TEAM 1500

WSJ Article on Sedation Dentistry -- Let's Hope The ADA Reads It Closely!

2007-06-19T15:18:00Z

A prominent article in today's Wall Street Journal focuses on the growing popularity of sedation dentistry and makes clear why the American Dental Association's efforts to stymie the spread of this successful treatment protocol are ultimately doomed to fail. (Read It Here -- WSJ Subscription Required)

The story, 'Did I Really Have a Root Canal?', makes a strong case of why sedation dentistry is proving popular with both patients and dentists, noting that roughly 85 million Americans still avoid the dentist out of dread.

The story, by reporter Joseph De Avila, quotes experts and dentists testifying to the safety of oral conscious sedation (OCS) and OCS medicines when administered by practitioners following existing ADA guidelines and state regulations.

That can't be an easy pill for the ADA to swallow.

The ADA -- or more specifically the ADA's Council on Dental Education and Licensure -- would like ADA members to believe that tougher standards are called for in order for OCS to be safe. Having the WSJ report that it is already safe under existing standards won't go down well with the ADA agitators who are trying to put the OCS genie back in the bottle.

Triazolam is "a very safe drug," said Dr. John Yagiela, division chair for diagnostic and surgical sciences at the University of California Los Angeles School of Dentistry. The Wall Street Journal article also cites a 2003 study by the Dental Organization for Conscious Sedation covering 28,881 OCS cases using Triazolam. Out of that large group, "there were 85 adverse cases -- 19 of which involved the administration of flumazenil [a reversal agent]. None resulted in the need for hospitalization," the Journal reported.

The newspaper found a single Ohio dentist who felt that she can achieve the same benefits offered by OCS using only nitrous oxide. But even the Journal had to rebut her, writing, "Nevertheless, many patients and dentists say the technique is invaluable."

Now that millions of additional readers of the Journal will know about the safe, effective benefits of OCS, we suspect those in the ADA who would like to slow the progress of this important protocol will face increased difficulties.

As we noted here not long ago, progress can sometimes be artificially delayed, but not even the ADA can kill it.

Minnesota Board of Dentistry to Revist 'Bathroom Monitor' Regulations

2007-06-19T00:50:00Z

The Minnesota Board of Dentistry, which in March approved a regulation requiring dentists to remain with their patients at all times, even if the patient or dentist goes to the bathroom, will revisit the rules at a hearing on June 20, 2007.

TEAM 1500 wrote about the new rules in May, noting that they raise "all order of potential bathroom embarrassments."

In support of the dentists in Minnesota who are working to reverse the ill-considered regulations, TEAM 1500 prepared a fact sheet. A copy of it appears below.

_____________________________________________

Minnesota Board of Dentistry Mission Statement: "To ensure that Minnesota citizens receive quality dental health care from competent dental health care professionals."

The Minnesota Board of Dentistry permanent rules that went into affect on March 19, 2007 require that a dentist “must remain in the operatory room to continuously monitor the patient once…conscious sedation is achieved and until all dental services are completed on the patient.”

While the rule is undoubtedly intended to further the Board’s mission of ensuring that Minnesotans receive quality and safe dental health care, it also produces consequences that the Board likely did not anticipate.

Most notably:

• Approximately one out of two oral sedation patients who receive extended-treatment ask to use the bathroom at least once while still sedated. Complying with the MBD new rules means dentists must accompany their patients into the bathroom under these circumstances, even when their patients are of the opposite gender.

Prior to the adoption of the new regulations, dentists could assign a specially trained member of their staff to closely and continuously monitor patients who must use the bathroom. Further, the old regulations permitted a specially trained member of the dentist’s staff to remain with the patient in the operatory when the dentist needed a brief bathroom break.

• If a Minnesota dentist has sedated a patient for a routine procedure under the new guidelines, that dentist is not permitted to attend a walk-in emergency patient even briefly. Indeed, the new regulation chains the dentist to the sedated patient regardless of extenuating circumstances. Previously, a specially trained member of the dentist’s staff could monitor a patient if the dentist’s services were required elsewhere.

• The restriction on Minnesota dentists requiring them to personally monitor their sedated patients at all times means that dentists – contrary to the current standards of care everywhere else in the country – can’t attend more than one patient, even during those periods when the sedation medication has yet to take full effect or is in the process of wearing off.

The practical impact of this, which is unique to Minnesota dentists, is that they must charge their patients significantly more for the same care, because they must fully dedicate themselves to only one patient at a time. Moreover, other patients who require standard, non-sedated care, find it more difficult to garner appointments with their family dentists.

Rather than encourage dental patients to seek needed care, the higher costs and longer wait times discourage patients from seeking timely and necessary treatments. The poor, elderly and disabled are disproportionately affected.

What Is The Record Pertaining To Staff Monitoring of Sedation Patients:

• Clinical observation in Minnesota and nationally encompassing more than one million adult patients who have been safely and effective treated with oral sedation find no reported cases of injury or death arising from a specially trained staff member briefly monitoring patients without the dentist in the operatory.

• At least 100,000 adult patients under the effects of sedation have safely used the bathroom during the course of their procedures without incident or injury when supervised and escorted by a specially trained member of the dentist’s staff.

• More than 7,500 dentists nationally, including all dentists in Minnesota with conscious sedation permits, have safely attended to emergency walk-ins and other non-emergency patients while permitting a specially trained staff member to closely and continuously monitor a sedated patient. The evidence-based support for the safety of such actions is indisputable.

The March 19th regulations require a dentist administering conscious sedation to a patient to have in attendance personnel who are currently certified in CPR. In an emergency, the MBD is saying that it has confidence that such support personnel can help save a patient’s life.

To the extent that the MBD already trusts specially trained personal to behave responsibly and professionally in the event of a cardiac event, it seems only logical to extend that trust to specially trained team members who monitor a healthy, sedated patient. In an emergency, these staff members know not only how to spot trouble early and attend to the patient, but also how to immediately summon a dentist who may be in the bathroom or attending another pressing health issue.

The MBD has a long and highly respected record of looking out for its citizens. In this instance, it can continue its service of quality and safety by modifying the regulations and permitting specially trained team members to monitor sedated patients without bringing harm to patients.

See Earlier Article on This Topic:

TEAM 1500 Issues News Release In Support of North Carolina Dentists

2007-06-15T20:26:00Z

TEAM 1500 issued a news release on June 15, 2007 to generate support for dentists in North Carolina who are opposed to regulatory changes that would raise the cost of dentistry in the State, without an improvement in patient safety.

"Job number one for members of the North Carolina Board is to protect patient safety," said Dean Rotbart, director of TEAM 1500 in the news release. "But by setting the bar so high to receive care, the board is making dental care less available to those who need it most and thereby actually compromising patient safety."

To Read Full Text of the North Carolina Release, Click Here!

A Refesher Course: What You Need To Know About TEAM 1500

2007-06-11T00:04:00Z

TEAM 1500 was recently approached by a journalist who asked that we explain ourselves and our mission to those dentists who are unfamiliar with us. We thought readers of this web site might also benefit from a Q&A about who we are and what we seek.

1) Please introduce TEAM 1500 to those unfamiliar with it. What is your organization? Who do you represent? What are your goals and agendas?

