Announcements

  • CDA Cares San Bernardino

    The CDA Foundation is looking for volunteers for CDA Cares in San Bernardino on Friday, September 27 and Saturday, September 28. If you are interested in volunteering, please click here to register.
  • ADA delegation application open

    The 2020 ADA House of Delegates will be held Oct. 16-19 in Orlando, Florida, with leaders from around the state having an opportunity to provide input on national issues. Beginning Sept. 1, CDA will be accepting applications for positions on the 13th district delegation. The application will be available at cda.org/leadership through Nov. 30. Questions may be directed to volunteer@cda.org.
  • Legislative victories for sugar-sweetened beverage bills

    Despite intense lobbying efforts by the soda industry, two bills that aim to reduce consumption of sugar-sweetened beverages that contribute to obesity, diabetes, tooth decay and heart disease have advanced in the Legislature. A CDA co-sponsored bill to end manufacturer discounts by SSB companies and a bill to require warning labels on sugar-sweetened beverages passed their first committee. A bill to enact a tax on sugar-sweetened beverages also passed in committee but has since been held. Assemblymember Jim Wood, DDS, (D-Santa Rosa) provided a strong message about the need for action to reduce consumption of sugar-sweetened beverages. Watch here.
  • ADA Statement on Study Involving Dental Floss

    January 14, 2019

    CHICAGO — Recent, wide-spread news coverage based upon a recent research study may raise unwarranted concern about the safety of certain types of dental floss. The ADA Science Institute finds the data insufficient to support the conclusions presented in this research and associated media coverage.  

    No restrictions on the use of dental floss have been issued by the U.S. Food and Drug Administration, the regulatory agency that oversees clearance of dental products marketed to the public. It is also important to bear in mind that this is a single study. Public health policy and safety decisions should be based on the collective weight of scientific evidence.

    The study, published in the Journal of Exposure Science & Environmental Epidemiology, involves a small sample of 178 women and their self-reported use of a wide array of consumer products and foods. 

    The study measured blood samples from 178 women and found that those who reported using a certain brand of dental floss had higher levels of a type of PFAS called PFHxS (perfluorohexanesulfonic acid) than those who didn't. 

    One of many shortcomings of this study, according to the ADA Science Institute, is that the study measured fluorine as a marker of PTFE (polytetrafluoroethylene), though the women in the study who reported using a particular brand of floss were found to have elevated levels of PFHxS. 

    PTFE is often used in food and beverage, pharmaceutical, and cosmetic applications. The fact that the researchers were able to find the PTFE marker in several brands of floss does not mean that it is the source of the PFHxS in the women.  

    Given that this was a retrospective study including self-reported use of products, there are likely many other differences between women who did and did not report having used the brand of floss mentioned.

    The ADA sees no cause for concern based on current evidence, and above all continues to encourage people to clean between their teeth daily with floss or other interdental cleaner as part of the ADA’s daily oral hygiene recommendations.
  • 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.”
  • 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.