Articulator Vol12_Issue3_5 - Metro Denver Dental Society



Articulator Vol12_Issue3_5 - Metro Denver Dental Society
December 2007/January 2008
Volume 12, Issue 3
I N S I D E :
Dentists Who Get Results
Practice Transitions
Rocky Mountain Dental
Convention Section
The Going Rate for Health &
Hope? $11 a Month!
Foundation News: Golfing
and Giving
Calendar of Events
Special RMDC
Section Inside!
Pages 5 – 15
Brett Kessler Briefs Capitol Hill
on the Ravages of Meth Mouth
Brett Kessler, DDS, a Stapletonbased general dentist and MDDS
Board member, has extensive
experience in restoring the dental
health of recovering addicts. As a
long-time volunteer at Sobriety
House, a Denver-based residential
substance abuse treatment center
for low-income and homeless
individuals, he now provides charitable dental care to meth patients
at the staggering rate of one to two
patients per week. “I didn’t go to
dental school to become a meth
mouth expert,” Dr. Kessler said. "It
came to me. These are real people
with real lives anxious to get back
into society." Since 2001, Dr.
Kessler has successfully restored
health and function to dozens of
recovered addicts.
An unforeseen consequence of
the methamphetamine epidemic
has been the alarming rise in cases
of meth mouth. In areas where
people have regular access to the
drug, more and more dentists have
been encountering patients with
teeth that are blackened, stained,
rotting and crumbling. The condi-
tion frequently leads to full-mouth
extractions and a lifetime of
wearing dentures.
Meth is taking a unique
and horrific toll inside its
users’ mouths, so much so that
the US Senate and House of
Representatives have taken
notice with the Meth Mouth
Prevention and Community
Recovery Act (H.R. 3186 —
Larsen/Sullivan and S. 1906 —
Baucus/Coleman) and the Meth
Mouth Correctional Costs and
Reentry Support Act (H.R. 3187 —
Baird/Sullivan and S. 1907 —
Baucus/Coleman). This legislation
aims to prevent young people from
falling victim to meth abuse and
the consequent need for extensive
dental care and to ease the burden
of treatment costs on state correctional institution budgets.
Jail and prison dental costs have
risen sharply as the methamphetamine epidemic has become more
widespread. By some accounts,
more than 30 percent of prison
inmates suffer from meth mouth
Continued on page 4
About the Problem and
the People It Affects…
By Dr. Brett Kessler
When Joe showed up in my
office, I liked him instantly. He
appeared as a clean-cut kid, all
of 24-years-old, with a great
sense of humor. Joe came to me
via a desperate plea from his
mother who heard about the
work I have done on recovering
addicts on the local news.
Keeping in mind that I am no
stranger to the likes of meth
mouth through my service to
Sobriety House, what I saw when
he opened his mouth astonished
me. From the looks of the photo
below, one might think that he
had used the drug his entire life.
the progression from
healthy dentition to the
worst case of
meth mouth I
Continued on page 4
A Simple Request — “Send My Records”
3690 South Yosemite Street Suite 200
Denver, Colorado 80237
Metropolitan Denver Dental Society
By Dr. Nathan Reynolds, Dentists Professional Liability Trust
A request that every dentist reading these
words has experienced or will experience
is that of a patient asking for his or her
record. All dentists will ask the question,
“What should I send?”
It is my opinion, and that of counsel,
that the record is whatever is between the
front and the back cover of the patient’s
file folder. The information found between
the covers is usually as follows:
1. Patient general information form
including insurance
2. Medical history including updates
3. Dental history including updates
4. Periodontal charting
5. Photographs
6. Examination chart
7. Written treatment plan(s)
8. Progress notes
9. Prescription copies
10. Lab prescription copies
11. Explanation of Benefit forms (EOB)
12. X-rays
13. Drawings explaining specific treatment
14. Correspondence
15. Models (copies)
An important part of the record is the
models. However, retention is a problem
in most cases as they are often destroyed
in laboratory work or they are discarded
due to storage concerns.
EOB forms can grow faster than you
ever imagined. These are replaceable
from the dental insurance company,
so a reasonable way to manage them
would be to retain one, two or three
years, then discard the oldest year as
you add a new year.
Continued on page 3
Do you have old patient
records and x-rays piling
up from the years prior to
and including 2000?
You can get rid of clutter and
free up valuable office space
while receiving discounted
shredding services that benefit
the Metro Denver Dental
Foundation’s Smile Again
Program. We encourage you
to join us for The 2008
Spring Cleaning, After
Taxes Record Shredding
Extravaganza in May 2008.
See page 13 for details!
R eflections
MDDS Articulator
Our Children Deserve “TOPS”
When It Comes to Dental Health
By Matt Dunn, DDS, editor
The literature on
children’s oral
health has perennially agonized over
the incidence of
dental caries. More
recently, there has
been increasing
concern about the
difficulty uninsured children face in
accessing dental treatment.
In early October, President Bush
vetoed legislation (HR 976) reauthorizing the State Children’s Health
Insurance Program (SCHIP). The veto
came despite the efforts of dozens of
healthcare organizations, including the
ADA. Coincidentally, one week later, the
cover of the October 11, 2007 New York
Times announced, “Boom Times for
Dentists, Not for American’s Teeth.”
The politics and publicity can be
disheartening, at times. I would like to
turn attention toward a local Denver
dentist who has been addressing the
problem of untreated carries head on.
Dr. Major Tappan, who practices in
northeast Denver, has introduced the
Total Oral Prevention Strategies (TOPS)
program in an effort to “short-circuit”
the incidence of caries.
For those who don’t know him, Dr.
Tappan has been around for quite some
time; in fact, of his 83 years he has
practiced dentistry for 60 of them – and
is showing no signs of slowing down. He
was best described in the UCHSC’s
April 2004 edition of The Bridge
newsletter as “a slightly-built man who
speaks in a quiet, deliberate tone but it’s
hard not to recognize his inner energy
and commitment when he talks about the
challenges and opportunities for improving the oral health of children in need.”
Dr. Tappan’s idea is prevention
through the earliest possible intervention. In his TOPS program he works with
up to 300 mothers of infants born
annually in the four neighborhoods
surrounding his Dental Access Center.
Under grants from The Colorado
Trust and the Colorado Health
Foundation, his plan is to try to keep
children completely caries-free over a
five-year period. Early treatment is
planned for those few who do experience
tooth decay. It is anticipated that most of
the care will be financed through
Medicaid and CHP+.