TEAM 1500 was organized in January 2007 to harness the energies and resources of healthcare professionals in opposition to unnecessary regulations that effectively restrict access to quality and affordable healthcare.

TEAM 1500 is committed to public safety. But our coalition members recognize that recent efforts by the American Dental Association to establish new guidelines for periodontal care and oral conscious sedation are aimed primarily at creating “cartel-like” protection for some segments of the dental profession at the expense of the general practitioner.

By imposing unnecessary regulatory hurdles on the general practitioner, the ADA and the state dental boards that rely upon the ADA to help establish their regulations, are making it more difficult for members of the public at large to have access to safe, affordable, quality oral healthcare.

TEAM 1500 believes that these unjustified regulations disproportionately impact the poor and minorities and raise the cost of quality medical and dental care for everyone.

Our members are primarily dentists and dental team members who are active in well-respected professional organizations including the ADA, the Academy of General Dentistry, the American Academy of Periodontology, and the Dental Organization for Conscious Sedation.

In the future, we hope to recruit additional support from non-dental healthcare professionals who also face unreasonable and costly regulations.

TEAM is an acronym for Trust for Equal Access Medicine. 1500 represents the initial number of participating healthcare professionals. That number has since risen significantly as word of our efforts spreads.

2)   What is the nature of your quarrel with the American Dental Association?

In October 2005, the broad governing body of the ADA – known as the House of Delegates – adopted a policy statement affirming the “remarkable record of safety” of anxiolytic sedative and anesthetic techniques by appropriately trained dentists.

Less than two years later, in December 2006, the ADA’s Committee on Anesthesiology proposed a dramatic overhaul of the very guidelines the House of Delegates lauded in late 2005.

Indeed, as initially proposed, the ADA Committee asked that dentists who offer their patients Oral Conscious Sedation (OCS) more than triple their prerequisite training and increase their live patient experiences from zero to ten.

The ADA Committee offered no scientific justification for such an about face, nor does there appear to be any rise whatsoever in reported injuries or fatalities in relation to adult oral conscious sedation.

Although the ADA’s Committee on Anesthesiology and its parent, the ADA’s Council on Dental Education and Licensure, explain their reasoning in terms of protecting public health, TEAM 1500 knows of no example where the existing guidelines have failed to prove completely effective in protecting the adult patient population.

We believe the ADA Committees’ actions, despite their protestations to the contrary, are designed to protect oral surgeons, dental anesthesiologists and other dental specialists from further encroachment on their turf by general dentists offering their patients OCS.

These ADA Committees, we believe, are using the pretext of public safety to protect the power elite of dentistry – not the public or the general practitioner.

3)   What do you feel ADA's policies are wrong? How should they be changed?

The ADA’s existing guidelines, combined with regulations set in place by state dental boards, are working. More than one million adult patients – most of whom previously avoided the dentist due to fear and/or anxiety – have been safely treated with OCS.

That is, as the ADA’s own House of Delegates affirmed in October 2005, a remarkable record of safety.

TEAM 1500 wants the ADA to leave its existing guidelines in place and unchanged. By raising the requirements affecting general dentists who wish to offer OCS, the ADA is also raising the “bar to entry” for general dentists.   In effect, the ADA is saying, “if you are going to take business away from oral surgeons and dental anesthesiologists, you’ll have to invest more time and money to do so.”

That is not good policy. And it certainly is not good for the many millions of patients who stand to benefit from OCS, if OCS remains readily accessible and affordable.

4) What is needed to improve dentistry in the U.S.? How do you feel your organization is contributing to dentistry?

The numbers of adults and children in the United States and globally who don’t regularly visit a dentist is staggering and appalling.

The dental profession should be working to remove all possible barriers between good oral healthcare and the public at large. This includes keeping costs down and promoting (not blocking) protocols such as OCS that help patients overcome their fear of dental visits.

As for what TEAM 1500 is contributing to dentistry, we are unafraid to speak our minds and defend the rights of general practitioners and their patients.

Our methods do offend the sensibilities of some traditionalists. And so be it. Those who put fairness and patient rights first have nothing to fear from us.

5)   What should dentists do?

Speak up. Virtually every supporter of TEAM 1500 is also a member of the ADA, AGD and/or AAP. Demand that the organizations that you pay to represent you do just that.

TEAM 1500 believes that the vast majority of ADA members do not support the proposed changes. But through their inactions and silence, they are allowing a small group of self-interested specialists to set the ADA’s agenda.

The ADA is your organization. Take it back!

More than 1,000 dentists and patients have already written protest letters to the ADA. ADA members who value their dental licenses and the rights conferred by them should write the ADA in protest of this usurpation of their authority to treat patients with proven, safe protocols without undue interference.

6) What should government do?

We believe it is imperative that individual state dental boards review the ADA’s guidelines carefully and not simply rubberstamp what the ADA recommends.

In general, states regulate dentistry with three goals in mind: public safety, access and cost. As for safety, both the old and new ADA proposals are more than adequate to ensure patient safety.

However, the new ADA guidelines would reduce patient access to care and raise the price of dental care for many, many patients – even those who aren’t treated with OCS.

7)   Anything further?

Yes. When it comes to OCS, trust the dentists who best understand its benefits and risks – those practitioners who use OCS regularly.

As far as we can determine, not one general dentist who has been trained in OCS protocols and uses them regularly has written to the ADA or TEAM 1500 in support of tougher standards. Not one.

The cry for new restrictions comes from dentists who are largely unfamiliar with OCS and don’t offer it to their patients. They speak not from experience.

More than 7,500 dentists currently offer OCS to their adult patients, safely and effectively. These are dedicated professionals whose values are above suspicion. If OCS dentists saw any evidence that these protocols were in any way risky for their patients, the OCS dentists would be pounding the ADA’s table to make changes.

IV sedation and OCS are not one in the same. Being an expert in the former doesn’t make a dentist an expert in the latter.

An Open Letter To ADA Leaders Who Care About The ADA

2007-06-04T23:45:00Z

Is this what it has come to?

Spokespeople for the American Dental Association – as this letter will demonstrate -- are now misleading their own members in an effort to justify an effort by a tiny group of ADA leaders to construct obstacles between general dentists and their ability to offer their patients oral conscious sedation.

Let’s look at two related articles the ADA News published on May 4th pertaining to this issue.

In the first, “Group opposing revisions spins surgeon general’s letter,” Dr. James Bramson, the ADA’s executive director, calls a recent news release from TEAM 1500 “one of the most shameless misreprentations of important public health information ever.”

The most shameless ever? Really?

Dr. Bramson goes on to say that the ADA researched the basis for TEAM 1500’s characterization of comments by Acting U.S. Surgeon General Kenneth P. Moritsugu and “found them to be a total distortion of the facts.”

Dr. Bramson’s remarks were not only published in the ADA News, he wrote them in a message to dental society executive directors.

Out of fairness, perhaps the ADA News should have also quoted the very first sentence of Dr. Moritsugu’s April 5th letter: “I appreciate your organization’s interest in and commitment to access for all Americans to healthcare.”

Perhaps, again out of fairness, the ADA News might have quoted the entirety of Dr. Moritsugu’s final paragraph: “Once again, I would like to convey my appreciation for TEAM 1500’s dedication to making quality healthcare available to all Americans.”

