find the ADA's Twitter account at twitter.com/AmerDentalAssn.
  • Dental Amalgam Control Program FAQ

    What is the Environmental Protection Agency’s Dental Office Point Source Category?

    The Environmental Protection Agency’s (EPA) Dental Office Point Source Category is a new regulatory program consisting of Pretreatment Standards, best management practices (BMPs), and other requirements meant to reduce discharges of mercury and other metals from dental offices into municipal sewerage treatment plants known as publicly owned treatment works (POTWs).

    What is the regulatory basis for this new program?

    The Clean Water Act, passed in 1972, established the National Pretreatment Program (NPP) to address indirect discharges from industries to publicly owned treatment works (POTWs).  The NPP, published in 40 CFR Part 403, provides the regulatory basis to require nondomestic dischargers to comply with Pretreatment Standards to ensure that the goals of the Clean Water Act (CWA) are attained.

    What is a Publicly Owned Treatment Works?

    Publicly owned treatment works (POTWs) collect wastewater from homes, commercial buildings, and industrial facilities and transport it via a series of pipes, known as a collection system, to the treatment plant(s).  The treatment plant then removes harmful organisms and other contaminants from the sewage so the wastewater can be discharged safely into a receiving stream.  Without treatment, sewage creates bad odors; contaminates rivers, lakes, and water supplies; and spreads disease.  POTWs are designed to treat typical household waste, biodegradable commercial waste, and biodegradable industrial waste, however, the treatment plants are neither designed for nor able to remove toxic or non-conventional pollutants that commercial and industrial facilities discharge.

    Who will enforce these new regulations?

    Unlike other environmental programs that rely on federal or state governments to implement and enforce specific requirements, under the NPP, most of the responsibility rests on local municipalities.  In general, all large POTWs are required to establish a local pretreatment program and must enforce all national pretreatment standards and requirements in addition to any more stringent local requirements necessary to protect the site-specific conditions of their treatment processes.  Consequently, a POTW with an approved pretreatment program is the Control Authority.

    In central and north Orange County, that local municipality is the Orange County Sanitation District (OCSD).  OCSD is a special district, a separate local government that delivers a limited public service (sewerage collection and treatment) to a limited geographical area.  Special districts are instrumental in localizing the costs and benefits of public services.  Initially formed in 1954 to take over wastewater treatment from its member city predecessors, OCSD is now entering its 64th year of protecting public health and the environment by providing effective wastewater collection, treatment, and recycling.

    Who is affected?

    The new Dental Office Point Source categorical regulations apply to wastewater discharges to POTWs from offices where the practice of dentistry is performed including large institutions such as dental schools and clinics; permanent or temporary offices, home offices; and dental offices owned and operated by federal, state, or local governments including military bases. 

    The EPA’s final rule includes a provision to significantly reduce and streamline the General Pretreatment Regulations for the dental offices, a.k.a. Dental Dischargers.  To simplify implementation of these regulations, the EPA has established that Dental Dischargers are not Significant Industrial Users or Categorical Industrial Users unless designated such by their Control Authority.  This regulatory approach eliminated many General Pretreatment Program requirements that that would have otherwise applied.

    What must Dental Offices do to comply with the new Dental Office Point Source categorical regulations?

    All Dental Dischargers must submit a Compliance Report to their Control Authority.  Dental dischargers that place or remove amalgam must also operate and maintain an amalgam separator, and must not discharge scrap amalgam or use certain kinds of line cleaners as detailed below.

    The program requires dental dischargers that place or remove amalgam to use technology-based pretreatment such as an amalgam separator (pretreatment is a term that refers to treating wastewater before discharge to a POTW), and to implement two BMPs:

    Waste amalgam including, but not limited to, dental amalgam from chairside traps, screens, vacuum pump filters, dental tools, cuspidors, or collection devices, must not be discharged to a POTW, and
    Dental unit water lines, chair-side traps, and vacuum lines that discharge amalgam process wastewater to a POTW must not be cleaned with oxidizing or acidic cleaners, including but not limited to bleach, chlorine, iodine and peroxide that have a pH lower than 6 or greater than 8.
    The Dental Discharger must also maintain records of various activities as defined in the Dental Office Point Source regulations.

    Are there exemptions?

    Yes, Dental Dischargers that do not place dental amalgam, and do not remove dental amalgam except in limited emergency or unplanned, unanticipated circumstances are exempt from any further requirements of the rule program provided they certify such in their Compliance Report to the Control Authority (OCSD).

    Dental dischargers that exclusively practice one or more of the following dental specialties:

    Oral Pathology,
    Oral & Maxillofacial Radiology,
    Oral and Maxillofacial Surgery,
    Orthodontics,
    Periodontics, or
    Prosthodontics
     

    and do not engage in the practice of amalgam restorations or removals, and therefore do not have any wastewater discharges containing dental amalgam should download the Limited Dental Discharger Compliance Report from OCSD’s website.  These regulations do not currently apply to Dental Mobile Units.

    What are the deadlines for compliance?

                New Dental Offices

    The compliance date for new dental offices ("New Sources") is the effective date of the rule, July 14, 2017.  New sources must immediately comply with all requirements of the Dental Office Point Source Category, and submit a Compliance Report to the Control Authority no later than 90 days following the introduction of wastewater into a POTW.  (New Source does not include an ownership change.)