In recent years, dental data indicate
that up to sixty percent of the poorest
children entering first grade have
already experienced dental caries, often
accompanied by dental pain. TOPS
intends to employ the combined effects
of educating parents, sound oral hygiene
practices, fluoride applications and other
measures to avoid the transmission of
dental caries-causing bacteria from
mother to child. Successful outcomes
will help children avoid dental problems
before they occur. Fewer dental problems
translates into less dental need and
demand for dental treatment, a reduction
that (for such children) impacts dental
manpower needs and access to care
Dr. Tappan says, and many pediatric
specialists agree, that school-based
programs are addressing the problem too
late. “I have seen many first graders who
already have advanced decay in permanent molar teeth!,” said Tappan. He is
TOPS intends to employ the
combined effects of educating
parents, sound oral hygiene
practices, fluoride applications
and other measures to avoid
the transmission of dental
caries-causing bacteria
from mother to child.
very well qualified to make that statement as he and Dr. Michael Raizen have
run several school-based initiatives. “We
know that school-based programs are
taking care of some problems for some
kids. But if we merely keep throwing
dental manpower at this problem,
without looking at the critical factor of
prevention, things won’t change.”
This makes sense for a number of
reasons. First of all, as the population of
children grows
there is a corresponding
increase in the
magnitude of
untreated oral
health problems.
In other words,
Dr. Major Tappan
unless there is a
corresponding miraculous increase in the
utilization of dental treatment services by
these kids, their well being will be more
compromised than before. Dr. Tappan
related the old expression, “When you
find yourself in a hole that keeps
growing, stop digging! The way of
stopping the dig is to cut off the supply
of new tooth decay. Obviously, no
program is fully capable of doing that.
However, we do hope to be able to
document the extent to which a community-based effort can have positive
impacts not only for oral health but,
potentially, in other ways of which we are
not yet fully aware.”
Over the course of the TOPS experiment, if pathology is avoided, it could
become a national model to address the
prevalence of decay in our children.
“We have sought and received important input from various members of the
dental profession, and that will remain a
priority for us. Typically, the dental
profession has had minimal concern with
dental issues in the prenatal period of
the child, and it is only recently that the
recommended time for the child’s first
visit was established at one year of age.
Except for pediatric dentists, most
dentists—I confess this includes me—
are reluctant to treat the very young
child. So, I think ALL of us can benefit
from preventing the occurrence of caries
in those individuals,” said Tappan.
I agree. An ounce of prevention is
worth a pound of cure, and more, for
good oral health.
We need to support this new project
both financially and through member
volunteerism. Clearly this is not a one
man job! Stay tuned for more information
on outcomes of this innovative strategy.
Dr. Matt Dunn
Michelle Cunningham
Dr. Matt Dunn, Chair
Dr. Gary Belanger
Dr. Michael Bellon
Dr. Paul Bottone
Dr. Douglas Carver
Dr. Mike Diorio
Dr. Erik Hekkert
Dr. Jeffery Hurst
Dr. Greg Ingalls
Dr. Erik Mathys
Dr. Deborah Michael
Dr. Kenneth Peters
Terry L. Brewick, DDS
Troy A. Fox, DDS
Vice President
Michael J. Scheidt, DDS, MS
George G. Gatseos, DDS
Charles S. Danna, DDS
Executive Director
Terri Gilpin
Zullo Design
Dilley Printing
The Articulator is published bi-monthly by the
Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of
Editorial Policy
All statements of opinion and of supposed fact
are published under the authority of the authors,
including editorials, letters and book reviews.
They are not to be accepted as the views and/or
opinions of the MDDS.
The Articulator encourages letters to the editor,
but reserves the right to edit and publish under
the discretion of the editor.
Advertising Policy
All matters pertaining to advertising should be
addressed to advertising sales manager,
Advertising Sales Department at MDDS, 3690
S. Yosemite St., Suite 200, Denver, CO 80237,
(303) 488-9700. All advertising appearing in
the Articulator must comply with official
published advertising standards of the
American Dental Association. The publication
of an advertisement is not to be construed as an
endorsement or approval by the Metropolitan
Denver Dental Society. A copy of the advertising
standards may be obtained upon request
through MDDS.
Inquiries may be addressed to:
Metropolitan Denver Dental Society
3690 S. Yosemite St., Suite 200
Denver, CO 80237-1827
Phone: (303) 488-9700
Fax: (303) 488-0177
©2007 Metropolitan Denver Dental Society
Dr. Tappan welcomes ongoing peer
guidance as well as visits to the
TOPS/Dental Access Center facility.
For more information or to get
involved, contact Dr. Tappan at
(303) 394-0231.
Braces and Baseball Come Together for a Cause
MDDS Member Orthodontist Offered Patients World Series
Ticket Opportunity to Benefit Food Bank of the Rockies
An splendid turnout was the result of Dr. Kevin Theroux’s World Series Tickets
Give-Away and Food Drive. Dr. Theroux's patients were encouraged to bring nonperishable food items as their entry fee in a water balloon toss/catch competition to
win the tickets. Nearly 100 teams gathered in his Lone Tree office parking lot for the
contest, contributing 546 pounds of canned goods in addition to cash donations of
approximately $300 to the Food Bank of the Rockies! Each dollar that was donated
translated into another 67 pounds of food. The two teams that tossed the water
balloon farthest without breaking them won a pair of tickets to Game 3 of the World
Series playoffs.
Congratulations to the winners, Josh Alston and Andrew Russell, and their fathers
(pictured left with Dr. Theroux in the center). They reported that the experience was
“out of this world.” Special thanks to Dr. Theroux for introducing young people to the
idea of philanthropy while reminding them that good oral health can be fun!
M D D S Articulator
Dentists Who Get Results
U p c o m i n g
Your team members are critical to the success of your practice, but how do
you recruit and retain your “dream team” without breaking the proverbial
Successful practice owners usually understand that high salaries alone are
not the answer. You can often keep salaries in check by addressing the issues
that are really important to team members.
While it’s true that a pay increase is a universal way to express value and
appreciation, it’s even more likely that other concerns are merely surfacing as
salary issues.
If salaries are fair, team members are actually attracted to and remain
with practices for a variety of distinctively different reasons other than
compensation. To discern how this might apply to your practice, here are five
key questions you can ask yourself:
1. Does your practice truly encourage positive and supportive interaction
with patients, other team members and yourself?