Does that sound, as Dr. Bramson put it, as “one of the most shameless mispresentaitons of important public health information ever?”

Reasonable people may read Dr. Moritsugu’s letter differently, but to characterize TEAM 1500’s interpretation as “a total distortion of the facts” is, itself, a distortion of the facts.

Is this who really represents the ADA? Do these ADA spokespeople wish to “win” at any cost, even their integrity?

I don’t want to bore you with a line-by-line rebuttal to each sentence in the ADA News articles, but suffice it to say that Dr. Bramson attributes motives to TEAM 1500 that may be reflections of his own culpability when he says our actions are, at worst, “an attempt to deliberately mislead the public.”

In the second ADA News article, titled “Proposed anesthesia guidelines ready for next step in process,” the ADA’s Karen Fox writes that “CDEL voted to approve several modifications to the proposed revisions based on some 1,500 comments received during the open-comment period – some opposed and many supportive of the revisions to the guidelines.”

I, not Ms. Fox, underlined the two words in the paragraph above.

Since my staff and I have sent the ADA more than 1,000 comments opposed to the initial Committee on Anesthesiology proposals, the truth – if the ADA News is still interested in the truth – is that “many opposed” the revisions while only “some” were supportive, not vice versa as Ms. Fox wrote.

Didn’t ADA members deserve to know that the vast number of responses the ADA received were, in fact, opposed to the changes? Why airbrush the truth?

The ADA News article goes on to quote Dr. Stephen K. Young, CDEL chair. “It’s unfortunate that a small group of opponents to the revisions has attempted to brand the revisions as coming from a ‘small but influential group of dentists.’”

But ask yourselves, honestly, if what Dr. Young is quoted as saying is true. The Committee on Anesthesiology consists of eight members. CDEL itself is 16 voting members. That adds up to 24 total dentists.

Doesn’t that factually constitute a “small group” of influential dentists? By contrast, TEAM 1500 represents more than 1,500 dentists and healthcare professionals, large numbers of whom invested the time and effort to personally write to Dr. Young to protest his Committee’s actions.

Once again, I’m compelled to ask, does Dr. Young wish to “win” at any cost, even his integrity?

I know that most ADA leaders don’t like or respect me and TEAM 1500. I don’t ask that you do either.

But please respect the fact that TEAM 1500 does represent a significant number of dedicated, hard-working dental professionals – almost all of whom are also proud ADA members.

I urge you to consider that as ADA leaders you represent all ADA members, not just those elite few appointed to high-level councils and committees.

Once you allow them to deliberately mislead your members (however noble some leaders may believe the purpose is), it becomes a slippery slope.

Are you truly willing to stain the ADA’s reputation to obtain a pyrrhic victory on this matter? Why pyrrhic? Because if the ADA House of Delegates approves these misguided proposals at the behest of Dr. Young, Dr. Bramson, and Ms. Fox, those three will be inflicting far more permanent harm on your organization
than any damage that they allege TEAM 1500 is doing.

In fact, with the benefit of 20/20 hindsight, it may well turn out that I, more so than Drs. Young and Bramson, am the ADA’s true ally when it comes to protecting your integrity. Why? Because I insist that your spokespeople retain theirs.

Sincerely,

Dean Rotbart, Director
TEAM 1500

P.O. Box 3714
Beverly Hills, CA 90212
Ph: 1-866-612-TEAM
Fax: 310-861-0763
dean@team1500.org

The Trust for Equal Access Medicine (TEAM) is a non-profit coalition of more than 1,500 independent healthcare providers who are dedicated to making quality medical and dental care available to all Americans.

TEAM 1500 seeks to overcome unnecessary and cost-prohibitive regulations and interference foisted upon the general public by self-serving bureaucrats and medical professionals who have constructed and defend economic and racial moats around quality, safe medical care.

TEAM 1500 believes that undue and burdensome regulation of healthcare professionals disproportionately impacts the poor and minorities and raises the cost of quality medical and dental care for all Americans.

ADA Is Disingenuous To Its Own Members

2007-05-10T18:12:00Z

A dentist posting on the Dentaltown Message Board credits TEAM 1500 with being “instrumental in making this an URGENT issue, which helped to jump start general dentists and the AGD to take notice and prompt action…even if one does not agree with their tactics.”

The dentist also asks what percentage of donations to TEAM 1500 go to pay for the “time and talents” of its Director, Dean Rotbart.

Here is how Rotbart responded:

In its ADA News article of May 4th, the ADA wrote:

"At its April 26-27 meeting, CDEL voted to approve several modifications to the proposed revisions based on some 1,500 comments received during the open-comment period -- some opposed and many supportive of the revisions to the guidelines."

First, note that TEAM 1500 has sent the ADA roughly 1,200 comments opposed to the revisions and have the documents to prove it. That alone should help dentists understand how disingenuous the ADA is being TO ITS OWN MEMBERSHIP when it states that "some opposed" the revisions, while "many" were supportive.

By my count those opposed had to outnumber those supporting by at least four-to-one. Probably more!

Let us say, for the sake of argument, that the ADA is correct and our news release was "a total distortion of the facts." (In case you wonder, I don't think it was that close to perfection.) Does that mean that the ADA should go forth and lie at will to its members about this issue and about TEAM 1500? I don't follow the logic.

In its ADA News article, for example, the ADA states that "many major dental organizations supported the proposed documents and offered helpful additional changes." Note, however, that the ADA names not one major dental organization that supported the proposed documents as originally proposed. Not one.

Yes, TEAM 1500 is a bull in a china shop. We were designed to be that way, because only by breaking lots of ceremonial glass can we get the entrenched powers of the ADA to do what is right for all dentists and all their patients, not just the few ADA insiders who set this absurd agenda.

As for my compensation, if I succeed in protecting the rights of ALL general dentists to offer oral conscious sedation without unnecessary interference, I will have earned every penny that the hundreds of individual donors to our cause have entrusted with TEAM 1500. I couldn’t do what I do without their unwavering support.

I Confess, The Truth About the ADA is ‘Shameless’

2007-05-09T23:33:00Z

By Dean Rotbart
Director

Okay, I’ll admit that I’m not exactly objective. But do you agree with James Bramson, Executive Director of the American Dental Association, when he describes a recent news release from TEAM 1500 as “one of the most shameless misrepresentations of important public health information ever.”

Ever?

Those frauds at Clonaid who claimed to have cloned a human being as well as all the diet drug hucksters and miracle cancer cure folks can get in line behind me. I, Dean Rotbart, director of TEAM 1500, have been officially anointed by Dr. Bramson and the ADA as the most shameless of all.

What is a credible organization such as the ADA doing disseminating such utter nonsense, not to mention vile? I have a shameless theory about this – of course -- and I think the ADA’s tactics say far more about the ADA than they do about me or TEAM 1500.

My theory is that the ADA has been caught in a self-dealing imbroglio and doesn’t like the glare of exposure.

TEAM 1500 has hammered on the ADA since early January over its nonsensical bid to overhaul existing guidelines pertaining to oral conscious sedation (OCS). OCS is a safe, effective, time-tested, patient-tested and increasingly popular form of helping anxious and fearful patients. The ADA knows all this and more.