                Existing Dental Offices

    The effective date of the rule is July 14, 2017.

    Existing dental offices must comply by July 14, 2020, and must submit a Compliance Report to the Control Authority no later than October 12, 2020.

                •  Existing amalgam separators may be operated for their lifetime or ten years, whichever comes first.

                •  When a separator needs replacement, or the ten-year period has ended and the separator does not meet the standard of the final rule, a dental office must replace it with one that meets the requirements of the final rule.

                Following Ownership Transfer

    For existing sources, the new owner must submit a new Compliance Report to the Control Authority no later than 90 days after the transfer of ownership.

    Who must follow the Best Management Practices (BMPs)?

    All dental practitioners must comply with the BMPs, including the dentists, hygienists, and any other personnel in the practice or clinic, when said individuals handle dental amalgam, or amalgam derived waste.   Train the appropriate staff in the manufacturer’s recommended operating and maintenance procedures for the amalgam separator; the proper handling, management, and disposal of amalgam materials and wastes; and the correct methods for cleaning chair-side traps, vacuum lines, and dental tools. The EPA suggests dental offices consider use of signs displayed prominently in the office or electronic calendar alerts to remind staff of dates to perform and document routine maintenance and inspections.  It is also recommended that the dental office maintain a log to demonstrate compliance with the BMP training activities. 

    Who is responsible for completing and submitting the Compliance Report Form?

    All operator/proprietor, a practitioner/owner, or the general partners must complete the “Dental Discharger Compliance Report” form for each dental office location.

    An Exempt Dental Discharger, a dental office that has eliminated the use of dental amalgam and only expects to remove amalgam to provide immediate treatment, must complete the “Limited Dental Discharger Compliance Report” form.

    Who must sign the Compliance Report Form?

    Per 40 CFR 441.50(a)(2), the Compliance Report must be signed and certified by a responsible corporate officer, a general partner or proprietor if the dental facility is a partnership or sole proprietorship, or a duly authorized representative in accordance with the requirements of 40 CFR 403.12(l).

                Responsible Corporate Officer (Authorized Representative)

    a)         If the applicant or User is a corporation:

    (1)        The president, secretary, treasurer, or a vice president of the corporation in charge of a principal business function, or any other person who performs similar policy or decision-making functions for the corporation; or

    (2)        The manager of one or more manufacturing, production, or operation facilities, provided the manager is authorized to make management decisions that govern the operation of the regulated facility including having the explicit or implicit duty of making major capital investment recommendations, and initiate and direct other comprehensive measures to assure long-term environmental compliance with environmental laws and regulations; can ensure that the necessary systems are established or actions taken to gather complete and accurate information for individual Wastewater discharge permit requirements; and where authority to sign documents has been assigned or delegated to the manager in accordance with corporate procedures.

    b)         If the applicant or User is a partnership or sole proprietorship: a general partner or proprietor, respectively.

    c)         If the applicant or User is a federal, state, or local governmental facility: a director or highest official appointed or designated to oversee the operation and performance of the activities of the government facility, or the designee.

                Duly Authorized Representative (Designated Representative*)

    d)         The individuals described in paragraphs (a) through (c) above, as Responsible Officers, may designate an Authorized Representative if the authorization is in writing, the authorization specifies the individual or position responsible for the overall operation of the facility from which the discharge originates or having overall responsibility for environmental matters for the company or organization, and the written authorization is submitted to OCSD.

    e)         An applicant or User not falling within one of the above categories must designate as the Responsible Officer an individual responsible for the overall operation of the facility. The Responsible Officer may designate an Authorized Representative.  (If signed by a duly authorized representative, the Certification must be accompanied by a completed and signed designated signatory form.)  

    * All correspondence regarding all permit and enforcement issues shall be sent to the Designated Signatory.  It is the Designated Signatory’s responsibility to keep the Responsible Officer informed at all times regarding all permit and enforcement issues.  The Responsible Officer remains legally responsible for all wastewater discharge to the sewer from this facility and for ensuring that he is duly informed by the Designated Signatory. 

    How often does the Compliance Report Form need to be submitted?

    In general, only once.  However, a new Certification should be submitted if there is a change in the following:

    Name, location, or ownership interest in the dental practice or clinic, or
    Change in the amalgam separation equipment.
    Do I need to retain a copy of the completed Compliance Report Form?

    Yes.  Per 40 CFR 441.50(a)(5), as long as a Dental facility subject to this part is in operation, or until ownership is transferred, the Dental facility or an agent or representative of the dental facility must maintain this One Time Compliance Report and make it available for inspection in either physical or electronic form.

    Are Dental Dischargers required to submit the Compliance Report in both hard copy and electronic formats?

    Yes.  To ensure Dental facilities only need to mail the report one time, OCSD would like to review the Compliance Report for completeness and accuracy before the hard copy is sent.  Please E-mail the completed electronic file to OCSD before submitting the hard copy of the completed form by post.  OCSD will reply to your E-mail confirming the report’s completeness or reply with suggestions for any deficiencies noted.  Finally, Dental facilities must submit a hard copy original with a “Live Signature” to satisfy the EPA’s requirements.

    How do I submit the Compliance Report Form?
    • E-mail Electronic Adobe PDF dentaloffice@ocsd.com
    • Mail Hard Copy with Live Signature
      Orange County Sanitation District
      10844 Ellis Avenue
      Fountain Valley, CA 92708-7018
      Attn:  Merrill Seiler, Div. 620 

      Who can I call for assistance with completing the Compliance Report Form, or if there are additional questions?