2. Do you regularly encourage your team to grow, learn and keep up with
the latest technologies and clinical developments?
3. Are you providing effective leadership and good communication?
4. Do your team members feel you have clear policies and procedures?
5. Do your team members know and share your mission and goals?
If you answered “no” to one or more of the above, corrective action is appropriate.
So what do team members say they like the least and contributes to underperformance or even turnover?
Poor communication
Insufficient training
Inadequate organization (usually scheduling chaos)
Ambiguous or inconsistent policies and procedures
A doctor or office manager breaking the rules or allowing others to do so
Underperforming team members who aren’t disciplined
There are specific steps you can take to address these issues:
1. Establish a schedule for making needed improvements and stick to it
2. Develop comprehensive policies and procedures, either by yourself or with
the help of a professional
E v e n t s
Recruit and Retain Your
Dream Team
By Janet Steward
Business of Dentistry 101
Presented by Janet and Larry Steward
In this three course series, Janet and Larry Steward will discuss the how to’s of hiring your
dream team, how to attract and retain patients, team leadership and financial and management controls with Eileen Sharkey from Sharkey, Howes & Javer. Join us the first Tuesday
of the month starting February, 2008 for the Business of Dentistry 101 course series. Your
patients and staff will thank you.
DATES: February 5, March 4 and April 1, 2008 TIME: 5:30 p.m. – 9:00 p.m.
Update on Bisphosphonate-related
Osteonecrosis of the Jaws
Presented by Kevin Patterson, DDS, MD
Join us for an evening of updates on this “hot topic” with our very own local expert. This
course will include discussion on the mechanism of disease, diagnosis, prevention and
DATE: February 21, 2008
TIME: 6:00 p.m. – 9:00 p.m.
PRICE: $99 per MDDS member
LOCATION: Cool River Cafe
Women Dentist Breakfast Forum
Presented by Cynthia Wellbrock, Esq.
Have you ever wondered how an employee could feel they were being unlawfully discriminated against or harassed? Find out what you can do about it before the situation escalates
to the EEOC or Federal Court.
DATE: January 18, 2008
TIME: 7:00 a.m. – 8:00 a.m.
PRICE: $35 per attendee
LOCATION: Rocky Mountain Dental Convention
The Scope of the Meth Problem in Colorado and its Effect
on Dentistry, Benefiting the MDDF Smile Again Program
MDDS is an ADA CERP and AGD PACE recognized provider.
( 3 0 3 ) 4 8 8 - 9 7 0 0 o r w w w. m d d s d e n t i s t . c o m
3. Create clear lines of communication (huddles and staff meetings are a
great place to start)
4. Praise your team members when appropriate and take action when one
or more team members are underperforming
5. Ensure your team understands and is committed to your mission and
6. Encourage professional development
While these workplace issues may not be important to you, they are very
important to team members, and they are much less expensive to correct
than either (a) high turnover or (b) trying to retain team members by increasing salaries above and beyond what’s fair and competitive.
Want more? Mark your calendars for the Business of Dentistry 101,
a three-course series beginning February 5, 2008. See the MDDS
Upcoming CE & Events Listing for more details.
Janet Steward is a speaker, consultant and author. Her book, What Do Dentists
Really Want? is available through or
Janet Steward, president of Quantum Leap Dental Consulting, can be reached at
(970) 207-0776.
A Simple Request — “Send My Records”
Continued from page 1
Many dentists have very extensive charts for long-time established patients. If you
get a request for records, call the person requesting and clarify what they want, specifically. The call will save time and effort of reproducing information unnecessarily while
providing what is needed.
Doctors’ notes are not part of the record! Your personal notes, feelings about
the patient, emotional thoughts that have been reduced to writing do not and should not
be released. Do not keep these in the patient’s chart, but in your desk with the
patient’s name on file. In the chart, they could be reproduced and sent away as part of
the record.
Lastly, if the request comes in the form of a release, read it carefully for exactly
what is being requested and that it is signed by the patient/proper party.
8151 SouthPark Lane Littleton 80120
Close to Highlands Ranch,
C-470 and Littleton Adventist Hospital area
Completed and ready for build-out November 2007
Pricing from $833,500 - $2,350,000
3,333 to 10,000 square feet available
Financing available
For more information contact:
Max Bumguardner (303) 799-6
December 2007/January 2008
P ractice Transitions
When a Dentist Passes Away
(Part 1of 2)
By Susan Spear
The unexpected death of a dentist is devastating.
You never think it can happen to you, but it can
and it does happen when we least expect it. The
result is often a state of chaos that can equate to
additional loss, both emotionally and financially,
for those left behind.
In most situations, a response to what is going
to happen with the business is put off because of
the shock, loss and grieving that naturally occurs.
The initial loss of the dentist is about a parent, a
spouse, a sibling and a friend. It is also the loss of
a caretaker, a boss, a leader and a mentor. When
a dentist dies without warning the loss can be
compounded by so many unthinkable events. If
we were willing to talk about it and make plans
for “just in case” maybe some of the unfortunate
outcomes could be minimized. Your death isn’t
just about you. It is also about what is going to
happen to your living business with patients and
staff once you are gone.
Without a plan in place at the onset of the
dentist’s death there is usually a period of time
somewhere between four to six weeks (often
longer) where there is no activity. The office may
close temporarily. Staff members face uncertainty
about their jobs while grieving themselves.
Patients may hear a sad message on the answering machine or find a note on the door asking
that they remain understanding while “someone”
figures out what to do. Maybe the staff goes into
the office each day trying to replicate some
normal operation by running the hygiene department to keep the practice afloat. Unfortunately
Brett Kessler Briefs Capitol
Hill on Meth Mouth
Continued from page 1
and about 40 percent of correctional dental spending goes toward
repairing or removing methamphetamine-ravaged teeth.
On October 9, 2007, at an
ADA-organized briefing on Capitol
Hill, Dr. Kessler urged congressional staffers working for members
of the Congressional Meth Caucus
to implore their bosses to cosponsor one or both meth mouth
bills currently under consideration
in Congress. So far, each bill has
20 co-sponsors in the House and
two in the Senate.
Dr. Kessler believes that the
inclusion of oral health in correctional reform will improve the
quality of life and offer an
optimistic chance for success in
rehabilitation. “To not help people
suffering from the devastating
consequences of meth mouth is
like imposing a long social and
emotional death sentence,” says
Dr. Kessler.