The more is that OCS is biting into the incomes, influence and egos of some of the ADA’s chummy leaders – especially oral surgeons – and they seem willing to go to just about any lengths to stop general dentists from continuing to provide OCS to their patients.

Talk about shameless. Just how shameless is it that the ADA’s own House of Delegates endorsed OCS as “remarkably safe” in late 2005, yet less than two years later the ADA’s clubby oral surgeons and their pals proposed tripling the required training hours OCS dentists would need to serve their patients?

The ADA is trying to push through these guideline changes without a single explanation – not one – of the rationale of dramatically reworking the existing guidelines, which have served the profession and public without incident.

So Dr. Bramson and the ADA grasp at any distraction they can muster. Their investigative reporting, according to Dr. Bramson, uncovered that the TEAM 1500 news release in which we quote directly from a letter by the Acting Surgeon General praising our organization’s mission was “a total distortion of facts.” Not 99%, mind you. Our distortion was “total.”

In attacking TEAM 1500, I suspect the ADA hopes to take some of the focus off its own duplicity. Here is an organization founded to serve the whole dental profession and the public at large, but instead has warped and twisted itself into a small group of power-hungry, turf-hungry dentists who will sell out its members and their patients to maintain a comfortable status quo.

If I were an ADA delegate or member, I would wonder on what basis my leadership is bringing such disregard upon my once-highly respected organization. Rather than lowering themselves to my “shameless” status by leveling ridiculous charges, the ADA should be doing its job without bowing to self-interest.

If Dr. Bramson and his cronies at the ADA think what has emanated thus far from TEAM 1500 has been shameless, they had better brace themselves.

There is lots more shameless truth to come.

Your Friendly Minnesota Dentist and Bathroom Monitor

2007-05-09T19:31:00Z

Adult oral conscious sedation patients in Minnesota who need to use the bathroom anytime after they’ve received their initial dose of medication can now count on their dentists coming into the restroom and even individual toilet stalls with them.

Makes no difference if the dentist is male and the patient female or vice versa. Effective March 19, 2007, qualified dentists – not trained (same gender) members of their staff – must remain at all times with a patient who is still under the effects of oral conscious sedation (OCS).

The new regulation raises all order of potential bathroom embarrassments. If a dentist needs to use the bathroom once an adult patient has received sedation, the dentist by law must take the patient with him (or her).

This is no joke.

In fact, it has dentists in Minnesota facing a real quandary of how to manage patients during what are often multi-hour treatments using oral conscious sedation. Prior to the new regulations, male dentists routinely sent a trained female staff member to accompany female patients to the bathroom or felt safe leaving a trained staff member with the patient while they made their own restroom stop.

This is no longer permitted in Minnesota.

Although no official group is known to monitor how often dentists or their patients typically make a trip to the loo during an oral conscious sedation procedure, some dentists in Minnesota report that roughly one out of every two extended-treatment OCS patients do at some point request the use of the bathroom.

No dentist contacted in the state can recall any incident arising from the previous practice of same-sex, staff-accompanied bathroom visits, yet members of the Minnesota Board of Dentistry could not be dissuaded from approving what is believed to be the nation’s first “gender-neutral” regulation covering bathroom usage by dental patients.

Although the Minnesota rule seems absurd on its face, the American Dental Association has proposed similar guidelines and other states are weighing their own regulations that would force dentists to double as bathroom monitors.

The goal in Minnesota, like that of the ADA, in the opinion of TEAM 1500 is aimed less at protecting patients – none of whom are known to have been injured under the prior system -- and aimed more at making general dentists navigate an increasingly difficult regulatory obstacle course if they wish to administer OCS.

The rules specify that dentists must remain with their patients at all times once the patients receive oral sedation medication. The regulations don’t specifically include or exclude bathroom visits. The real intent, it seems, was to prevent dentists from tending to more than one patient at a time – thus imposing an economic “tax” on those dentists who practice OCS.

In Minnesota, as on the ADA’s Council on Dental Education and Licensure (CDEL), those proposing the guidelines and making the rules are predominately oral surgeons and other dental specialists who themselves won’t have to follow the new bathroom etiquette (because they typically have shorter appointments or don’t offer their patients OCS).

While one of the patient benefits of OCS is that previously fearful and anxious patients find they have little memory of their dental office visits, in Minnesota that could change. Patients aren’t likely to soon forget – nor relish -- such a grand intrusion on their personal privacy.

Some OCS dentists in the state are pessimistic that the Minnesota Board of Dentistry – dominated as it is by oral surgeons and other specialists -- will retract the new regulations now that they’ve been approved.

But members of the Dental Board and the Minnesota State Legislature which oversees it, no doubt have spouses, children and neighbors who one day may need to be seen by an OCS dentist who won’t want to be “seen” by that dentist in the bathroom. The rule is ludicrous and the Minnesota Board of Dentistry undoubtedly has not heard the last from the public on this issue.

Words Alone Won't Save Oral Conscious Sedation

2007-05-08T02:08:00Z

The American Dental Association will shortly publish the final draft of its proposed guidelines governing oral conscious sedation (OCS). From all indications, the ADA’s Council on Dental Education and Licensure (CDEL), which met to discuss the matter in late April, has approved new anesthesia guidelines that are so abhorrent they very well could result in millions of current and future dental patients facing the choice of doing without OCS or doing without dental treatment altogether.

That’s a choice no patient should have to make, given the phenomenal safety and effectiveness track record that OCS has demonstrated. More than one million adult patients have received oral conscious sedation with no known injuries or deaths.

Not long ago, we called upon all concerned dental professionals to write the ADA in protest and more than 1,000 of you and your patients did. Indeed, the ADA itself recently acknowledged the “well-organized opposition” to its proposals.

But words alone won’t stop the ADA or save oral conscious sedation.

For every dollar we have at our disposal, we estimate that the American Association of Oral & Maxillofacial Surgeons (AAOMS) and their allies are funneling seven dollars into the campaign to shut down OCS among the ranks of general dentists. Moreover, AAOMS and the ADA are putting the full force of their staffs and enormous infrastructure behind their efforts.

To remain viable, we need concerned dentists such as you to help fund our cause. Contributing to TEAM 1500 is the only way to bring the ADA and CDEL to their senses, since our letters alone have not yet convinced them of the foolishness of their proposals.

Although we are outnumbered and out-financed, we do have one powerful weapon going for us: We are on the right side of the issue.

Our efforts going forward will be threefold:

Continue to exert pressure on the ADA to relent in the face of strong opposition from members, patients and the media.

Lobby the 450-plus members of the ADA’s House of Delegates – who will vote on the final proposals in September -- to defeat CDEL’s agenda. (While CDEL is dominated by oral surgeons and other specialists, the House of Delegates is a far more representative body.)

Work closely with the dental boards in every state to discourage them from adopting the ADA proposals as regulations.

We know how hard you work and how many demands there are on your resources. That is all the more reason that you shouldn’t let the oral surgeons and others on CDEL rob you and your patients of the right to use oral conscious sedation.

Please take a moment right now to make a meaningful financial contribution to our efforts. We are asking all dentists who use OCS to contribute $1,000, $2,500 or $5,000 according to their means and the importance of OCS to their patients. (Payments can be made all at once or in three or six monthly installments.)