      Merrill Seiler, Principal Environmental Specialist
      Office: (714) 593-7436
      E-mail:  dentaloffice@ocsd.com

  • Deadline July 14, 2020: Don’t Be In Violation Of The Clean Water Act

    The Environmental Protection Agency’s Dental Office Point Source Category, effective July 14, 2017, requires Dental facilities without amalgam separators to install amalgam separators and submit a One-Time Compliance Report to the local control authority by July 14, 2020 (some exceptions apply). Brand new practices must immediately comply with the amalgam separator requirement, and practices with amalgam separators installed on June 14, 2017 have until June 14, 2027 to change their separators.

    Dental offices in central and north Orange County may download the Compliance Report forms and obtain additional information on complying with this regulation at www.ocsd.com (click the “Dental Office Point Source Category” link under the Businesses tab), or by contacting Merrill Seiler at the Orange County Sanitation District (714-593-7436 or DentalOffice@ocsd.com). Refer to the EPA’s Frequently Asked Questions on the Dental Office Category Rule for more information.
  • Eligible Premier providers to be mailed Delta Dental settlement notices

    Dentists eligible for payments under CDA’s settlement agreement with Delta Dental should expect to receive allocation notices within a few weeks. The class action settlement administrator plans to mail letters to approximately 14,000 Premier providers who had their fees impacted by Delta Dental’s “inflationary adjustment percentage.” Dentists who did not have their fees reduced improperly by the inflationary adjustment percentage will not receive notices or payments under the settlement.

    CDA advises Premier providers to watch for the letters, which are expected to provide information regarding payments and next steps. Those receiving payments, which range from $500 to many thousands of dollars, do not need to file a claim in order to receive a portion of the $65 million settlement agreement. Awards will be based on Delta Dental’s record of requests for fee increases submitted to Delta, any application of the inflationary adjustment percentage to those requested fee increases and claims history for services performed during the period of Jan. 1, 2011, through Sept. 14, 2017.

    Besides the settlement amount, CDA secured additional protection for dentists, including those not receiving payments. Under the settlement agreement, Delta Dental must provide:
    • 120 days’ written notice of material changes to participating dentist agreements to all contracted providers.
    • Each Premier provider affected by any attempt to reduce reimbursement rates with an individualized illustration of how those reductions would potentially affect the dentist’s practice.
    • CDA with 12 days’ advance notice of changes to participating dentist agreements to prepare for questions from members.

    Although this agreement does not prevent future rate reductions, CDA successfully blocked Delta Dental’s attempt to reduce Premier provider reimbursement rates during the five-year litigation, saving dentists — even those not receiving settlement payments — more than $600 million in Premier plan fee reductions.

    For more details on the settlement, visit DeltaDentalofCaliforniaSettlement.com. Members with questions about the terms or meaning of the settlement may contact CDA at 800.232.7645.
  • CDA, CMA, file statewide soda tax measure for 2020

    A ballot measure to protect public health through a state soda tax has been filed for the November 2020 ballot by CDA and the California Medical Association.

    The filing comes four days after the multibillion-dollar soda industry proposed a ballot measure that jeopardized the fiscal outlook of local governments, forcing the state to pre-empt local authority and pass an unprecedented 12-year moratorium on any local soda tax.

    Specifically, the soda industry’s proposal would have required cities and counties achieve a two-thirds vote instead of the current 50 percent vote threshold to raise taxes.

    The 2020 ballot initiative by CDA and CMA would implement a statewide tax of 2 cents per fluid ounce on sugar-sweetened drinks, providing at least $1.7 billion in revenue for critical health programs and constitutionally preserving the ability of California’s local communities to make their own decisions regarding future soda taxes.   

    Dustin Corcoran, CMA chief executive officer, and Carrie Gordon, CDA chief strategy officer, said in a statement:      

    In the face of growing public support for local health taxes on sugar-sweetened beverages, the billion-dollar global soda industry last week put corporate profits ahead of public health and forced an ultimatum upon the leadership of California’s state government.

    Big Soda may have won a cynical short-term victory but, for the sake of our children’s health, we cannot and will not allow them to undermine California’s long-term commitment to health care and disease prevention.         

    There is overwhelming evidence of the link between obesity, diabetes, tooth decay, and heart disease and the consumption of sugary-sweetened beverages such as soft drinks, energy drinks, sweet teas and sports drinks.

    Around the world and in local communities, reasonable soda taxes have been proven effective in dramatically reducing consumption of sugary drinks and improving the public health, especially among children.

    California’s health care provider community is united behind ensuring that California voters have the opportunity to protect our children’s well-being — not the profit margins of soda conglomerates.
    Sugar-sweetened beverages are the single largest source of added sugar in the American diet and a primary cause of dental decay — the most common chronic childhood disease, experienced by more than two-thirds of children in California. And soda is the most consumed beverage in the U.S. with more than 60 percent of teenagers drinking at least one sugar-sweetened beverage daily. The frequent consumption combined with the high levels of sugar and acid make these beverages exceptionally damaging to teeth.

