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United States Public Health Service


DENTAL NEWSLETTER


A publication of the Dental Professional Advisory Committee



Volume V, Issue 1








February 2005


In this issue of the USPHS Dental
Newsletter:


Click on the titles below to go directly to
the articles.


COVER STORY

Challenges Dental Public Health 1



REGULAR SECTIONS

Chief Dental Officer’s

Column 2


DePAC Chair’s Column 3

DePAC Vice Chair’s Column 4

Agency Updates

8

Organizational Updates 10

DePAC Work Groups 14


FEATURES

Clinical Acanthosis Nigricans 18

Senior Denta
l Spotlight 19

Junior Dental Spotlight 20

CDC Opportunities 20


DePAC Roster

21

Upcoming Events 23

Editor CDR Stephen P. Torna

Editor CDR Suzanne Saville

Consultant CDR Timothy Ricks




The
USPHS Dental Newsletter

will be
published 3
-
4 t
imes annually, and is distributed
electronically through the USPHS Dental
Bulletin Board, agency distribution lists, and the
USPHS Dental Directory.


The next issue of the newsletter will be
published in June 2005. The deadline for

submitting articles is

May 13, 2005.


If you have suggestions or comments about the
newsletter, or would like to submit an article,

please contact the co
-
editors CDR Steve Torna
Steve.torna@mail.ihs.gov

or CDR Suzanne Saville

ssaville@d11.uscg.mil












Challenges to Dental Public Health

Agency Perspective


By CDR
Steve Torna, Co
-
Editor

And

CDR
Suzanne Saville, Co
-
Editor

PART I:

AGENCY

LEADER

PERSPECTIVES:

CHALLENGES

TO

DENTAL

PUBLIC

HEALTH

AND

MEETING

THOSE

CHALLENGES


Editors Note:
This is the first in a series of articles examining the
current issues that affect the USPHS Dental
Category, how these issues
are being addressed, and the future challenges and opportunities we
face. The series begins with this issue, as the editors asked and received
feedback from the Clinical Directors from various agencies/OPDIVs


CAPT Chris Hallid
ay, Indian Health Service; CAPT Nick Makrides,
Federal Bureau of Prisons; CAPT Deborah Noyes, U.S. Coast Guard;
CAPT Carolyn Tylenda Agency for Toxic Substances and Disease
Registry; RADM Bill Maas, Centers for Disease Control & Prevention.


What are the f
uture challenges and opportunities facing our health
programs?


Halliday

-

I see one of the largest challenges as thoroughly assessing the oral
health status and needs of the public, and then planning, implementing and
evaluating dental public health progr
ams that will best meet the needs of the
populations we serve. Each of the agencies employing Dental Officers has a
unique mission, values and goals, so the overall implementation of the various
dental public health programs will vary somewhat amongst the

agencies. What
we need to do is to identify those components that are common amongst our
programs and develop mechanisms by which we can collaborate and work
together to more efficiently and effectively meet the needs of those we serve.
There is great p
otential for such collaborations and that is what I view as being
the opportunity that we need to focus on.


Tylenda

-

Some challenges that face our health programs today will continue
into the future. An example of this challenge is the fluoridation o
f water. In
spite of the proven safety and efficacy of water fluoridation, well organized,
well intentioned misinformed groups pose a constant threat to existing water
fluoridation programs as well as to the proliferation of programs in previously
non
-
flu
oridated communities. Another continuing challenge is improvement in
restorative materials
. Continued on page 5


Page
2



USPHS Dental Newsletter February 2005













Dushanka Kleinman, DDS
, M.Sc.D.


RADM USPHS


Assistant Surgeon General








The next several issues of the newsletter will explore future opportunities and challenges facing the public’s oral health an
d oral health
programs under
the leadership of the US Public Health Service and how the dental category can respond. This “exploration” will
allow us to hear from individuals at all levels and capture different perspectives of how we can best prepare for the future.

Factors
that aff
ect our day
-
to
-
day operations, such as the Commissioned Corps transformation, our readiness, funding of our programs, and
recruitment and retention of officers and dental professional among others, serve as one backdrop. Another backdrop is the
knowledge
that issues of the future will in many ways reflect those of the past: access to care for many populations will continue to
be
a challenge; disease prevention and health promotion will stay a priority goal, and workforce capacity, diversity and distrib
uti
on will
remain an essential backbone of support.