Pledge Form

But even if you can only contribute $250, it will help us continue the fight and demonstrate convincingly to the ADA, CDEL, AAOMS and their cronies that we will not be intimidated by their poorly disguised turf grab.

You and your patients have every right to enjoy the benefits of OCS. Don’t forfeit them by your inaction.

TEAM 1500 Pledge Form

2007-05-06T23:40:00Z

Those who wish to contribute to TEAM 1500 can fax back this PDF form. Pledge Form

Are The ADA And AGD TEAM 1500’s Secret Puppet Masters?

2007-05-06T22:58:00Z

By Dean Rotbart
Director

I had a contentious phone conversation this week with a member of the American Dental Association’s Council on Dental Education and Licensure, also known as CDEL.

It is CDEL that is recommending a major overhaul of the ADA’s existing guidelines pertaining to the practice of oral conscious sedations (OCS) – changes that we at TEAM 1500 believe are wholly unnecessary and designed primarily to protect the financial turf of oral surgeons, dental anesthesiologists and other specialists.

This CDEL member made it clear from the start that he doesn’t respect me or TEAM 1500. His contention was that we are working outside the established systems and are using questionable methods to promote our cause.

Our nearly 20-minute phone conversation followed CDEL’s meeting in Chicago late last month to consider the newly proposed guidelines that were submitted to CDEL by its Committee on Anesthesiology, also known as Committee H.

I had already discovered from another CDEL member that CDEL mostly – if not entirely – endorsed the recommendations that Committee H presented to CDEL’s 16 members. I wanted to confirm my facts and try to understand what rationale CDEL was using for proposing radical changes to the very same guidelines that the ADA’s own House of Delegates had praised in the fall of 2005 for their “remarkable safety record.”

There was more heat than light generated during our conversation.

The CDEL dentist, in particular, presented me with this false syllogism: Since most of TEAM 1500’s many donors and thousands of supporters also are members of the independent Dental Organization for Conscious Sedation (DOCS), then really it is DOCS who has been harassing CDEL, the ADA and others who are promulgating the new regulations.

What a non sequitur!

As I pointed out, those who are most opposed to the ADA’s proposed overhaul of the OCS guidelines are ALSO members of the ADA and Academy of General Dentistry (AGD). So in fact, if the CDEL member’s logic were correct, it is the ADA and AGD – not DOCS – that are actually pulling the strings of TEAM 1500.

Trying to trivialize the thousand-plus dentists who at TEAM 1500’s suggestion wrote the ADA to protest CDEL’s proposals by suggesting they are a small group of self-interested dentists is the pot calling the kettle black.

The truth is really quite simple. Those thousands of dentists who practice oral sedation dentistry, and hence are familiar with its long and admirable record of safety and efficacy – in vast numbers oppose the ADA’s new guidelines.

Those dentists who dominate both CDEL and Committee H, who can be counted in the dozens – not thousands -- do not practice OCS, have little or no personal experience with the protocols, and have rejected all overtures to attend an OCS course. These “pots” want to put a stop to the many “kettles” because they fear OCS infringes on their sacred economic turf.

During my conversation with the CDEL member only I raised – time and time again – what is in the best interest of patients. He used the opportunity only to cast accusations about me, TEAM 1500, DOCS and any other scapegoat he could conger.

For the record, TEAM 1500 is not a puppet of DOCS, the ADA, the AGD or any other organization.

We are a grassroots group of dedicated and concerned dentists and other healthcare professionals who believe that what’s in the interest of patients is of paramount importance.

The CDEL member I was speaking to didn’t buy any of my explanations. It seems that he and his fellow committee members simply don’t want to let the truth get in the way of their comfortable dismissal of all we do – and why.

TEAM 1500 Is No Gentleman -- Thankfully!

2007-05-06T11:28:00Z

If you, your staff and your patients were jumped by astreet gang one night as you left the office, who would you want fighting onyour side?

Would you prefer allies who are well versed in theMarquess of Queensberry boxing rules – i.e. “a man on one knee is considereddown and if struck is entitled to the stakes” – or would you want to pair withthe fire-breathing, acerbic rascals who kick your opponents in their privatesand only then deign to discuss the rules of engagement?

The question is not merely rhetorical.

General dentists, particularly those who faithfully servetheir fearful and anxious patients using oral conscious sedation, have beenambushed by a gang of bullies. Thisparticular gang may wear white overcoats and hang framed degrees on theirwalls, but nonetheless they are out to rob and rough up their victims asassuredly as any common hoodlums.

In this scenario, playing the role of the muggers are theAmerican Association of Oral and Maxillofacial Surgeons (AAOMS) and somewell-placed members of the American Dental Association who seek to deprivedentists and their patients of the single safest, most effective, proven methodof treating dental-phobics – oral conscious sedation (OCS).

Like real mobsters, these big shots want hard-workinggeneral dentists to pay “protection” money, ostensibly to ensure publicsafety. But those of us who saw allthree parts of The Godfather trilogy or watch The Sopranos know who are thereal beneficiaries of such “protection.”

By “protecting” the public from the “dangers” of OCS withthe superfluous, impractical and costly new proposed guidelines, what AAOMS andits friends at the ADA really crave is to protect their own influence andincomes from the growing popularity of OCS among general dentists and theirpatients.

Have no illusions, the OCS battle is over turf, notsafety.

Against this backdrop, it is worth examining the methodsbeing used by organized dentistry to combat these very real professional thugs.

With few exceptions, the nobles of general dentistry arestill rolling up their sleeves and reviewing their rulebooks months after thebattle has been engaged.

And it’s not just the ADA that AAOMS and its pals areintimidating. In various states aroundthe country, oral surgeons are putting the squeeze on dental regulators toadopt the rigid new ADA proposals, even before those proposals have beenapproved by the full ADA House of Delegates. General dentists in Maine, North Carolina, Massachusetts, California,Alabama and Minnesota already have had their rights to offer OCS severelychallenged by oral surgeons in their states.

If there ever was a time for Town Hall socials, surveys,polite and collegial dialogue, it is long since past.

National dental organizations that are supposed to beprotecting their members’ rights and the public’s health by now should bethrowing punches, kicking and yelling, much as is TEAM 1500. From the very start, TEAM 1500 has beenactively knocking heads in the scrum that is the struggle over the ADA’sproposed OCS guidelines.

To be honest, some dentists don’t like TEAM 1500’s styleof self-defense. TEAM 1500 is not beinga “gentlemen” in the tactics it is using to respond to the nicely dressed andcoiffed muggers, some critics have written.

Indeed, recently, a major national dental organizationthat purportedly represents the interests of general dentists went out of itsway NOT to offer support to TEAM 1500, but to try and impugn TEAM 1500’stactics.

Come on, folks! Get real.

TEAM 1500 is not the villain in this play.

Quiet diplomacy has been tried time and again concerningOCS and other issues impacting general dentists with the same results. The gentlemen boxers wind up knockedunconscious, bruised and robbed of their livelihoods. And their patients suffer the consequences.

Combating the deeply entrenched powers of AAMOS and theADA isn’t for wimps or dilettantes. Battles get messy when the stakes are this important.

Sure, TEAM 1500 might overshoot sometimes in itszealousness to prevail on behalf of needy patients and dedicated dentists. Get over it!