    California jurisdictions that already impose sugar-sweetened beverage taxes, including Albany, Berkeley, Oakland and San Francisco, are allowed to maintain the taxes and are not affected by the statewide bill signed Thursday by Gov. Brown. CDA supported the Albany, Oakland and San Francisco initiatives that passed at the polls in 2016, citing that they would not only discourage consumption but fund programs to combat dental disease, obesity, diabetes and other disease tied to excessive consumption of sugar-sweetened beverages.

    CDA will keep members informed about the status and progress of the ballot initiative on cda.org and in the CDA Update.
  • Bill to increase dental plan transparency clears Senate with bipartisan support

    CDA-sponsored Senate Bill 1008 (Skinner, D-Berkeley), which calls for more value and transparency from dental plans, is moving swiftly through the Legislature. The bill in late May passed the Senate with bipartisan support despite strong opposition from the dental plan lobby.

    SB 1008 supports patient choice of provider and helps level the playing field for providers and patients. The bill will require standardized disclosures for all dental benefit plans using a uniform Summary of Benefits and Coverage template, which will include the dental plan’s dental loss ratio (DLR) along with other plan details, including covered services, reimbursement levels, estimated enrollee cost share, limitations and exceptions.

    The bill also requires plans to disclose specific information to out-of-network providers so they can help their patients make informed decisions regarding their dental treatment. This information includes the criteria and procedure the plans use to decide whether to pay for services, the dental treatment and procedures covered, the actual percentages or amounts payable as a benefit toward dental care or treatment, and notification of payment issued by the insurer to the insured for dental treatment rendered by the billing provider.

    The standardized form will help purchasers and patients better understand and evaluate their options for dental coverage. Requiring that plans fully communicate with providers about an enrollee’s coverage and benefits will allow dentists to better educate and counsel their patients in treatment planning and help avoid high “surprise” bills.

    “With SB 1008, we continue our advocacy work to hold dental benefit plans accountable and require greater plan transparency so consumers can make purchasing decisions knowing more about how their health care dollars are spent,” said CDA President Natasha Lee, DDS.

    The bill builds off legislation CDA sponsored in 2014, AB 1962, also authored by Skinner, which created a standardized requirement for dental plans to annually disclose to state regulators and the public their “loss ratio,” or how they spend patient premium dollars. Three years of dental plan reporting demonstrated a wide variation in DLR by product type and market, with plans falling as low as 4 percent spent on patient care, raising significant questions about the consistency and value of plans. The average DLR in 2014-15 in California was 61 percent, considerably lower than the 76 percent average reported nationwide.

    As CDA reported in March, under current law, all medical insurance plans must adhere to a “medical loss ratio” standard requiring them to disclose how they spend insurance premium dollars and to spend a certain percentage directly on patient health care rather than administrative overhead and profits. Medical plans for large groups must spend 85 percent of all premium dollars on health care; 80 percent is required for small group and individual products. The MLR requirement ensures a minimum value for consumers and holds insurance companies accountable for how they are spending patients’ dollars, but currently there is no standard for assuring value in commercial dental benefit plans.

    Language in SB 1008, as introduced in February, would have required dental benefit plans to meet a minimum DLR, but this language was removed as the Legislature was not comfortable with implementing a DLR without greater standardization of dental benefit plans. However, the current bill does include a requirement that dental plans provide consumers with the previous year’s DLR for each product, whereas the 2014 legislation only required the plans to report this information to state regulators. While it will not be the only item consumers evaluate when purchasing a dental benefits plan, CDA believes it will raise significant questions for a purchaser who sees that a specific plan spends a low percentage of premium dollars on patient care and encourage them to look for a higher value plan.

    Legislators hear from CDA members

    CDA thanks the hundreds of CDA members who engaged in grassroots advocacy, responding to the association’s call to action by contacting their representatives or sending letters urging them to support the bill.

    “CDA believes that patients deserve greater protections and value from their dental plans,” said Dr. Lee. “If passed, SB 1008 will improve dentists’ ability to educate their patients and move California further down the path.”

    The bill will next be heard in the state Assembly.

    CDA will update members on the status of the bill on cda.org and in an upcoming issue of the Update.
  • CDC addresses reprocessing of dental handpieces

    CDA Practice Support often receives calls from members who have questions about reprocessing dental handpieces, which as medical devices are regulated by the Food and Drug Administration.

    Recognizing the dental community’s need for clear and consistent guidance on this subject, the Centers for Disease Control recently issued a statement pointing to its current recommendations.

    “CDC guidelines for infection prevention and control state that, between patients, dental health care personnel should clean and heat-sterilize handpieces and other intraoral instruments that can be removed from the air and waterlines of dental units,” the statement reads. The CDC explains that this recommendation is based on studies indicating that “retained patient material can be expelled intraorally during subsequent uses.”

    Also, from the California Code of Regulations on minimum standards for infection control: “All high-speed dental handpieces, low-speed handpieces, rotary components, and dental unit attachments such as reusable air/water syringe tips and ultrasonic scaler tips, shall be packaged, labeled and heat-sterilized in a manner consistent with the same sterilization practices as a semi-critical item.”

    The detachable handpieces can be sterilized through autoclaving, dry heat or unsaturated chemical vapor according to the manufacturer’s specified sterilization time, pressure and temperature.