Given these factors and issues, it is gratifying to see the resources and partnerships the PHS dental category continues to g
enerate that
will serve us well as we continue to address our mission. To facili
tate partnerships with other organizations in addressing issues such
as access to care, disease prevention and related key actions of “A National Call to Action to Promote Oral Health” the PHS d
ental
category has established a web site for (
http://www.phs
-
dental.org/ncta/
) that includes a Federal Inventory of related selected PHS
projects and programs. Ultimately the vision is to have our federal inventory contribute to a comprehensive directory of pro
grams
that
foster the objectives of the Call to Action. To address our immediate workforce’s education and career development needs, t
he PHS
dental category has partnered to become an integral component of the Federal Services Dental Educators forum, where PHS

residency
and CE directors share, learn from and plan with directors of programs conducted by the Air Force, Army, Navy and Veterans
Administration. Plans are underway to further expand and maximize cross
-
service training and collaborations. Realizing
that
creative ideas do not reside only within our borders, we continue to benefit from international collaborations. The Chief De
ntal
Officer of England and members of his staff will be coming to the United States in May to present at the National Oral He
alth
Conference and the PHS Oral Health Coordinating Committee so that we can learn from one another’s experiences. Through these

and other interactions we are positioned to contribute to the Surgeon General’s emerging Global Health Call to Action.


Alan
Kay, the developer of the idea of personal computing and the laptop computer, has said “The best way to predict the future is

to
invent it.” Our “inventions” will emerge from our public health expertise and commitment. Are we taking advantage of the man
y
public health laboratories that are part of our routine work? What are we learning from our service delivery programs, our
deployments? How should we share and document these lessons learned? What do we need to do to move emerging science more
rapidly i
nto practice within our programs? How can we optimally apply our PHS assets as we continue collaborations with other
services? The future brings change where chance plays a key part and creates unknown scenarios. As active members of the US

Public Healt
h Service we are well situated within this interplay of the “knowns” and the “unknowns.” Our collective capacity to
access and apply expertise in public health sciences and practice, research, regulatory affairs, program administration, poli
cy
development

and clinical care places us in a “prepared” position. I look forward to the coming issues and dialogue as we explore
future challenges and opportunities and position ourselves to invent the future.





Page
3



USPHS Dental Newsletter February 2005








By CAPT

Gary
Pannabecker
, DDS


What is the role that DePAC plays regarding the theme of this and several upcoming newsletter issues? To meet future challeng
es and
opportunities in areas of clinical care/service, research, administration, policy
, and global issues, Commissioned Officers need to

feel secure and connected with the personnel system that supports them. In other words, to do a job well, with commitment, an

individual needs to feel like the system is committed to the individual. DePAC
provides the individual dental officer and Dental
Category as a whole with a link to the system in the following ways: Communication
-
The dental list serve and dental bulletin board,
administered by the DePAC Communications Workgroup, provide prompt, curren
t, relevant information regarding issues including
promotion, COERS, dental benchmarks, and a means to solicit input from officers regarding these issues.


1.

Resources/dental officer support
-

The Dental Category Website,
http://www.phs
-
dental.org/depac/newfile.html
,
provides a wealth of useful information for dentists; I invite you to examine it. Included is the CV format, developed
by the DePAC Recruitment/Retention/Appointment (RRA) Workgroup 200
4, with input from Agency Chief Dental
Officers, that provides an effective, consistent structure for CV’s submitted to an officer’s OPF. The CV format will
be reviewed and modified during 2005 to further improve its ease of use.

A “Survival Guide for PHS
Dentists” is currently under development by the DePAC Membership and RRA
Workgroups to assist PHS Dentists (Commissioned Corps, Civil Service, Tribal Hire) with orientation to their
respective personnel system.

The DePAC Mentoring Workgroup links Junior wi
th Senior Officers to aid in career development, advice. To
become a mentor or protégée, contact CDR Robin Scheper
RScheper@tracencapemay.uscg.mil
.

Dentists with unresolved personnel related issues ma
y contact the DePAC Chair (CAPT Gary Pannabecker
Gary.Pannabecker@mail.ihs.gov
) or Vice
-
Chair (CDR Tim Ricks
Tim.Ricks@ihs.gov
) who will assist the dentist in
d
irecting the issue to the most effective route for resolution.


2.

Recognition
-

The DePAC Awards Workgroup administers the annual Dental Category Awards. Additionally, the
Workgroup intends to place sample CC Award nomination narratives on the Dental Category

Website to assist
officers in writing awards.


3.

Special Issues
-

The Minority Issues Subcommittee (MIS) and Women’s Issues Subcommittee (WIS) provide a
means to identify concerns of minority and women dentists. The WIS survey conducted in recent years helpe
d
illustrate the need for OCCO to establish mandatory EEO training for all officers and identify online training
programs for sexual harassment. Should you have minority or women’s issues of concern, please contact the MIS
Chair (LCDR Phillip Woods
PWoods@bop.gov
) or the WIS Chair (Dr. Mary McEnery
MMcEnery@mail.ihs.gov
).


Finally, it is the role of DePAC not only to serve as a conduit of information, but also to strongly a
dvocate the concerns and issues of
PHS dentists. It is my sincere desire and commitment as DePAC Chair 2005 to meet that objective.

