To our way of thinking, we’d rather land solid blows mostof the time – missing occasionally – than sit on the sidelines commentingself-righteously on the skills and manners of the combatants.

There is a role for in dentistry for gentlemanboxers. But if they aren’t willing toengage an unscrupulous opponent, at the very least they should stay out of theway of those of us who will fight back when attacked.

U.S. Surgeon General Lauds TEAM 1500 in its Effort To Stop the ADA

2007-04-16T22:07:00Z

Rockville, MD – Kenneth P. Moritsugu, M.D., M.P.H., the acting U.S. Surgeon General, encouraged a coalition of healthcare providers to continue in its efforts to prevent the American Dental Association and various state dental boards from adopting onerous new guidelines that would restrict the public’s access to quality, affordable dental care.

In a letter dated April 5, 2007, Dr. Moritsugu praised TEAM 1500, a non-profit coalition of 1,500-plus healthcare providers that is fighting to prevent the ADA and some state dental boards from restricting the availability of a safe and effective treatment protocol known as oral conscious sedation. TEAM is an acronym for Trust for Equal Access Medicine.

“I would like to convey my appreciation for TEAM 1500’s dedication to making quality healthcare available to call Americans,” Dr. Moritsugu wrote. He noted that his responsibilities are “to advance the health of our Nation by providing the American public with the best scientific information available for improving their health, by advocating for effective health promotion and disease prevention strategies, and by articulating scientifically based health policy analysis and advice to the Secretary of Health and Human Services and the President.”

[Read The Full Text Of Dr. Moritsugu's Letter]

Dr. Moritsugu’s letter to TEAM 1500 came in response the organization’s call for the Surgeon General to take a position on efforts by the ADA to pass new guidelines that would effectively prevent hundreds of thousands of fearful and anxious patients from continuing to receive the increasingly popular form of treatment known as oral conscious sedation, or OCS.

OCS is a safe and effective protocol for relieving the stress of dental visits through the administration of a mild oral sedative that has been on the market for decades and is in wide use by both general dentists and medical doctors. More than one million previously hesitant dental patients have relieved their anxiety thanks to family dentists who offer OCS.

In a landmark report on the nation’s oral health, Dr. David Satcher, the U.S. Surgeon General in 2000, challenged the healthcare community to embrace innovative methods to reach out to the tens of millions of Americans who lack adequate access to dental care.

One group of dentists who heeded Dr. Satcher’s call were oral conscious sedation dentists, who have had enormous success in serving the very communities most in need of improved dental care, including the poor, the elderly and members of certain racial and ethnic groups, TEAM 1500 noted.

In appealing to Dr. Moritsugu to use the weight of his office to highlight the hypocrisy of the ADA’s proposals, TEAM 1500 pointed to more than 1,000 dentists and patients who have also written letters of protest to the ADA.

“While the public at large generally believes the ADA’s function is to protect its interests, the dental association has succumbed to internal political pressures and is instead trying to reverse progress to appease a small minority of self-interested dentists,” says Dean Rotbart, director of TEAM 1500.

“Dr. Moritsugu clearly endorses and supports our commitment to access for all Americans to healthcare,” Rotbart adds. “We hope the ADA will eventually come to its senses and also do what is right by the American people.”

According to its mission statement, TEAM 1500 “believe that undue and burdensome regulation of healthcare professionals disproportionately impacts the poor and minorities and raises the cost of quality medical and dental care for all Americans.”

True Patient Safety and the ADA’s Proposed Education ‘Tax’

2007-03-14T18:31:00Z

For all the contentiousness that has surrounded the ADA’s move to revamp its guidelines for oral conscious sedation, there is one point on which almost everyone agrees: Patient safety is of paramount importance.

The conflict arises over the question of who is best equipped to decide what is best for patients and whether those determinations are colored by economic self interest.

On one side, we find general dentists and others who have years of experience offering oral conscious sedation in compliance with existing ADA guidelines and state regulations. By the thousands, these OCS dentists report that existing training and protocols have been sufficient to ensure patient safety.

Indeed, no one has yet to accurately point to a single instance of a death or serious injury that befell an adult OCS patient who was under the care of a dentist adhering to existing guidelines. That is a remarkable record, given that more than one million patients have benefited from OCS treatments since 2000.

In opposition to the dentists who regularly use OCS in their practices stand oral surgeons, dental anesthesiologists and other specialists who rely primarily on methods of anesthesia other than oral conscious sedation. Their point is that however strong the track record is for OCS to date, the risks remain too high.

Those pushing for new, stricter guidelines, such as the oral-surgeon laden ADA Committee on Anesthesiology and the ADA’s Council on Dental Education and Licensure, would like to see the training requirements for dentists offering OCS raised dramatically. Only then, they contend, will the patient population be truly safe.

Caught in the middle of this are the patients themselves, all of whom – if surveyed – would no doubt say that they want safe dentistry.

So pretty much, it seems, everyone advocates safety: General dentists, non-specialists, oral surgeons, dental anesthesiologists, specialists and patients.

What then is the issue and who gets to decide?

Once safety is no longer a debatable point, what remains is mostly economic self interest. Once again, it is not surprising to see that just about everyone agrees here too. They want, more or less, to do what’s in their own self interest.

If the general dentists and others who offer OCS are correct, and OCS is safe under existing guidelines, then what incentive is there for them to more than triple the training they’ve already received? Will it bring them more business? Decidedly not! Will it allow them to charge more to their existing patients? Unlikely.

As one dentist wrote us just this week referring to the ADA’s new proposals, “60 hours and ten [live] patients would take me out of the office for a month.”

Not much economic sense in that.

For the oral surgeons and others who are pushing to tighten the guidelines governing OCS, the economics look better.

These folks, after all, have already invested real dollars and time in advanced dental training. Why should general dentists and others be able to skim off their patients after only a three-day, reasonably priced course in oral conscious sedation?

By raising the requirements on those who do or would practice OCS, the oral surgeons and their supporters are really trying to bring more parity to the economic playing field.

If general dentists want to offer sedation to patients who previously required the services of a more highly educated dental specialist, then let the general dentists and non-specialists at least invest more time and money in their training, too! It’s not about safety, it’s about fairness.

Now the scenario unfolds in a manner more to the specialists’ liking. General dentists and non-specialists who wish to offer their patients OCS will pay an “educational tax” to do so. Describe the “tax” as a safety precaution if you must, but recognize it for what it really is.

Those dentist who can’t afford the new tax, won’t get the benefits of providing the protocol.

Oral surgeons have already paid their taxes, why shouldn’t the rest of dentistry follow suit?

In figuring out how to bridge these conflicting interests, it is important not to confuse the issue. It has little, if anything, to do with safety, since everyone agrees that patients must be safe.

So what is in the patients’ best interest when dentists squabble over dollars and cents and turf rights?

If the Committee on Anesthesiology proposals are approved by the full ADA, patients will pay more – and likely wait longer – to see an OCS dentist. Those patients who don’t have the extra money or can’t wait, will either have to make do without OCS or make do without seeing a dentist altogether.

In the end, every patient who stays away from the dentist because the cost is too high, the wait is too long, or the distance to find a qualified dentist is too far, is a patient at risk.