    For cordless dental handpieces that function independently of airlines and waterlines, the CDC recommends that dental care providers follow current FDA regulations for cleaning these devices, which call for using only “FDA-cleared devices” and following the manufacturer’s directions on cleaning, lubricating and sterilizing them. Manufacturers are instructed to follow the FDA’s 2015 guidance on writing reprocessing instructions that have been scientifically validated. Providers who have concerns about the validity of these instructions can either contact the manufacturer or, if that fails, contact the FDA’s Office of Compliance.

    Handpieces that cannot tolerate high temperatures and therefore cannot be heat-sterilized, as well as those that have not been cleared by the FDA, should not be used.

    “These infection control guidelines should be followed in every dental office,” says CDA Regulatory Compliance Analyst Teresa Pichay, who recommends that offices as a best practice designate one team member to monitor infection prevention protocols and ensure that the personnel adhere to them.

    Pichay also recommends the CDC’s DentalCheck app to help offices stay on top of infection control best practices. The CDC used its “Infection Prevention Checklist for Dental Settings” to develop the app, which covers cleaning and sterilization of handpieces and includes easy “yes-no” checkboxes to indicate compliance.

    Reference the CDC statement and infection control guidelines for the dental office. For CDA Practice Support resources on infection control, visit cda.org/resourcelibrary.
  • Regulatory Compliance Alert

    State law required all dentists who are licensed prescribers to have registered for access to California’s Controlled Substance Utilization Review and Evaluation System (CURES) by July 1, 2016 or upon issuance of a DEA certificate.

    If you are a licensed dentist with DEA registration who has not registered for CURES 2.0, know that you are now out of compliance with California law.

    Register today.

    •  Application to access CURES 2.0 is easy and fully automated.

    •  Visit oag.ca.gov/cures to apply now and achieve compliance.

    Learn more.

    For CURES guidance and opioid pain management resources, visit cda.org/opioid.
  • DEA registrants targeted by extortion scam

    Criminals posing as Drug Enforcement Administration employees are targeting DEA registrants as part of an extortion scam, the administration said in an April 2 email alert according to the ADA.
    The scammers are reportedly contacting the registrants by phone using a disguised telephone number that appears on registrants’ caller ID as the DEA’s 800 registration support number. The impersonators then make their demands with threats to suspend DEA registrations.
    “Please be aware that a DEA employee would not contact a registrant and demand money or threaten to suspend a registrant’s DEA registration,” the email alert states.
    Any DEA registrant who is contacted by individuals claiming to work for the DEA and demanding or requesting money or threatening to suspend the registrant’s DEA license are urged to report the call using the DEA’s online extortion scam report form, available on the DEA’s Diversion Control Division website. The one-page report gives registrants the option of receiving a callback from DEA personnel about the incident.
    DEA registrants with questions may contact the DEA Registration Helpline at 800.882.9539.
  • Become a CDA volunteer

    Applications for available positions on CDA councils, committees and boards are now available online at cda.org/leadership, where a host of volunteer opportunities are identified. The application process is easy — download the application and email it with your CV to volunteer@cda.org by May 31. 

    Incumbent members of a council, committee or board who are eligible for another term of service were emailed a special link to indicate their interest in continuing service. If they are interested in different or additional positions, they should apply through cda.org/leadership.

    Contact volunter@cda.org with any questions.
  • Callers seek fraudulent access to sensitive practice information

    Dental practices are reporting to Henry Schein Practice Solutions that they have received calls from an individual posing as a company employee who then asks for remote access to the office servers. The company in late January stated that, according to the practices, the callers provided multiple reasons for their calls, such as communicating problems with computer system backups and viruses and hardware failures, before requesting access to the system.

    Such calls are a type of phishing scam, a form of internet fraud whereby scammers pretend to be key personnel or set up look-alike websites and emails to fool individuals into providing sensitive information such as passwords, access codes, patient account numbers or Social Security numbers. With this information, scammers can then steal information and profit from its sale. Dentists and health care providers are increasingly targeted by these scammers who rely on individuals’ lack of awareness and preparation for such schemes.

    To help dentists avoid falling for this scam, CDA Regulatory Compliance Analyst Teresa Pichay advises that they “train staff to verify a caller’s credentials and information before providing practice information to the individual.”

    Similarly, the Federal Trade Commission in “Protecting Personal Information: A Guide for Business” emphasizes the importance of appropriate and periodic employee training in safeguarding the data of patients, customers and employees. 

    “Your data security plan may look great on paper, but it’s only as strong as the employees who implement it,” states the guidance, which goes on to recommend employees be trained to spot vulnerabilities. Specifically addressing fraudulent calls, the guidance recommends that employers or trainers do the following:

    Warn employees about phone phishing. Train them to be suspicious of unknown callers claiming to need account numbers to process an order or asking for — contact information. Make it office policy to double-check by contacting the company using a phone number you know is genuine.

    The FTC also advises businesses of every type to warn employees about possible calls from identity thieves who impersonate IT staff in an attempt to gain access to passwords or other sensitive information. “Let employees know that calls like this are always fraudulent, and that no one should be asking them to reveal their passwords,” the guidance states.

    Henry Schein responded to the reports it received by recommending that its customers follow several FTC-recommended practices, such as verifying the identity of every caller and not providing sensitive information to unexpected and unknown callers. The company further recommended that recipients of suspicious calls “gather information, such as the person’s name, company and/or employee ID#,” take down the phone number and provide it, along with other information gathered, to Schein.