Join us on Friday, April 18, 2008
for Dr. Kessler’s presentation on
the effects of methamphetaminedamaged mouths. Proceeds from
this lecture will benefit the MDDF
Smile Again Program. Contact
(303) 488-9700, ext. 3271 or
visit for
M D D S Articulator
without guidance, the staff works aimlessly; not
knowing what to say, how to reassure patients
and all the while unable to comfort themselves. It
may be that a few caring dentists volunteer their
time to help the practice. But that cannot last
indefinitely. Time ticks away.
Not addressing the possibility that one can die
suddenly could be a time bomb waiting to
happen. Here are some fundamental provisions
that every dentist should have in place.
Acquire a life insurance policy that protects your
family from the loss of income that the practice
provides. If you haven’t reviewed it lately, it is
time to make sure it is adequate for where you
are financially at this time in your life.
Create a will that is updated or at least
reviewed annually and appoints someone with
Power of Attorney. Activate the Power of
Attorney now! If the estate waits to exercise the
appointment when the dentist dies, the courts
can take several weeks before they approve the
designation. Think very carefully about who this
person should be. The appointed Power of
Attorney, who handles the business, may not
always be the spouse. Remember, your spouse
is grieving at the time of your death and will
not be thinking about the business. Like your
spouse, your brother, sister, father or mother
may not be in a position to respond objectively.
They too need to grieve and their emotional
responses to business decisions may not serve
the estate’s best interests. This person should
have knowledge of your business. He or she
should know how you want the process to
unfold. Your appointee needs to understand
that the process of selling your business will be
extremely time consuming. It means he or she
will need to be able to answer telephone calls,
meet with advisors, make decisions quickly and
unilaterally, manage the staff, address the
accounts payable, know about liabilities to the
practice, assist in keeping the practice operating, etc. If you appoint someone who cannot
commit to this process, the result can be painful
for everyone involved.
Unexpected death happens and affects all of us at
sometime in our life. Look for Part II of this article
in the March/April 2008 issue of the Articulator
Magazine, where I will continue to outline what
can happen with your practice if you avoid putting
a contingency transition plan in place and how
acting responsibly can make such a difference for
your team, your patients and, of course, your
Susan A. Spear is founder and owner of SAS
Transitions, a nationally focused transition company
dedicated to providing customized practice transition consulting services for all dental professionals.
Susan has over 30 years of experience in many
aspects of dentistry, including: transitioning both
private and commercial dental practices, providing
clinical and business management support for
general and specialty practice, serving as a healthcare administrator and educator. She can be
reached at (303) 973-2147 for more information.
About the Problem and the People It Affects
Continued from page 1
have ever seen happened over the
course of about one year.
Joe tried meth for the first time
at age 16; a peer pressure situation fueled by a desire to fit in with
the popular crowd at school. One
try and he was hooked. He experienced an instant feeling of
euphoria, followed by an intense
crash. In order to combat the
crash, Joe used more and more,
often leading to illegal activities
such as minor thefts and subsequent misdemeanor arrests. His
diet included many sweets and
alcohol, and his drinks of choice
were between Mountain Dew and
Red Bull. Meth users crave sugar
and caffeine to keep the buzz
From one bad, naïve decision,
addiction took hold. Joe no longer
had a choice, he had to use.
Completely consumed by meth, he
learned how to manufacture the
drug. The process of manufacturing meth can be found easily
through web search engines such
as Google and Yahoo.
The addicted mind lowers its
values; it justifies and rationalizes
why doing more meth is the most
important reason for existence.
Joe’s fate? His teeth were utterly
destroyed by his drug use. When
Joe was arrested for intent to sell
meth at age 18, his teeth were in
this condition. He first entered
rehab, and then served his time in
prison. For the duration of his
sentence, three
years, he
received no
dental treatment.
Once he was
released and on
probation, he
found it virtually
impossible to find
a job. But, as I
mentioned, Joe is
a likable guy and
was taught the
trade of auto
mechanics in prison. He did find
work as a mechanic, but only on
the condition that he would have
no contact with the customers as
his appearance was “too hideous.”
The only thing more hideous than
his teeth was his self-esteem. He
told me that he felt better in
prison. At least there, his prison
mates understood why his teeth
looked like they did. Most people
in prison are there as a result of a
chemical dependency issue.
By the time I met Joe, there was
no hope of saving any of his teeth.
There were horrible infections in
his jaw bones that were spreading
through his system. The only
option was to remove
all of his teeth and
have dentures made.
Meth mouth renders
individuals, sometimes younger than
Joe, dentally
challenged for life.
The punishment of
the devastation of
oral health and
hopelessness often doesn’t fit
the crime.
If a meth mouth case has never
presented in your office, let me
assure you, it will. As dentists, we
play an important role in removing
the visible scars of this type of
addiction. My hope is that we can
rise to the occasion and do this
with compassion and understanding. When you meet a guy like
Joe, it is more than worth it.
Now that Joe has served his
time and addressed his addiction,
he is working to become an
addiction counselor for at-risk
youth to help others learn from
his mistakes.
F inance
How to Reduce Your Personal Liability
Using Default Investment Options
It's time for your
"Financial Check-up"
By Scott Brookes, AIF®
For practices that sponsor a 401(k) retirement plan, the dilemma of what to do for
participants who fail to manage their retirement accounts has been a liability issue for
years. Lots of employees fail to choose an investment for their 401(k) deferrals or
annual profit sharing contributions, so they are often defaulted into an investment
chosen by you (and dictated in your plan document).
Until recently, plan fiduciaries did not have protection from lawsuits unless an
employee independently chose their 401(k) investments (among other rules).
Fiduciaries (you, as employer) could potentially be held liable for losses incurred in
default investments if they were deemed “imprudent.” Opportunity cost was the buzz
word in legal circles. What would the return have been if the plan defaulted the participant into a “prudent” mix of stocks, bonds, real estate and cash? Who would be
responsible for making up these losses?
The good news is that the Pension Protection Act of 2006 (PPA) now permits you to
assist those employees who were barely involved (even completely uninvolved) with
their retirement plan investments. It permits you to automatically choose an acceptable
investment option for a participant’s account when the employee fails to provide any
investment directions, without this cloud of liability.
How so? Simple — under PPA, if a trustee establishes a “qualified default investment alternative” (QDIA), as part of their plan document, the provisions of this new tax
law will protect you on this issue.