OCS is and will be safe no matter what the ADA does and no matter which side prevails. The true danger to patients is pricing them out of the market for dental care – which all sides should also agree, is not at all safe.

Put succinctly: It is the lack of OCS that is the most important safety issue to consider when weighing the ADA’s proposals.

-- DEAN ROTBART

TEAM 1500 Asks U.S. Surgeon General To Intercede With ADA

2007-03-09T23:55:00Z

March 9, 2007

Rear Admiral Kenneth P. Moritsugu

Office of the Surgeon General

5600 Fishers Lane

Room 18-66

Rockville, MD

Dear Dr. Moritsugu:

In May 2000, Surgeon General David Satcher issued the first-ever report on oral health and challenged the healthcare community to embrace innovative methods to reach out to the tens of millions of Americans who lack adequate access to dental care.

One group of dedicated dentists took up the call, focusing on the large segment of the adult population who avoid visiting their dentists out of fear and anxiety, resulting in the kind of serious oral disorders that Dr. Satcher warned “may undermine self-image and self-esteem, discourage normal social interaction, and lead to chronic stress and depression as well as to incurring great financial cost.”

By honing methods that had been in informal use for decades, these dentists developed a safe and effective protocol for relieving the stress of dental visits with the administration of a mild oral sedative that was and remains in wide use by the general medical community. Best of all, these dentists developed a curriculum that could teach the entirely safe use of this innovate procedure – known as oral conscious sedation – to family dentists and their staffs during a readily comprehensible three-day course.

In fulfillment of Dr. Satcher’s vision, these dentists succeeded greatly in reducing the barriers between patients and oral health services. Indeed, what began with a small group of general dentists snowballed and since 2000, well over one million patients – most of whom previously avoided seeing a dentist altogether – have been treated safely and effectively with oral conscious sedation.

Many of the dentists who administer oral conscious sedation tend to the very communities most in need of improved dental care, including the poor, the elderly and members of racial and ethnic groups. These general dentists and non-specialists typically live and work in the very communities that they serve.

One example is Dr. Matthew Winkle, who works in a public health clinic serving the Confederated Tribes of Siletz Indians in Oregon. “In this rural community, dental caries and periodontal disease are higher than the typical United States population,” Dr. Winkle notes. “Many are also dental phobic to a paralyzing degree.”

Oral conscious sedation has been a huge aide to Dr. Winkle and more than 7,000 other similarly trained dentists. Their efforts offer a blueprint for the kind of public-private partnerships envisioned in the Surgeon General’s May 2000 report.

But the work and dedication of these oral conscious sedation dentists has not been universally lauded.

As often happens, these dentists have run up against the entrenched interests of some of dentistry’s most influential actors, who are now mobilizing to rob the dentists such as Dr. Winkle and their patients of the amazingly effective protocol of oral conscious sedation.

Under the pretext of protecting the public’s health, two highly influential committees of the American Dental Association have proposed new guidelines to govern the use of oral conscious sedation. The guidelines, for which there is no scientific or even anecdotal justification, would ask all dentists who wish to provide their patients this valuable service to triple the number of hours of educational training they receive and add an unnecessary, financially burdensome and impractical clinical component.

Such a severe increase in the training requirements (as well as the associated costs) will put the attainment of accreditation in oral conscious sedation outside the reach of most general dentists, even those who’ve long administered oral conscious sedation safely and effectively.

That appears to be the very goal of those pushing this misguided ADA agenda.

In the view of a group of oral surgeons and dental anesthesiologists – who dominate the ADA committees that govern educational and practice guidelines – general dentists who offer oral conscious sedation have been too successful in reaching needy members of the public. In the effort to preserve what has historically been the province of the oral surgeons and dental anesthesiologists, these ADA committees are maneuvering to shut down the family dentists’ practical ability to offer oral conscious sedation.

More than 1,000 dentists and patients have already submitted letters of protest to the ADA, noting the long, proven safety record and effectiveness of oral conscious sedation under existing ADA guidelines and in compliance with existing state-mandated regulations. But the letters are falling on deaf ears.

While the ADA’s mission is to serve the public interest, the reality is that merit is not always the basis for its actions. Unfortunately, sometimes internal political considerations trump what’s in the public’s best interest.

(It is worth noting that in the fall of 2005, less than two years ago, the broad ruling body of the American Dental Association, known as the House of Delegates, affirmed the safety and efficacy of OCS and other forms of anesthesia and lauded their “remarkable record of safety” under existing ADA guidelines. The ADA in 2007 offers no explanation whatsoever as to why now it feels that significant new training is required.)

As the nation’s chief health educator, you and your staff by word and action have a vital influence on preserving public health and minimizing the risks of illness and injury. Moreover, you are charged specifically with elevating the quality of public health practice.

With those responsibilities and obligations in mind, I am writing to you today on behalf of the thousands of dedicated oral conscious sedation dentists and hundreds of thousands of their patients who implore you to intercede to protect the public’s access to safe and effective dental care.

Specifically, we would ask that you and your office speak out to help prevent the American public from losing a vital, effective treatment method solely because it infringes on what a small cabal of dentists view as their exclusive domain.

We believe that as powerful as these ADA committee members are, their sway with the overall membership can’t compare with a clear, unambiguous endorsement from the Surgeon General’s office in favor of the continued availability of oral conscious sedation under existing, safe and proven ADA and state-mandated guidelines.

Thank you in advance for your attention to this matter. By your prompt actions, you will literally bring a smile to faces of millions of your fellow citizens.

Sincerely,

Dean Rotbart, Director

Team 1500

Phone: 1-866-612-TEAM/Fax: 310-861-0763

The Trust for Equal Access Medicine (TEAM) is a non-profit coalition of more than 1,500 independent healthcare providers who are dedicated to making quality medical and dental care available to all Americans.

TEAM 1500 seeks to overcome unnecessary and cost-prohibitive regulations and interference foisted upon the general public by self-serving bureaucrats and medical professionals who have constructed and defend economic and racial moats around quality, safe medical care.

TEAM 1500 believes that undue and burdensome regulation of healthcare professionals disproportionately impacts the poor and minorities and raises the cost of quality medical and dental care for all Americans.

Many Dentists Who Can Use IV Sedation Still Prefer OCS

2007-03-08T23:42:00Z

Among the hundreds of dentists who have shared their letters of protest with TEAM 1500 concerning the ADA's proposed restrictions on oral conscious sedation are dozens who are qualified to offer IV sedation, but choose OCS instead.

This is noteworthy because unlike most OCS dentists, those with IV permits and relevant training, won't be required to significantly upgrade their training to comply with the ADA's proposed guidelines. Still, these dentists are taking the time and making the effort to let the ADA know just how misguided the new proposals are.

Here is one such letter that recently reached us from Daniel L. Steinke, DDS, MAGD of Dover-Foxcroft, Maine:

Dear Committee Members:

I am writing in regards to the proposed changes in the guidelines for oral conscious sedation. For 25 years, I have provided oral conscious sedation with/without nitrous oxide nearly every day of my career. I have never had a significant complication and have allowed many people access to care that probably would not have been able to have the care otherwise.

I did a residency with an anesthesilogy rotation and am qualified to do IV sedation, but have chosen not to because, in a general practice, it is safer and more efficient to use oral sedation with/without nitrous oxide. Should we be listenting to oral surgeons who do not use this technique or should we be listening to those general dentists treating millions of cases without serious complications utilizing this technique on a daily basis?