    Taiba Solaiman, risk management analyst at The Dentists Insurance Company, also advises dentists that they should be aware of and appreciate the impact staff members have on their overall liability. “It’s essential that dentists be proactive and train staff on what guidelines and protocols they must follow in order to reduce professional liability risks associated with their practice.”

    Find the FTC guidance referenced in this article along with additional guidance on data security.
  • ADA Announces Interim Opioids Policy.

    The ADA News (3/26, Garvin) reports the Association announced on March 26 a new interim policy on opioids that supports mandatory continuing education for dentists, prescription limits, and utilization of prescription drug monitoring programs. Titled Interim Board Policy on Opioid Prescribing, the new policy is thought to be the first of its kind among major health professional organizations. “I call upon dentists everywhere to double down on their efforts to prevent opioids from harming our patients and their families,” said ADA President Joseph P. Crowley. “This new policy demonstrates the ADA’s firm commitment to help fight the country’s opioid epidemic while continuing to help patients manage dental pain.”

    In a second article, the ADA News (3/26, Garvin) reports that “the April issue of The Journal of the American Dental Association focuses on the subject of opioids and dentistry.” The four cover articles examine opioid prescribing patterns among US dentists; disparities in opioid prescriptions for Medicaid dental patients; the benefits and adverse events associated with acute pain relief from opioids and nonsteroidal anti-inflammatory drugs; and prescription monitoring programs.

    Also reporting are CBS News (3/26, Strickler), the Associated Press (3/26, Tanner), The Hill (3/26, Roubein), UPI (3/26, Brokaw), and Dr Bicuspid (3/26, Edwards).

    For more information about opioids, including upcoming webinars and subscriber tips, visit ADA.org/opioids.
  • Just one of the benefits of being an OCDS member is FREE Online CE

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  • TDSC marks first-year milestone with $500K in member savings

    One year after clicking the “place order” button to purchase dental supplies online through The Dentists Service Company’s Marketplace, James Stephens, DDS, added up his 12-month savings — $13,000 total. Stephens, who owns a Palo Alto practice with his wife and business partner Susan Park, DDS, was among the first dentists to test the new TDSC Marketplace in February 2017, and he knew at the time that CDA was about to change the way dentists buy supplies.

    “The savings are substantial — buying through the Marketplace has saved us enough money to cover our tripartite dues, invest in our practice and even take a vacation,” said Stephens, past CDA president and past TDSC board chair. “The Marketplace has become the new norm in my office and it provides significant savings to my practice.”

    After a successful testing phase, the TDSC Marketplace was launched last June as a free benefit to all CDA members in response to members’ desire to have more control over their practices, including the ability to compete with large group practices that negotiate supplies at lower prices than solo practice owners.

    “Big dental supply companies set prices the way they want to because they can,” said Ruchi Sahota, DDS, associate editor of the CDA Journal. In her February 2018 editorial “One-Stop Shopping Equals Savings and Support,” Sahota enthusiastically urged all CDA members to buy supplies through the Marketplace, which has saved her Fremont practice time and money. “If we want these amazing prices to stick around, then we have to buy. We have to utilize the Marketplace. The more we buy, the bigger TDSC’s buying power becomes. The more we buy, the more TDSC can negotiate prices.”

    Built on values important to dentists, the Marketplace delivers savings and selection through an easy-to-use site for members and office teams who handle supply ordering. From composites to bonding agents, burs and gloves, the Marketplace boasts more than 25,000 products across 32 categories, with each item from a trusted, authorized vendor.

    Throughout 2017, the Marketplace platform added enhancements with features like “saved lists,” which offer the ability to save frequently ordered items and to set automated subscriptions for products ordered regularly to ensure a practice never runs out of the things used most. With a large catalog selection, products are categorized in a logical way and are easy to find via the on-site search function. Thanks to consistent feedback and hands-on support from early shoppers, the Marketplace has continually improved in this area, and today shoppers can easily search and find products by their product name, description or product number.

    In its inaugural year, the Marketplace garnered national attention, not only from dental industry manufacturers and suppliers but also dental-related publications. CDA member Jonathan Ford, DDS, shared his Marketplace experiences in both Dentistry IQ and Dental Economics magazines. In his January 2018 Dental Economics article, “How I compete with that DSO-supported office down the street,” Ford wrote that the Marketplace saved his practice more than $4,800 in the first six months.

    “Buying online has affected every other facet of the retail economy, so it’s no surprise that as the digital and dental worlds have evolved, e-commerce has found its way into the dental supply landscape as well,” Ford wrote. “Organized dentistry is at its best when we can leverage the shared strength of our membership to find innovative ways to stay ahead of a shifting landscape.”

    Following the Marketplace’s successful first year, TDSC is now focusing on growth for 2018. As more members discover significant savings on their dental supplies, CDA and TDSC want to ensure that all members know about this newest member benefit so they can capitalize on savings for their practices. Additionally, work is underway on out-of-state expansion plans that would allow the Marketplace to strengthen the group’s buying power and continue to drive savings.

    TDSC Marketplace access is a free benefit of CDA membership. To compare products, see savings and start shopping, visit tdsc.com.
  • House Passes Action For Dental Health Act.