So what is a QDIA?
The IRS and Dept. of Labor have defined a “qualified default investment alternative” as:
1. An age-based, life-cycle or targeted retirement date fund or account;
2. A risk-based, balanced fund; and/or
3. A “qualified” investment management service.
Note: Any investment option offered must be diversified so as to minimize the risk of
large losses and communicated to your staff before being selected and at least once
each year thereafter. You will notice that a “Stable Value” or money market option is
not listed as an option and will not qualify for protection.
While this is great news for most practices, we know employers need help with the
administration of their retirement plan. Taking advantage of these new opportunities
requires the skills and involvement of an experienced attorney and investment advisor
for the initial evaluation, selection, and monitoring of your plan’s QDIAs. If you have
any questions about this article, please drop us a line or call us for help.
Scott Brookes, AIF®, is Director of Retirement Plan Services at Sharkey, Howes &
Javer, Inc., a Denver based, FEE-ONLY, financial planning and investment management firm. Visit or call for more information at (303) 639-5100.
The Going Rate for Health
& Hope? $11 a Month!
The Metro Denver Dental Foundation, established in 2005 as a 501c3
organization, was created to advance awareness and education for improved
oral health and to enhance access to dental care for all populations served
by MDDS members. Donated dollars help us pay for dental laboratory fees
and materials associated with patient treatment and program administration
for the Smile Again Program.
Please consider lending your support to the Foundation. A little can go a
long way. For example, if each MDDS member dentist donated $134 over
the next year (that’s just $11.16 a month), we estimate that we could keep
the Smile Again Program in operation for the next ten years! With that kind of
support, the Foundation could expand to assist other worthy local programs.
While metro Denver communities are fortunate to have many wonderful
dental clinics and programs in service — the need far outweighs the
resources available.
All contributions are tax-deductible to the extent of the law. We will use
your contributions wisely. Contact (303) 488-9700, ext 3270 or
[email protected] for information or simply return the enclosed flyer.
We would like to express our gratitude to the following community foundations and organizations that believe in the purpose of providing oral
healthcare to abuse survivors and have recently awarded us with financial
assistance. We feel so fortunate to be the beneficiary of these grants and to
be in the company of such special organizations and people.
We provide thorough
examinations and
financial "x-rays"
We can brighten your
financial smile !
Corporate supporter of the
Colorado Dental Association
Call us at 800-557-9380
or visit our website at
MDDF News: Golfing and Giving
Local dentists and friends of the dental
community reveled in the competitive
spirit of 18 holes of golf, while
contributing $4,000 to the Metro
Denver Dental Foundation’s Smile
Again Program (formerly the Domestic
Violence Dental Care Program). Many
grateful survivors of abuse are
“smiling again” thanks to the generosity of 100 golfers participating in the
Michelle Cunningham, MDDS communi2007 MOLARS Golf Championcations director, accepts the donation
ship hosted by Dr. Scott Whitney.
on behalf of the Foundation from Dr.
The second annual tournament was
Scott Whitney and Dr. Helena Becker
held on September 14, 2007 at The
Ridge at Castle Pines North and
served as an excellent networking opportunity for a good cause.
Dr. Whitney is an endodontist who practices in the Denver metro area.
He is both an MDDS member and a Smile Again Program volunteer, but
wanted to do more than donate his time. He developed the MOLARS Golf
Championship to increase awareness of the program in addition to raising
funds. Dr. Whitney and his dental team meticulously planned all the details
and did all the hard work and provided a great experience — in the fashion
of the old granddad of tournaments itself, “The Masters.”
“Golf is my game, the Smile Again Program is my cause and dentistry is
my passion. The Molars is my personal expression of how small groups of
people can make a big impact on the lives of others through the game of
golf,” said Dr. Whitney.
The Smile Again Program offers free dental care to disadvantaged
survivors of domestic abuse in the greater metro area in an effort to restore
oral health and assist in recovery and eventual self-sufficiency. Its mission
could not be achieved without the important partnerships that are developed
with all 138 volunteer dentists who participate in the program. These partnerships fulfill a promise to our communities. Dr. Whitney, his tournament and
his spirit are the embodiment of this promise.
Call (303) 397-7668 to reserve your spot for the 2008 Molars Golf
Championship, scheduled for Friday, September 12, 2008.
Special thanks to Dr. Whitney and the following sponsoring organizations
for their commitment to the Molars Dental Golf Championship and the Smile
Again Program:
Caring for Colorado
Wells Fargo Community Assistance Fund
The Rotberg/Comens/Booth Charitable Foundation
Comphehensive Personal Financial Advisors, LLC, Paul R. Wurr & Associates, Care Credit,
Berkley Risk Management, Dentemax, Ameritas, Goetze Dental, Matsco, Utex Enterprises, and Anthem
December 2007/January 2008
Calendar of Events
December 6
February 2
Rocky Mountain Dental Study Club
I-Cat & Implant Update
Presented by: Drs. Debra Gander
& Erik Mathys
6:00 p.m. – 9:00 p.m.
Aurora Summit Steak House
Aurora, Colorado
(303) 758-9106 or
[email protected]
University of Colo. School of Dentistry
Local Anesthesia Trouble-Shooting
Presented by: Ms. Donna Stach
Aurora, Colorado
(800) 736-1911 or
December 12
University of Colo. School of Dentistry
How to Solve Unusual Diagnostic
Presented by: Dr. John McDowell
Aurora, Colorado
(800) 736-1911 or
January 5
University of Colo. School of Dentistry
What You Should Know About
Biophosphates and
Presented by: Dr. Mark Lucas
Aurora, Colorado
(800) 736-1911 or
January 17–19
Metro Denver Dental Society
Rocky Mountain Dental Convention
Colorado Convention Center
Denver, Colorado
(303) 488-9700 or
January 24
Rocky Mountain Dental Study Club
Recognizing & Treating GERD in
Our Young Patients
Presented by: Dr. Betty Barr
6:00 p.m. – 9:00 p.m.
China Beijing
Denver, Colorado
(303) 758-9106 or
[email protected]
February 5
Metro Denver Dental Society
Business of Dentistry 101: Session 1
Presented by: Janet and Larry Steward
5:30 p.m – 9:00 p.m.