An 18-20 hour course with ACLS certification and proper monitoring is reasonable in light of the evidence. More would not be evidence based and would restrict access to care to the possible 50% of patients who are fearful of dentistry.

Physicians are prescribing Benzodiazapines by the hundreds without any controls, but you are attempting to withhold services to our patients, prescribing only one or two plus the very safe nitrous oxide which has three times the amount of oxygen as the Ambient Air. Dr. Stan Malmed reported in a course just one year ago that using Benzodiazapines plus nixtrous oxide is much more safe than using nothing at all for the high fear patient.

The proposal you are considering has no scientific merit and is based only on politics which is detrimental to the patients we serve. I strongly suggest you alter your recommendation to that of the AGD white paper on conscious sedation.

This rule is for general dentists in the trenches attempting to serve their patients in the highest quality, safest manner. Taking away oral sedation or making it unachievable to the bulk of excellent general dentists would seriously jeopardize the oral health of Americans.

If This Doesn't Make You Angry, What Will?

2007-03-08T01:47:00Z

If this information contained in this post doesn’t make you angry, I don’t know what will.

Why should you be angry?

Because a small but influential group of dentists care more about themselves and their turf than they do about the public’s health.

Because these same spiteful dentists are determined to stop you from practicing dentistry as you think best – replacing their judgments for yours.

Because your future and that of your patients is being decided right now by two ADA committees that are pledged to act in the public interest, yet have demonstrated very little interest in the public.

Because those who would undermine your practice and make a mockery of your professional dedication are mobilizing to influence your state dental board to act against you.

If a robber breaks into your home and attempts to walk out with all that you have worked for, you wouldn’t sit by passively. Well these “robbers” wear white clinic coats and often have advanced educational degrees. But make no mistake about it; their aim is also to rob you of all that you’ve worked for professionally.

Take Dr. Steven M. Sullivan, Professor and Chairman of the Department of Oral and Maxillofacial Surgery at .

I sent Dr. Sullivan an email (along with many other dentists) detailing the negative impact that the ADA’s proposed guidelines on oral conscious sedation would have on the dental profession and current and future patients.

Although my email never once mentioned the Dental Organization for Conscious Sedation (DOCS), this is verbatim what Dr. Sullivan wrote me back:

“I agree with the policy to restrict people like DOCS.”

There you have it.

This fight is not at all about protecting public health. It’s not about ensuring access to dental care for the most needy patients. It’s about Dr. Sullivan, an oral surgeon, and others like him who want to punish DOCS and its members for having the audacity to encroach upon their sacred territory.

That more than one million patients have safely and effectively been served by DOCS-trained dentists is immaterial to Dr. Sullivan and his pals. DOCS and its members must get their comeuppance – at any cost – because they had the nerve to be dental innovators.

By the way, Dr. Sullivan is a colleague at the OU College of Dentistry with Dr. Stephen K. Young. Dr. Young is both Dean of the and – importantly – chairman of the ADA’s Council on Dental Education and Licensure, also known as CDEL. It is CDEL and its Committee on Anesthesiology who are pressing for changes in the ADA’s guidelines for anesthesia.

When I got Dr. Sullivan’s email stating that he favors restricting “people like DOCS,” I wrote him back.

Dr. Sullivan: DOCS is an organization with more than 3,000 members. Do you believe they are all incompetent to provide their patients oral conscious sedation under existing ADA guidelines? How do you explain the fact that they’ve treated more than 1 million fearful and anxious adult patients without incident? On what basis would you like to restrict these dedicated dentists?

By the way, do you know or work with Dr. Stephen K. Young, chairman of CDEL? Have you discussed this subject with him?

Do you know how Dr. Sullivan replied? Professor and Chairman of the OU Department of Oral and Maxillofacial Surgery and colleague of CDEL Chairman Dr. Young, his entire response was “Yes and Yes.”

Jealously is a powerful motivator.

It is moving the American Association of Oral and Maxillofacial Surgeons (AAOMS) to conduct a well-funded, well-organized campaign to persuade state dental boards that they should adopt the ADA’s newly proposed restrictions on oral conscious sedation even before those guidelines have been formally adopted by the ADA itself.

AAOMS is so confident that Dr. Young and his CDEL council members will vote its way, that AAOMS is presenting the new guidelines to state boards as if they’ve already been adopted and telling the states they must comply with the ADA’s intent.

Perhaps, you are thinking, Dr. Young and his friends will come to their senses and understand the great benefits provided by putting oral conscious sedation into the hands of competent, well-trained general dentists and other non-specialists. Perhaps.

But thus far, Dr. Young and his council members haven’t even deigned to familiarize themselves with the very organization (DOCS) and its members who they are seeking to restrict.

Did you know that last year DOCS invited trustees of the ADA and members of CDEL and its Committee on Anesthesiology to take a free DOCS course so they could judge for themselves the quality of the education being provided by DOCS, the largest educator of OCS dentists in the world?

The ADA Board of Trustees considered the invitation and then flat out rejected it. You see, when committee members such as Dr. Young have already made up their minds, they don’t want to let the facts confuse them.

“I agree with the policy to restrict people like DOCS.” So quoth Dr. Sullivan. So quoth the majority of those on CDEL and its anesthesia committee.

What is to be done? How do we combat the small-mindedness of Dr. Young, Dr. Sullivan and their cohorts?

TEAM 1500 has already submitted more than 1,000 letters of protest to Dr. Young and the ADA from concerned dentists and their patients. (Thank you for your efforts.)

But more is needed.

We need to work with and provide information to each and every state dental board to counter the arguments already being laid before them by AAOMS.

We need to reach out to each and every ADA delegate who will have the opportunity to vote on the CDEL proposals at the organization’s annual meeting this September.

We need to contact the local media in all 50 states as well as the national news media to let them know that if Dr. Young and Dr. Sullivan get their way, the cost of dental care in their states will rise, even as the availability of quality dental care will decline.

We need to continue our efforts to inform all general dentists – whether or not they offer oral conscious sedation – that these proposals rob them of the rights conferred on them by their dental licenses.

We need to continue to work tirelessly to ensure that quality dental care is available to all segments of the population, including the poor, minorities and the elderly.

To be effective, we need your financial support and we need it today. TEAM 1500, a non-profit coalition, is funded entirely by concerned dentists such as you. Every dollar counts in our crusade against CDEL, Dr. Young, Dr. Sullivan and their powerful friends.

Attached to this post you’ll find a pledge form. Please fill it out and return it today. If you wish to pay your pledge over several months, please note it on the form. And even if you can’t donate as much as you’d like at the moment, please donate whatever you can.

We are up against powerful forces who wish to rob you and your patients of the dedicated care you provide them. We have two powerful defensive weapons. 1. We are on the right side of the issue. 2. We are backed by dedicated professionals such as you – who put their patients ahead of their egos.

“I agree with the policy to restrict people like DOCS,” says Dr. Sullivan. Please fill out the attached pledge form and let him know just how much you think of his policy.

Many thanks,

Dean Rotbart, Director

Support TEAM 1500 Now!

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2007-03-05T23:20:00Z