“As we ring in the new year, we have the opportunity to reflect on efforts that

have helped
create a healthier and safer America, and look forward to what is to come in 2005…. In 2005
we must work to reach all Americans with science
-
based health messages, including healthy
indoor environment, correctional and community health, preven
ting child maltreatment, and
global health.”
VADM Richard H. Carmona, Surgeon General

Page
4



USPHS Dental Newsletter February 2005







By CDR
Tim
Ricks
,
DDS
, MPH



Your Dental Professional Advisory Committee (DePAC) has been off to a quick start in 2005, trying to address the issues of
importance to the Dental Category. As always, the DePAC exists to serve all PHS dentists and your input i
nto current issues is
strongly encouraged.


One of the first things you will notice with this newsletter is that I am no longer editor. After four years in the capacity

as editor, I
have turned this role over to two very capable officers, CDR Steve Torna
and CDR Suzanne Saville. I appreciate their willingness to
give up so much of their time to continue to timely inform our Dental Category about important issues. In addition to these
two
officers, LCDR Lynn Van Pelt has assumed the role of administrator
of the USPHS Dental Bulletin Board and USPHS Dental
Discussion List, our two category LISTSERVS. Currently, under the direction of our Chief Dental Officer, LCDR Van Pelt is ad
ding
all of you with government e
-
mail addresses to the Bulletin Board in the h
ope of continuing to improve category communications.
However, you may choose to unsubscribe to this listserv and not receive category communications. I appreciate CDR Torna, CDR

Saville, LCDR Van Pelt, CAPT Chris Halliday (listserv co
-
administrator), CD
R Jim Webb (Webmaster), and CDR George Bird
(webmaster) for their continued service to the category in improving communications.


Our DePAC is committed to continuing to foster a good relationship with the various organizations in dentistry, and we believ
e

that all
of us can better participate in organized dentistry by being aware of current issues. For that reason, we have begun a proce
ss by which
dental organizations


the ADA, AGD, AAPHD, APHA, COA, AMSUS, AAWD, HDA, NDA, and others


communicate with
D
ePAC on a regular basis. We are extremely grateful of all of the PHS representatives of these organizations and their tirele
ss efforts
in communicating with DePAC.


A current issue that we are working on is the revision of the category
-
specific promotion
benchmarks. Many of you have responded
to our requests for your input into the benchmarks, and we continue to solicit your recommendations for changes for Promotion

Year
2006. You may e
-
mail your recommended changes to me at
tim.ricks@ihs.gov
. To view the benchmarks, click on this link:
http://dcp.psc.gov/promo_info/promotions/Dental_Benchmarks.pdf
.


We continue to encourage your par
ticipation in the Dental Professional Advisory Committee. Elsewhere in this newsletter, you will
see the current roster of DePAC members. If you would like to volunteer for any of the workgroups or subcommittees, or if yo
u have
suggestions on issues that

concern you, please contact either the workgroup/subcommittee chairs or me.

























The USPHS Commissioned Corps Mission Statement 2005


“Protecting, promoting, and advancing the health and safety of the Nation”


“As America’s uniformed service of public health professionals, the Commissioned Corps
achieves this mission through:




Rapi
d and effective response to public health needs,



Leadership and excellence in public health practices, and



The advancement of public health science.”

Page
5



USPHS Dental Newsletter February 2005


Cover story continued from page 1


Although there have been tremendous advances in restorative materials in recent years, there is still no good cost
-
effec
tive substitute
for dental amalgam.


Makride
s

-

The most difficult challenge is finding clinicians who are willing to work in public health/correctional medicine. Too
many graduates are leaving professional school with debt that looks more like a mortg
age payment. The allure of the private sector is
too good to pass up.


Noyes

-

The biggest challenge facing the Coast Guard health services program is ensuring CG members’ readiness in support of the
Commandant’s direction of Readiness, People, and Stewa
rdship. The Coast Guard has recently undergone a transition to external
accreditation. All 32 of our dental and medical clinics undergo external review by an accreditation organization. We have a

contract
with Accreditation Association for Ambulatory He
althcare, Inc. (AAAHC). We are also looking toward implementing a more formal
peer review program. Currently, we have explored internal vs. external peer review and are leaning toward an external peer r
eview
program.


Maas

-

Shortages of dentists has bee
n a long
-
standing problem for clinical programs; however, the shortage of public health trained
dentists is a challenge with both acute and future consequences. Also, a shortage of public health trained dentists in those

organizations with which the publi
c health service partners in order to further our mission also presents a challenge.


What are the future challenges and opportunities facing the public’s oral health
?