Denver, Colorado
(303) 488-9700 or
February 8
Columbine Periodontal Study Group
Periodontal Regenerative Therapy:
A Mixture of Art and Science
Presented by: Dr. Michael McGuire
9:00 a.m. – 5:00 p.m.
The Inverness Hotel & Conference Center
Englewood, Colorado
Margaret DeLauro, (303) 988-0733
February 10–17
Rocky Mountain Dental Study Club
Vail Ski Meeting
Vail Cascade Resort & Spa
Vail, Colorado
(303) 758-9106 or
[email protected]
February 11
Colorado Prosthodontic Society
A Silk Purse from a Sow’s Ear:
Quality Removable Prosthodontics
Presented by: Dr. Nadar Sharifi
9:00 a.m. – 4:00 p.m.
Holiday Inn DIA Conv. & Conf. Center
Denver, Colorado
(303) 422-0094 or
February 21
Metro Denver Dental Society
Update on Bisphosphonate-associated Osteonecrosis of the Jaws
Presented by: Dr. Kevin Patterson
6:00 p.m – 9:00 p.m.
Cool River Cafe
(303) 488-9700 or
Visit for more calendar listings.
Dr. Charles Amen, 77, a retired periodontist and
endodontist passed away on September 16, 2007. Having
had a very distinguished dental career, Dr. Amen was
widely regarded as one of the most admired and
respected periodontal and endodontic surgeons in the
country. He served as MDDS president in 1978/79 and
was an MDDS Honus Maximus Award winner, the
Society’s highest honor. Donations in his honor may be made to Rocky
Mountain RYLA, PO Box 5073, Greenwood Village, CO 80155-5073.
In September 2007, Dr. John R. Sexton, a pediatric
dentist practicing in Lakewood, received the ADA
Certificate of Recognition for Volunteer Service in a
Foreign Country for his meritorious and extensive service
to the people of Romania and Uganda. The certificate,
awarded through the ADA Committee on International
Programs and Development, is a gesture of professional
appreciation and public recognition highlighting the personal effort and selfsacrifice of members who serve as volunteers in lesser developed countries to
improve the health of its people.
Dr. Damien Mulvany, an Englewood-based general
dentist, was honored as the 2007 recipient of the
1-800-DENTIST Cares Award. This award is another
of many notable dental and civic commendations
Dr. Mulvany has received for his generous service in
providing care to homeless teens through Urban Peak
Shelter and Mount St. Vincent’s Home and his
commitment to delivering care to those in need in Africa through
International Medical Relief.
Established in 1920, the American
College of Dentists (ACD) is the
oldest national honorary organization
for dentists. On September 27, 2007,
312 dentists were inducted into the
ACD as new Fellows at the organization’s annual convocation in San
Francisco, CA. Congratulations to all
Colorado section Fellows, including
Dr. Jeffrey Astroth, Dr. Terry Brewick, Dr. George Gatseos II, Dr.
Darrell Havener, Jr., Dr. Brett Kessler, Dr. Erik Mathys, Dr. John
McFarland, Dr. Jeanne Salcetti and Dr. Daniel Wilson.
On October 14, 2007, the Pierre Fauchard Academy, an international
honorary dental organization, held its installation of new Fellows at the
Columbine Country Club in Littleton. The following individuals were installed
as new Fellows for 2007— MDDS members are noted with asterisks. Front
row, left to right: Dr. Terry Brewick* (Colorado Section Chair), Dr. Melissa
Hatzidakis*, Dr. Roberta Shaklee*, Dr. Denise Kassebaum* and
Dr. Bob Murphy. Middle row, left to right: Dr. John Raabe*, Dr. Doug
Heller*, Dr. Brett Levin*, Dr. Beth Kreider*, Dr. Ellen Sachs*,
Dr. George Gatseos II*, Carole Englander and Dr. James Englander
(President). Back row, left to right: Dr. Neil Schoemaker, Dr. Jennifer
Garza*, Dr. Tom Pixley, Dr. Troy Fox*, Dr. Michael Scheidt*,
Dr. Michael Varley*, Dr. Chuck Danna*, Dr. Sheldon Newman*,
Dr. Celia Turner, Dr. Sally Preston* and Dr. Dan Wilson*. Not pictured:
Dr. Gary Pascoe*, Dr. Dr. Michael Rollert* and Dr. Brian Butler*.
To connect with more news and
information about our profession,
visit frequently!
M D D S Articulator
Submissions should be received, in
writing, no later than January 21, 2008
to appear in our next issue. MDDS
makes no claim, stated or implied, as to
the quality of goods and services or the
accuracy of the following ads.
POCKET? Remain focused on your patients
while receiving the best administrative training for your staff. Training includes: dental
terminology, productive scheduling, treatment
presentation, billing/collections procedures.
More advanced training also available. Call
Dynamic Dental Systems today at (303) 5204196 or email [email protected] to
start making more money.
Ridge: 3,200 sq. ft. (divisible to 1,000 sq.
ft.) in Ridge Village Center at the intersection of 38th & Sheridan. Fort Collins:
1,200-3,300 sq. ft. available in Cedarwood Plaza at the intersection of Taft Hill
Rd. & Elizabeth. Call Nick Perry at (303)
741-6644 (office) or (303) 359-1918 (cell).
DENTISTRY? Well-established metro
Denver area practice seeking general dentist
for associate position. Fee for service only
practice. Three years experience or GPR
required. For more information, please
contact Malcolm E. Boone II, DDS, MS, at
(303) 388-1661 or (303) 451-1111 for
details or fax CV to (303) 451-7238.
DENTIST: General dentist opportunity available with high-tech general group practice in
Boulder, Colorado. Large patient base and
no managed care. Seasoned dentist with 5plus years practice experience desired. Fax
CV to (303) 443-0073 or email to
[email protected]
Beautiful San Luis Valley! Dental Condo part
of the sale! Modern Cosmetic Restorative
Practice! This practice opportunity is all about
life style! Owner dentist nets over $210K, 4
days per week with 70 days off per year! Feefor-service, Digital X-ray, state-of-art facility.
Enjoy mountain living with hiking, fishing,
hunting, skiing and more! Town has its own
airport! High producing practice in a small
town atmosphere! Call Susan Spear @ (303)
973-2147 or [email protected]
HYGIENISTS: Great part- and full-time
career opportunities. Large multi-practice
group offering flexible work schedule and
excellent compensation/benefits package.