    The ADA News (2/27, Garvin) reports that the House of Representatives voted 387-13 on Feb. 26 to pass the Action for Dental Health Act of 2017, which calls for Congress “to amend the Public Health Service Act to improve essential oral health care for low-income and other underserved individuals by breaking down barriers to care, and for other purposes.” ADA President Joseph P. Crowley sent an action alert to ADA members, calling the legislation’s passage “a huge victory for dentistry and patients everywhere.” Dr. Crowley said, “All Americans deserve good dental health and this bill helps fund programs that combat dental disease before it starts.” The article reports that “the ADA is working with Senators to take action on this legislation.”

    For more information about the ADA’s Action for Dental Health initiative, visit ADA.org.
  • Dentists with DEA numbers must be registered with CURES 2.0

    “All health care practitioners authorized to prescribe or dispense Schedule II-IV controlled substances were required to register to use CURES 2.0 no later than July 1, 2016,” the Dental Board of California reminds dentists in an email distributed late January.

    California’s Controlled Substance Utilization Review and Evaluation System, or CURES 2.0, aids prescribers and dispensers in identifying fraudulent activity and is intended to reduce prescription drug abuse and diversion without affecting legitimate medical practice or patient care. Prescribers will soon be required to check a patient’s prescription history in the CURES 2.0 database prior to prescribing a Schedule II-IV substance in certain situations, with some exemptions.

    The dental board “encourages all licensed dentists who hold a DEA registration to take measures immediately to ensure they are in compliance with this CURES 2.0 registration requirement.” One of the following browsers is required to access CURES 2.0: Microsoft Internet Explorer Version 11.0 or greater; Mozilla Firefox; Google Chrome; or Safari.

    Register to access CURES 2.0. For CDA resources on CURES and opioid pain management, visit cda.org/opioid. For assistance with CURES 2.0 registration, contact the CURES helpdesk by email or at 916.227.3843.
  • New infection control standard applies to treating exposed dental pulp

    An emergency regulation soon to be adopted by the Dental Board of California amends the minimum standards for infection control to require that water or other methods used for irrigation be sterile or contain recognized disinfecting or antibacterial properties when treating exposed dental pulp. All individuals licensed to practice dentistry in California will be required to follow the new infection control standard.

    Assembly Bill 1277 (Daly, D-Anaheim), signed into law last October by Gov. Jerry Brown, requires the dental board to adopt the emergency regulation “for the immediate preservation of the public peace, health and safety, or general welfare.” An outbreak of mycobacterial infection at a children’s dental clinic in Southern California in 2016 prompted the legislation, which CDA supported. More than 60 children were hospitalized as a result of their infections, some with severe complications. The investigation that followed suggested a bacterium was introduced by water during the performance of pulpotomies.

    This infection control standard adds to existing dental board regulations on water quality, which require that dental water lines be purged at the beginning of each workday and flushed between patients.

    The dental board is in the process of adopting the emergency regulation and has until Dec. 31, 2018, to adopt a final regulation that is consistent with the emergency regulation.

    CDA will keep members informed about any further action the board takes and additional regulatory requirements for dentists.
  • APPLICATIONS BEING ACCEPTED FOR NEW CDA TASK FORCES

    ​Applications are being accepted through February 16 at cda.org/leadership for CDA’s two newest task forces: 

    The Dental Benefits and Economics Task Force will identify opportunities for CDA to assist members in response to the changing dental benefits marketplace. Volunteers who are diverse in practice experience, location and practice modality, with a range of experience with dental reimbursement and economic challenges are encouraged to apply. The following qualifications are desired:

    Direct knowledge of dental benefit plans as either a current or former dental PPO or HMO participating provider (required)

    Evidence-based thinkers experienced with dental benefit best practices when managing their dental practices  

    The Dental Office Staffing Task Force will evaluate factors contributing to staffing shortages, identify specific areas of staffing concerns, and help to develop actionable responses. Volunteers with diverse dental practice types, experience with dental office staffing issues, policy development and practice management experience, including engaging in related component activities, advising a local dental assisting program or working individually to address staffing shortages are encouraged to apply.

    If you have any questions, please contact the governance team at governance@cda.org. Thank you.
  • FDA bans active ingredients from nonprescription antiseptic products

    In a final rule issued by the Food and Drug Administration, 24 active ingredients used in nonprescription antiseptic products are “not generally recognized as safe and effective” (GRAS/GRAE) for use by health care professionals in health care settings or situations “due to insufficient data.” The rule — or the ban on use of these ingredients in over-the-counter antiseptics — finalizes the 2015 Health Care Antiseptic Proposed Rule and takes effect Dec. 20, 2018.

    By the rule’s definition, health care antiseptics include:

    Health care personnel hand washes
    Health care personnel hand rubs
    Surgical hand rubs
    Patient antiseptic skin preparations (i.e., preoperative and pre-injection skin preparations)
    Although the rule, which was published in December 2017, applies to 24 active ingredients, data from the FDA’s drug product registration database suggest that only triclosan is found in nonprescription antiseptic products that are currently marketed, as many manufacturers began phasing out the other ingredients following the FDA’s proposed rulemaking.

    In its summary of the major provisions of the final rule, the FDA cites new data suggesting that the “systemic exposure to these active ingredients is higher than previously thought, and new information about the potential risks from systemic absorption and long-term exposure is now available.” Additionally, new information has prompted the FDA to “reevaluate the data needed to determine whether health care antiseptic ingredients are generally recognized as effective.”

    The FDA has deferred rulemaking on six additional commonly used active ingredients —   benzalkonium chloride, benzethonium chloride, chloroxylenol, ethyl alcohol, isopropyl alcohol and povidone-iodine — until scientific studies have been completed.