Halliday

-

One challenge is to raise the public’s awareness of the fact that oral healt
h disparities and lack of access to care are actual
public health problems. Oral health disparities and lack of access to care are, unfortunately, a common dilemma for many of
the
populations that we serve. Public health problems have been defined as hav
ing the following 2 criteria:



There is a condition or situation that is a widespread actual or potential cause of morbidity or mortality



There is a perception on the part of the public, government, or public health authorities that the condition is a publi
c health
problem

We need to work together to help raise the awareness in the general public of the fact that oral health disparities and the l
ack of access
to dental care of all Americans are indeed factual public health problems.


Tylenda
-

A challenge th
at dentistry continues to face is the lack of patient education in preventive dentistry. Without adequate
knowledge of proper oral hygiene, even the best restorative treatment will be short
-
lived. Another major consideration is how to
motivate people to
develop and practice good preventive habits. Poor preventive care is prevalent in particular groups, some of which
are populations served by the Public Health Service. I have had the opportunity to work at Indian Health Service clinics on
temporary
duty
assignments. In general, my observation is that the quality of dental care provided is very high. I am always impressed by
the
dedication and strong work ethic of the dental officers. In spite of the excellent educational programs, there is clearly a
la
ck of
motivation on the part of many dental patients to practice good oral hygiene. In the few weeks I spend each year working in
IHS
clinics I have found it frustrating to see patient after patient with a mouthful of broken down dentition. This is clear
ly a major
challenge for IHS dentists. The ability to provide good restorative treatment, particularly among populations such as the pr
ison
population, is a major challenge. The use of amalgam is on the decline, but composite resins do not yet have the p
roperties that give
them the longevity of an amalgam restoration.


Makrides
-

From a correctional standpoint, the nation’s incarcerated population continues to grow. At the present time, there are over
2 million incarcerated individuals in the United Stat
es (to include the BOP). Many come from lower socioeconomic backgrounds.
The burden of disease is great.


Noyes
-

Access to care and cost of oral healthcare are the major challenges we face.


Maas


There is significant weakness in most state oral health

programs and their ability to describe the status of oral health in the

state, lead broadly based and effective coalitions, develop state and oral health plans, and assure delivery of effective com
munity
based preventive services to the public. Most sta
tes do not have the capacity to provide essential public health services and
community prevention interventions that have been shown to be effective are underutilized. Only 24 states have met HP objecti
ves for
community water fluoridation and only 2 states

have met HP objectives for sealants. Having a National Oral Health Surveillance
System, deemed to be feasible and including important measures of oral health is an opportunity, but the inadequate capacity
in most
states to collect this essential infor
mation is a challenge.




Page
6



USPHS Dental Newsletter February 2005


Which of these can be addressed by the dental category through our programs?


Halliday
-

Raising the awareness of the fact that oral health disparities and lack of access to dental care are public health problems i
s
the responsibi
lity of all dental staff in the United States Public Health Service. We have all witnessed the oral health disparities that
our populations experience and it is incumbent upon all of us to share these facts with other health care providers and the g
eneral

public. Dental Public Health is concern for, and activity directed toward, the improvement and protection of the oral health

of the
entire population.


Tylenda
-

All of the programs can address issues of concern in dentistry. Dentists in IHS and BOP cli
nical billets, for example, are in
a prime position to directly influence patient care through implementation of dental education programs. NIH, with its highl
y trained
research scientists and clinicians, has the capability to develop initiatives that cou
ld lead to improved patient care.


Makrides
-

I believe that the category should help more dental officers pursue training and careers in Dental Public Health.
Furthermore, we need to encourage

these officers to stay within their respective clinical agenc
ies to assist with policy development
and implementation. Good planning goes a long way.


Noyes

-

We provide comprehensive dental care to our active duty members in our 32 dental clinics and also authorize and fund private
sector care for those members rem
otely stationed. We offer a Tricare Dental Plan for active duty family members as well as reserve
members.


Maas


We can apply public health principles to all of our programs, follow evidence
-
based guidance when available, and we can
demonstrate that prog
rams following public health principles have better outcomes.


What role does your agency play in addressing these challenges?


Halliday
-

Since the mid
-
1950’s, the Indian Health Service dental program has maintained a system for monitoring oral health and

estimating the treatment needs of the American Indian and Alaska Native patients. The monitoring system has provided communi
ty
leaders and program planners with a wide range of information on the oral health status of the American Indian and Alaska Nat
iv
e
population. The oral health disparities of the American Indian and Alaska Native people are profound when compared to the ge
neral
United States population. Studies have shown that fewer American Indian and Alaska Native children have experienced tooth
decay
and a greater percentage of older adults have lost all of their teeth. Additionally, American Indian and Alaska Native peopl
e have
more severe periodontal disease partially due to the high prevalence of diabetes. American Indians and Alaska Natives

suffer levels of
oral disease that are in many instances much greater than the general United States population. Studies have shown that fewe
r
American Indian and Alaska Native children have experienced tooth decay and a greater percentage of older adult
s have lost all of
their teeth. Additionally, American Indian and Alaska Native people have more severe periodontal disease partially due to th
e high
prevalence of diabetes. American Indians and Alaska Natives suffer levels of oral disease that are in ma
ny instances much greater
than the general United States population. The Indian Health Service is the primary health care advocate and health care pro
vider to
the American Indian and Alaska Native people. Our mission is to raise the health status of the
populations we serve to the highest
possible level, ensure personal and public health services to Indian people, uphold the Federal government’s obligations to I
ndian
people, and to honor and protect the inherent sovereign rights of tribes.