Call Sonja at (303) 285-6022 for more
DENTIST: Perfect Teeth is seeking senior
Dentists in Arizona, Colorado and New
Mexico with a compensation range of
$90,000 to $200,000+. Successful private or
group experience required. Benefits package.
Also seeking Associate Dentists with a
compensation range of $75,000 to $95,000.
Specialist opportunities also available for part
and full-time Ortho, Endo, Oral Surgery, Pedo
and Perio with exceptional compensation.
Call Dr. Mark Birner at (303) 691-0680,
email at [email protected] or visit
all pediatric residents! Established pediatric
dentist has exceptional opportunity for busy
practice in Eureka, California. This is an
opportunity for someone who loves children
and is looking for an enriched quality of life.
Eureka is nestled next to the Redwood Forest
and outlined by the beautiful Pacific Ocean.
The practice is located in a new facility with
all of the “bells and whistles.” Don’t miss out
on a once in a lifetime opportunity! Call
Susan at (303) 973-2147 or email
[email protected]
dental office space consisting of 1,243 sq. ft.
is available for lease. Currently partitioned,
plumbed and wired for 3 dental operatories.
The dental suite is in excellent condition and
is in a wonderful location and beautiful building in Aurora. Great visibility and easy access
near a highly residential area. Ideal location
for GP, ortho, pedo, prosth, perio or endo.
Call Dr. James Trompeter at (303) 688-3838.
operatories available to rent in an upscale
general practitioner’s office in Aurora.
FURNISHED with patient operatory chairs,
storage and X-ray machines. Exceptional
opportunity for a satellite office. Excellent
location with easy highway access in high
traffic area. Free patient parking onsite.
Please call Dr. Jonathan Rones at
(303) 743-7662 or (303) 341-6961.
Aurora, Colorado. Isn’t it time you had a
practice to call your own? Earn $130-$140K,
call you own shots, build equity with a very
low investment. Nice facility, Great Staff!
Seller will help make this happen! Call
Susan Spear @ (303) 973-2147 or
[email protected]
plains of Colorado that is netting $315,000
per year. Very flexible on price. For more
details, please contact Larry Chatterley at
(303) 795-8800 or visit
paying rent/own your own building. New
professional buildings available in Littleton
and other metro Denver locations. Call
Max Bumguardner for more information
(303) 799-6809.
OPPORTUNITIES: Have you been
looking for more than just a job? Do you
want to practice dentistry in Colorado and
someday call your practice your own? Are
you looking for a partner to share your
practice? Call Susan Spear today to learn
about how she can help you with all of your
practice transition questions. (303) 973-2147
or [email protected]
ASSOCIATE: New high tech office in new
mall development looking for an outgoing,
easy going individual for part-time associate
dentist position to grow into full-time partner
or buy-in or buy-out option. General dentist
sought, experience preferred, but will train the
right recent grad, including TMJ and ortho.
Interested parties should fax their resumes to
(303) 989-4445.
ASSOCIATE: Busy SE Denver dental
practice seeks general dentist for full- or parttime employment. Associate position with
ownership opportunities in an established
group practice of over 30 years. Complete
benefits package. Please contact Dr. John
Pfalzgraf at Cherry Hills Dental Associates at
(303) 757-8446.
Springs, Colo. Five ops., new equipment with
digital X-rays and grossing $477,000. Can
also purchase building. Call Larry Chatterley
at (303) 795-8800 or go to
Grossing $159,000, two ops with room for
another op. Call Larry Chatterley at (303)
795-8800 or go to
PRACTICE FOR SALE: Small town southern Colorado. Grossing $341,500, 51
percent overhead, busy practice, facility and
equipment look great. Call Larry Chatterley
at (303) 795-8800 or go to
Acquire the building and the practice for
$220,000. Call Larry Chatterley at (303)
795-8800 or go to
PRACTICE FOR SALE: Eastern Colorado
Grossing over $500,000 with about 50%
overhead. Priced under $100,000. Call
Larry Chatterley at (303) 795-8800 or
go to
SALE: Littleton, CO Grossing $286,000.
Call Larry Chatterley at (303) 795-8800 or
go to
like more information on how to buy, sell or
associate in a practice, please check our
website, or call CTC
Associates at (303) 795-8800.
Tree. Just north of Lincoln and Super Target.
Contact Jan Friedlander, CCIM @ (303) 8859200 or [email protected]
SPACE FOR LEASE: Join the many busy
practices in this State-Of-the-Art Professional
Office Building in Highlands Ranch. 4185 E.
Wildcat Reserve Parkway, just 1 mile south of
University Blvd. Contact Jan Friedlander,
CCIM @ (303) 885-9200 or [email protected]
dental bldg. 125 Inverness Drive East — just
off Dry Creek, east of I25 in Englewood.
Contact Jan Friedlander, CCIM @ (303) 8859200 or [email protected]
Nestled within this large professional office
campus. 11 West Dry Circle in Littleton near
S. Broadway, County Line Rd. & C470.
Contact Jan Friedlander, CCIM @ (303) 8859200 or [email protected]
Profile Building visible from I-25. 9025 N.
Grant St., east of I25 & south of North
Suburban Hosp. in Thornton. Contact
Jan Friedlander, CCIM @ (303) 885-9200
or [email protected]
end-cap space with windows on 3 sides.
Last space available in this two building
medical/dental campus. 3405 S. Yarrow St.
near NW corner of Hampden & Wadsworth
in Lakewood. Contact Jan Friedlander,
CCIM @ (303) 885-9200 or
[email protected]
LEASE: Prestigious Academy Park
Professional Bldg. 7373 W. Jefferson St.
near SE corner of Hampden & Wadsworth
in Lakewood. Contact Jan Friedlander,
CCIM @ (303) 885-9200 or
[email protected]
Lakewood, Colorado Practice producing
$400K part-time. Nice facility, dentist is well
established and has an exceptional reputation
in the Lakewood community, good patient
base and transferability. This opportunity
won’t last long! Call Susan Spear @ (303)
973-2147 or [email protected]
Why close your office for lack of vacation,
pregnancy, disability coverage? I am semiretired, quality oriented, GP DDS — willing to
cover your office on a short-term basis
anywhere in Colorado. Terms negotiable.
(970) 547-1440.
A HAPPY STAFF??? Consider making
your staff happy by freeing up storage space
and saving them from sorting through
hundreds of forceps and old boxes of
supplies that you are never, ever are going to
use. Instead, do a good deed by donating
your UNUSED equipment and supplies to
PROJECT CURE. We help set up dental clinics
all around the world. For info or pickup, call
Dr. A. at (303) 877-7804.