    The rule does not cover consumer antiseptic washes or rubs.

    Ban does not apply to use of triclosan in toothpaste

    Dentists and their patients may have questions about the use of triclosan in toothpaste, which is not banned by the FDA’s final rule. The FDA states that after reviewing extensive data showing the effectiveness of triclosan in Colgate Total toothpaste, “evidence showed that triclosan in that product was effective in preventing gingivitis,” whereas the FDA in its final rule cited a lack of evidence that triclosan in nonprescription antiseptic washes and rubs is more effective than washing with regular soap and water.

    Dentists can refer patients who express concerns about triclosan in toothpaste to the consumer update “5 Things to Know About Triclosan” on the FDA’s website.

    Questions about the rule can be directed to the FDA at druginfo@fda.hhs.gov or 855.543.3784. View the final rule, which includes the complete list of banned ingredients, in the Federal Register.
  • Updates to 2017-18 Required Poster Set

    Regulatory changes have occurred since the printing of the 2017-18 CDA Required Poster Set. As of December 2017, the three changes are:

    The California Department of Industrial Relations updated Wage Order 4-2001 to reflect increases in the state minimum wage. The correct industry wage order, available on the department’s website, bears a revision date of 12/2016.
    Starting Jan. 1, 2018, all California employers are required to post a “Transgender Rights in the Workplace” poster developed by the Department of Fair Employment and Housing. The poster can be accessed on the DFEH website.
    The Division of Occupational Safety and Health, under the California Department of Industrial Relations, in November 2017 updated the Safety and Health Protection on the Job notice. All employers are required to print and post the notice found on the DIR website.
    All notices are required to be placed in an area frequented by employees and where they may be easily read during the workday.

    Because these changes come after the 2017-18 CDA Required Poster Set printing, each employer or practice owner is required to print and post the updated notices. The Required Poster Sets will not be reprinted to reflect this change.

    For more information, see the CDA Practice Support resource “List of Required Postings in a Dental Office.”
  • 10th Annual Ken Sanford, DDS Memorial Ride

    Don’t miss the 10th Annual Ken Sanford, DDS Memorial Ride in Baker City, Oregon September 16-18, 2018.

    Book your room NOW at the  Geiser Grand Hotel by calling 541.523.1889

    The “CDA Rides” discounted hotel rooms close on February 14, 2018! 

     

    For more information, please email DentistRides@GMail.com
  • Volunteer Now for CDA Cares Anaheim 2018

    CDA Cares is coming to Orange County and we need your help in making the Anaheim event a huge success. 

    Each CDA Cares clinic provides dental services at no charge to an average of 1,950 individuals in just two days. We rely on hundreds of volunteers to make it happen. General dentists, oral surgeons, hygienists, assistants, lab techs, physicians, nurses and pharmacists share their clinical skills. Community volunteers register patients and volunteers, help set up, enter treatment data, escort patients, interpret and more.

     
    Location:
    Anaheim Convention Center, Hall E
    800 W Katella Ave
    Anaheim, CA 92802

    Dates:
    Friday, April 27, 2018
    Saturday, April 28, 2018
     
    Patient follow-up care:
    If you are a licensed dentist in California, providing patient follow-up care after the clinic is also a great way to volunteer your skills. Sign up today for patient aftercare

    VOLUNTEER NOW
  • Pharmacies are rejecting prescriptions due to noncompliant forms

    Dentists have reported to CDA that pharmacies have rejected their prescriptions due either to forms that are out of date or are missing required elements. All prescriptions have been for controlled substances, which must be on tamper-resistant forms printed by California-approved printers and containing California-specific pre-printed elements.

    Dentists should immediately check that their tamper-resistant prescription forms have the following:

    Security features that include a latent, repetitive “void” pattern printed across the entire front of the prescription blank; a watermark showing “California Security Prescription” printed on the backside; a chemical void protection that prevents alteration by chemical washing; a feature printed in thermochromic ink; an area of opaque writing so that the writing disappears if the prescription is lightened; and a description of the security features included on each prescription form.
    Six quantity checkoff boxes for the prescriber to indicate the quantity by checking the applicable box where the following quantities shall appear:
    1–24
    50–74
    101–150
    25–49
    75–100
    151 and over
    In conjunction with the quantity boxes, a space or line to designate the units referenced in the quantity boxes when the drug is not in tablet or capsule form.
    Printed at the bottom, the statement “Prescription is void if the number of drugs prescribed is not noted.”
    The preprinted name, category of licensure, license number, federal controlled substance registration number (DEA number) and address of the prescribing practitioner.
    Check boxes for the prescriber to indicate the number of refills ordered.
    A place to indicate the prescription’s date of origin.
    A check box indicating the prescriber’s order not to substitute.
    An identifying number assigned to the approved security printer by the Department of Justice.
    A check box by the name of each prescriber when a prescription form lists multiple prescribers.
    Each batch of controlled substance prescription forms will have the lot number printed on the form and each form within that batch shall be numbered sequentially beginning with the numeral one.
    The law that establishes the requirements for tamper-resistant forms was last amended in 2012. For descriptions of  other requirements for controlled substances prescriptions, read the CDA Practice Support article, “Controlled Substances Prescribing and Dispensing.”

    A list of state-approved printers can be found on the website of the state Attorney General.