Tylenda
-

A
TSDR addresses health issues related to exposure to toxic substances. Although the agency does not have oral programs
per se, exposure to hazardous chemicals can results in oral problems. The Division of Toxicology develops toxicological prof
iles of
haz
ardous substances, in which potential adverse effects from exposure are reviewed with regard to organ system. Toxicological
profiles, including those on fluoride and mercury can be found on ATSDR’s website,
www.ats
dr.cdc.gov
. The agency maintains a 24
-
hour toxicology information phone line (888
-
42ATSDR). Many calls relate to substances found in materials used in dental practices,
such as fluoride and mercury. Callers are provided with answers to their questions,

and, if appropriate, are referred to other sources
for further information.


Makrides
-

The BOP leadership has asked the Chief Professional Officers (BOP) to devise staffing patterns that will equitably
distribute resources and personnel. These standardi
ze plans will redistribute FTEs (Civil Service and PHS) to institutions that are in
need.


Maas


The CDC addresses these issues through:



Development of state infrastructure and capacity.



Dental public health residency.



Guidance and data dissemination for
National Oral Health Surveillance System.



State based system of water fluoridation surveillance.



Strengthening the evidence base to promote community water fluoridation.

Page
7



USPHS Dental Newsletter February 2005




Convening a National Oral Health Conference where PHS dentists can share scientific fi
ndings and experiences with our
non
-
federal partners.


What major hurdles
-

staffing etc.
-

affect these challenges?


Halliday
-

Recruitment and retention of staff members remains to be a paramount hurdle for most health care programs, including the
Indian

Health Service Division of Oral Health. The ability to offer competitive personal, professional and financial incentives to
health care providers is a constant challenge in the increasingly competitive career market of today.


Tylenda
-

Staffing is a ma
jor issue. At the present time, ATSDR hiring is virtually frozen, and, due to budget cutbacks, the situation is
unlikely to improve in the near future. When an employee retires or moves elsewhere, the FTE may not be filled. If permissi
on is
given to ann
ounce the position, hiring is limited to Agency employees, i.e., transfers from other offices/divisions within the Agency.
Not only is it important to have a critical mass in terms of numbers for a group to function effectively, but it’s also impor
tant to

bring
in new people who bring with them fresh ideas and creative thinking. Without the influx of new people the work environment c
an
become stagnant. Of course, dwindling budgets affect more than just staffing. Major program cuts and lack of support fo
r new
program lead to a less effective operation.


Makrides
-

The Dental Category is shrinking.

The BOP has relied heavily on the Corps to fill dental vacancies. However the current
recruitment trends are alarming. Even with a Civil Service work cadre t
he BOP is still experiencing vacancies.


Noyes

-

The biggest hurdle is keeping our dental clinics staffed and minimizing gapped billets. Since the reorganization of OCCO and

OCCFM, the current hiring process has been handicapped.


Maas


Resources will al
ways be inadequate in addressing public health needs. We need a vision and commitment to life long
learning and pledge of mutual support to professional development while holding members to high expectations.


What do you see as some of the major challeng
es to the Dental Category?


Halliday
-

The ability to not only recruit health care providers into entry
-
level positions, but also retain those providers who have
invested so much of their personal interest, energies and beliefs into our public health progr
ams. It is absolutely imperative that we
offer our colleagues a personal and work environment that satisfies as many of their needs as possible. Much time and effort

is
expended in recruiting our well
-
trained oral health care providers and we need to con
stantly challenge ourselves to not only improve

the oral health status of the populations we serve, but to do so in a manner which allows personal and professional rewards t
o our oral
health care providers.


Tylenda
-

The major issues are recruitment and r
etention. While improvements in pay and particularly bonus pay are a positive note,
the new rule on promotions whereby an officer may be frozen in grade after three unsuccessful attempts, creates a major moral
e
problem. Promotion potential is a major mot
ivating factor in performance. It is likely that good officers may leave the Corps years
earlier than they had planned due to the lack of promotion opportunity. Another issue is support for training. I have talke
d to dental
officers in clinical billets
who get little support from their respective agencies for continuing education. The lack of support is not just
a moral issue, but is also a practice issue. We, as dentists, need to know about the most recent advances in our profession.