NEARBY STATES: Aurora, Boulder, Cherry
ORTHODONTIST: Board-certified,
Invisalign-trained Orthodontist needed
4 days/wk for multiple practices in
Denver/Boulder area. Adults and children.
75K orthodontic-patient base. New case
potential is 1K per month with referrals
from 19 general dentists. E-mail CV to
[email protected] or fax to
(303) 443-0073.
TRANSITIONS: Do you want to retire, but
need help deciding how to begin? Let Susan
Spear at SAS Transitions help you find the
answers! Call Susan today, (303) 973-2147
or [email protected]
Cheyenne, Wyo. Three operatory practice
grossing $820,000, with 45 percent
overhead. Call Larry Chatterley (303) 7958800 or go to
ASSOCIATE BUY-IN: Hotchkiss, Colo.
Very busy practice with six ops. Call Larry
Chatterley at (303) 795-8800 or go to
Creek, Colorado Springs, Crested Butte,
Denver, Eagle, Loveland, Glenwood Springs,
Grand Junction, Edwards, Lakewood,
Louisville, Pueblo, Central Mountains,
Colorado Southern, Colorado Southwest,
Mountain Resort, Steamboat, Dillon, Winter
Park, AZ, NV, SD, WY, IA, NE-Scottsbluff.
Specialties CO: 2 Oral Surgery practices; 1
Pediatric practice. See
for details or call ADS Precise Consultants:
Peter Mirabito, DDS or Jed Esposito, MBA at
(303) 759-8425.
Positions leading to Buy-in: Colorado Springs,
Denver - (Spanish speaking a must), Parker,
Oral Surgery. Nearby States: Casper, WYBrand new state of the art facility; ADS Precise
Consultants: Peter Mirabito, DDS or Jed
Esposito, MBA. (303) 759-8425
office consisting of 1,193 sq. ft. (expansion
potential) available for lease November
2007. Currently partitioned, plumbed & wired
for 3 dental operatories. Free visitor parking
on site. Call Mindy Weiner-Aaron at (303)
Under Construction and due to be completed
Nov/Dec 2007. 9695 S. Yosemite St. in Lone
60,000 sf medical office bldg. near I76 &
Bromley Lane near the new Platte Valley
Medical Center in Brighton. Contact Jan
Friedlander, CCIM @ (303) 885-9200 or
[email protected]
This is a fantastic opportunity for an experienced general dentist! This fee for service
practice is located in north Denver and is
expected to gross over $1.1M in 2007. This is
currently a single doctor practice, but the four
operative and two hygiene operatories would
accommodate two doctors. All of the latest
technology is employed including CEREC,
chairside workstations with patient viewing
monitors and digital radiography. A fantastic
lease on 3,600 square feet contributes to
keeping the overhead at less than 55%! The
selling doctor currently lives over sixty miles
from the practice and wishes to relocate
closer to home. Offered at $920,000. Call
Jasmine Rinehart with Strategic Dental
Management, Inc. at (303) 506-6362.
LEASE: Rare opportunity for specialist or GP.
1,066 sq. ft. in downtown Denver’s University
Building located on the 16th Street Mall.
Recently vacated by established endondontists. Includes 3 operatories, sterilization area,
waiting room, reception, private office and
private internal bathroom. Space is fully
plumbed and connected to centralized
compressor system. With excellent dental
neighbors, building is home to numerous
general practitioner and medical practices.
Also have 635 sq. ft., 2 operatory space
perfect for small practice or lab. For information call David at (303) 825-1887 or email
[email protected]
ASSOCIATE BUY-OUT: Grand Junction,
Colo. Grossing $680,000/yr in 2006. All fee
for service patient base with four ops. Call
Larry Chatterley at (303) 795-8800 or go to
Colo. Very modern facility with six ops. Call
Larry Chatterley at (303) 795-8800 or go to
Grossing $360,000 with three ops. Call Larry
Chatterley at (303) 795-8800 or go to
PRACTICE FOR SALE: Longmont, Colo.
Grossing over $521,000 in 2006, fee-forservice patient base. Call Larry Chatterley at
(303) 795-8800 or go to
Grossing $120,000 with two ops. Call Larry
Chatterley at (303) 795-8800 or go to
Member orthodontist, Dr. Erin Sloss, helps a little peacock with brushing technique
at the Children’s Museum of Denver’s Trick or Treat Street event on Halloween.
December 2007/January 2008
Commercial Real Estate
Brokerage and Consulting
Rose McKee
[email protected]
I have years of experience
specializing in all types
commercial real estate
transactions to the
healthcare community.
I offer the best in
today’s technology
with a personal touch!
Jennifer Nieto
[email protected]
Development Projects
Financial Analysis
1031 Exchanges
Lease Rate Analysis
Sale Price Analysis
Your office accepts credit cards and
the fees you pay can be expensive!
Our rates are great – for swiped card transactions – you pay $0
per transaction fee + $ volume x 1.74% debit card, 1.94%
Visa/MC/Discover credit cards; 2.44% Rewards/Mileage+
Fax us a recent credit card statement
to 1-866-717-7247...
and let us complete a FREE cost comparison to learn how much
you will save.The average dental office has
saved more than $800 a year!
Jan Friedlander, CCIM
Friedlander Commercial Real Estate, LLC
[email protected]
You usually keep your same equipment and conversion is
seamless without interruption to your bank deposits!
Call 303-482-2773 / Toll Free 877-739-3952
Powered by First Data Corp
Registered ISO/MSP with BankcorpSouth/Tupelo, MS
my Kirsch &
You have the clinical skills to
provide excellent dentistry….
We provide the business and leadership
skills to take your practice to the next level.
Let Amy Kirsch & Associates customize a program
to help you achieve your professional goals.
The SPA that comes toYOU
Let us come to you and give you, and those you love
and appreciate, refuge from the hectic world with the
Our therapeutic services offer the essence of
life-relaxation and rejuvenation of the mind, body and spirit...
massage, stone therapy, pedicures,
manicures, facials, reflexology
and much, much more.
Call us or visit our website at:
Creating Successful
Members of the Academy of
Dental Practice Management
Consultants and the National
Speaker’s Association
The Authentic
Leadership Series
For Dentists
Amy Kirsch &
Karla Gunner-Barringer

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