We need to
have
the opportunity to engage in dynamic exchange on topics of concern to dental practice by attending seminars, conferences and
continuing education courses.



Makrides
-

R & R . . . Recruitment and Retention. The private sector offers salaries that make it

difficult to compete. Graduating
dentists are going private and 20 yr Corps Officers opt for an early out for the chance at a second career.


Noyes

-

The inability to hire experienced DoD dental officers that are seeking employment with the PHS.


Maa
s


Many public health trained PHS dental officers are retirement eligible and will be leaving the Corps. Most public health
trained dental officers are senior and may not be competitive for reassignment to other programs based on a belief that exper
ience

in
the larger organization in which the program is located is more important than the public health knowledge held by the office
r. Having
individuals gain broad experience and allowing programs to prosper from broadly experienced officers is hindered by a

promotion
process that penalizes officers new to positions and agencies, since success in promotion requires supervisor evaluation of
“perfection” and agency recommendation over most other officers within that agency.


Editor’s note


the following is the

schedule for this series:

May/June



interviews with representatives from the NIH, NIDCR, and HRSA, as well as with flag officers in the Category (Part II)

Sept/Oct



interview with the Chief Dental Officer of the USPHS and representatives of OCCO and OCC
FM (Part III)

Nov/Dec



interview with the Surgeon General of the U.S. (Part IV)

Page
8



USPHS Dental Newsletter February 2005












By CAPT
Monina Klevens, DDS, MPH



CDC is emphasizing the need for expanding the focus on
adult oral health.

Over the past se
veral decades the
percentage of older adults who have retained their natural
teeth has increased steadily. In 26 (52%) states more than half
of adults aged 65 years and older reported having most (i.e.,
losing five or fewer) of their natural teeth. This t
rend of
increasing retention of natural teeth is expected to continue
and to result in improved oral function and quality of life.
Although this is a positive development, increased tooth
retention also brings challenges. Older adults have
more
untreated

tooth decay than any other age group
, at levels that
affect nearly one in three dentate adults. In addition, CDC
estimates older adults experience 1.3 new decayed surfaces
annually, a value that is about
30% higher than estimates of
new caries among chil
dren

obtained from a systematic review.
Reasons for increased risk include gingival (gum) recession
that exposes “softer” root surfaces and use of medications that
produce xerostomia (dry mouth).


Most disease prevention and health promotion activities

are
targeted at children. Although available information indicates
that fluoride delivered through community drinking water,
toothpaste, mouth rinses, or topical application is effective in
preventing decay among older adults, there is a need to
strength
en the evidence supporting the effectiveness of these
and other preventive interventions at the self
-
care, clinical,
and community levels. There is also a need to improve oral
health
-
related knowledge, attitudes, and behaviors of adults
aged 65 and older.

A recent national survey revealed that only
about 41% of older white adults and 34% of older non
-
white
adults knew that use of fluorides would help keep their teeth
healthy. In contrast, about 80% of older adults responded that
use of fluorides would hel
p keep the teeth of young children
healthy.


Dental public health programs are encouraged to: 1) heighten
awareness among dental professionals, professionals from
other health disciplines, and the general public to the
significant oral health problems face
d by older adults; 2)
utilize disease prevention interventions, especially those
involving the use of fluorides, 3) advance healthy lifestyles and
behaviors (as possible), including drinking fluoridated water,
brushing twice daily with a fluoride toothpast
e, eating a proper
diet, and obtaining regular dental care, and 4) seek ways to
expand partnerships to address the health needs of older
adults. Promotion of older adult oral health and utilization of
established prevention interventions may reduce the bu
rden of
oral disease for this population.

















































“Administrators and clinicians of the IHS and tribal dental programs have a responsibility to increase access to
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Consu汴lnt

Page
9



USPHS Dental Newsletter February 2005







By CAPT
Chris
Halliday
, DDS, MPH


The Indian Health Service Division of Oral Health has been
working on sev
eral Information
-
Technology related projects
over the past year. The goal of these projects has been to
improve the availability of information transfer amongst staff
member and to potential applicants. One such project has
been the updating and improvem
ent of our recruitment
website (
www.dentist.ihs.gov
) which offers the potential
contact/applicant to not only find general information about
the Indian Health Service, but also offers the individual the
opportuni
ty to submit information online; such information is
then stored in a database and is made available, via a secure
site, to our national and regional dental recruiters. For the first
time ever, the Indian Health Service Continuing Dental
Education Program

has placed our CDE course catalog online:
(
http://www.ihs.gov/MedicalPrograms/DentalCDE/index.cfm
)
The CDE site will allows the opportunity to peruse the
complete listing of continuing

dental education courses that
are offered to IHS Division of Oral Health staff. These
courses are also available for non
-
IHS employees, but only on
a space
-
available basis.


The Indian Health Service Division of Oral Health staff
directory is now avail
able online
(
http://www.ihs.gov/medicalprograms/dentaldir/
) and offers
the capability for those with administrative access to the
directory database to update staff listings at each Indian Heal
th
Service
-
direct, Tribally
-
managed and Urban
-
managed dental
clinic. In the creation process is an Oral Health
Promotion/Disease Prevention website. Once completed, this
website will serve as a repository for OHP/DP
-
related
materials and allow for the sh
aring of information pertaining
to different IHS OHP/DP
-
related projects and programs. Last,
but certainly not least, the IHS continues to pursue to
procurement of a commercial dental software package to
interface with the IHS RPMS legacy software package
. Pilot
testing of commercial software packages has been completed
and soon a choice will be made as to which commercial
software package the IHS Division of Oral Health would like
to recommend for procurement. This has been a labor
-
intensive project inv
olving many administrative and clinical
staff members in the IHS and input has been garnered from
literally all involved in the steps taken to date, to evaluate and
rank order our recommendation for the software package that
we hope to offer to all IHS den
tal programs.


Bringing the IHS Division of Oral Health to the forefront of
information
-
technology related matters has been a top priority
of the Division of Oral Health. With the ultimate goal of
offering better and more complete communication to our
cur
rent staff and prospective
-
hires as well as improving the
documentation of patient oral health status, the Indian Health
Service Division of Oral Health has been busy dealing
pursuing the use of these various electronic mediums. While
vacancy rates of ora
l health providers and oral health
disparities experienced by the American Indian and Alaska
Native people are paramount concerns for the Indian Health
Service, we are confident that the pursuit of these information
-
technology related projects will help us

to better the services
provided to the American Indian and Alaska Native people,
our current staff and our prospective hires. These projects
should help us to ultimately improve the oral health status of
people served by the Indian Health Service.








By CAPT
Nick
Mackrides
, DDS, MA, MPH



2005 will bring many new changes to the Bureau of Prisons
(BOP) Dental Program. The most significant of which is the
new Dental Program Statement. For those BOP dentists
rea
ding this for the first time your eyes are not deceiving you.
The BOP Dental Program Statement (policy)
has finally

been
approved and released.



BOP dentists can now access the new policy via the intranet
on Sallyport. Dentists needing assistance in ac
cessing the
policy should contact their respective Regional Dentists. All
Bureau dentists are expected to make modifications to their
existing local policies to reflect the new Program Statement.



Perhaps the most anticipated and discussed change for 20
05 is
the new staffing guidelines for the Health Services Division.
Many dentists have expressed concern regarding the proposed
dentist to inmate ratios. These concerns have been heard and
appropriate changes are being made to correct the ratios.
While

change is often difficult, this next proposed change
should be well received by most BOP dentists. Recent
meetings between the Health Services Division (HSD) and the
Program Review Division (PRD) have resulted in a
streamlined Program Review process. Fo
r those dentists not
assigned to the BOP, Program Review is an agency audit that
examines the compliance laws, rules, regulations, and policy.
BOP dental managers can expect an abbreviated Program
Review. Only policy compliance (ACA) will be reviewed by
the Program Review team. Issues relating to clinical care will
be addressed by the Peer Review process.











Page
10



USPHS Dental Newsletter February 2005







By CAPT
Deborah Noyes, DMD., MS


The Coast Guard Dental Program continues to support the

Commandant’s directives of Readiness, People, and
Stewardship. Medical readiness continues to be at the
forefront of ensuring that our CG members are ready for
worldwide deployment. All Coast Guard dental clinics in and
outside the Continental United St
ates have been tasked to
increase their normal operation tempo in order to fulfill these
requirements to get additional Coast Guard personnel to the
field fast and fit. At the same time, all of our clinics are
undergoing a transition to external accredita
tion review while
assimilating ongoing new initiatives related to medical and
dental readiness, electronic patient records, and quality
improvement processes. This past year, the Coast Guard has
implemented a more stringent Weight/Physical Fitness
Standar
ds Program. In addition to other Coast Guard
readiness standards and requirements, this program also
requires a Personal Fitness Plan.


The recent move in the Navy to merge their Medical and
Dental Commands into one Medical Command has caused a
reduction
in the number of dental officer billets, consequently
spurring a high volume of inquiries from Navy dental officers
for possible job opportunities in the Coast Guard dental
program. We came out of last assignment season (November)
with seven dental officer

vacancies and we will still have two
vacant O
-
5 billets this summer in clinics at Sitka, AK and
Juneau, AK.







By CAPT
Mark
Nehring
, DMD, MPH



Children's Dental Health Month Resource


The National Maternal an
d Child Oral Health Resource Center
(OHRC) in collaboration with the MCH Library at
Georgetown University released a new edition of its
knowledge path about oral health and children and
adolescents. Presented in time for Children's Dental Health
Month in
February, the electronic resource guide offers a
selection of current, high
-
quality resources that analyze data,
describe effective programs, and report on policy and research
aimed at improving access to and the quality of oral health for
children and ado
lescents. The knowledge path is aimed at
health professionals, program administrators, educators,
policymakers, and others who are interested in obtaining
timely information. It is available at
http://www.mchoralhealth.org/knwpathoralhealth.html
.
Knowledge paths on other maternal and child health topics are
available. [See
http://mchlibrary.info/KnowledgePaths/index.html

]. Your
comments and help in disseminating this information to the
MCH community is welcomed.


Bright Futures Pocket Guide


The OHRC recently produced the Bright Futures in Practice:
Oral Health

Pocket Guide offering health professionals an
overview of preventive
oral health supervision for five
developmental periods

pregnancy and postpartum, infancy,
early childhood, middle childhood, and adolescence. The
pocket guide is designed to be a useful tool for a wide array of
health professionals including dentists, den
tal hygienists,
physicians, physician assistants, nurses, dietitians, and others
to address the oral health needs of infants, children, and
adolescents.


Bright Futures Oral Health Toolbox


To offer health professionals and families online access to
materi
als focusing on oral health supervision, OHRC has also
developed the Bright Futures Oral Health Toolbox located on
the OHRC Web site at
http://www.mchoralhealth.org/Toolbox/index.html
. The
toolb
ox consists of descriptions of and links to Bright Futures
in Practice: Oral Health

Pocket Guide and other materials
that complement the Bright Futures philosophy of promoting
and improving the health and well
-
being of infants, children,
and adolescents wi
thin the context of family.












By CDR
Doug Shepherd, DDS



It is time in this new year to begin thinking about what
Continuing Education courses you are going to attend. What
better

way than attending the annual Academy of General
Dentistry meeting. The meeting this year is slated for July 13
-
17 in Washington, DC. The host hotel is the Marriott
Wardman Park Hotel and Convention Center, which is located
in a prestigious Washington n
eighborhood; just minutes from
the White House, National Zoo and the National Cathedral. It
is also only eight miles from Reagan National Airp
ort and just
steps to on
-
site Metro stop.

Don’t miss out on another great
meeting with improvements by the AGD o
n hard
-
to
-
find
hands
-
on courses, shorter courses, free lectures, and better
variety. Some of the other things planned include:


Page
11



USPHS Dental Newsletter February 2005




1) An interdisciplinary team panel discussion, followed by
corresponding participation courses on topics ranging from
crown l
engthening, temporization, and TMD/orofacial pain.

2) A two
-
day participation course developed in conjunction
with the Academy of Laser Dentistry.

3) The Pankey Institute returns to offer a three
-
day intensive
CE experience.

4) A two
-
d
ay perio flap surgery course, by Don Rolfs, DDS,
offered for the last time. If you haven’t taken it, don’t miss it!

You can check out available courses and other important
information on this upcoming meeting at
www.agd.or
g.



In 2005, the AGD will introduce a new All
-
Member/Attendee
event on Saturday evening of the AGD Annual Session; in the
past it has traditional been broken down into individual
constituent meetings. The AGD has contracted for a
performance at the Ma
rriott by "The Capitol Steps", a satirical,
political entertainment group, followed by a separate ticketed
event called "Monuments by Moonlight", an evening
Washington, D.C. monument tour. Costs for the All
-
Member/Attendee event will be built into the reg
istration fee.
The AGD Gala will now move to Friday evening.






By CAPT
Paul
Wood
, DDS



The last annual session of the ADA meeting was held in
Orlando, Florida. Current issues discussed at the Delegate’s
meetings were:



Portability of dental licenses in the U.S. License by
credentials will help tribal programs and urban clinics
in underserved areas.



Fluoride varnish has become a large part of the
prevention efforts in the IHS as an adjunct to the
school b
ased sealant program.



The Commission on Accreditation is continuing to
look at programs that provide advanced education in
areas of general dentistry to determine their eligibility
to be accredited. This issue will most likely be solved
over the next few y
ears.



The IHS has tested an electronic dental record and
will be beta testing it in clinics in 2005. The IHS will
have some clinics with digital radiography in the near
future.

There are currently 256 PHS Commissioned Officers who are
ADA members.


ADA Ann
ual Session
-

October 6
-
9, 2005, Philadelphia,
Pennsylvania. For more information on this meeting go to:
http://www.ada.org/prof/events/session/2005_general.asp
.


Other issues of inte
rest include ergonomics, access to care
especially for children and elderly, and Multi
-
Year Retention
bonuses have increased to meet the DoD rates.


Please note: The PHS reports to the ADA councils will be
made available on our bulletin board.





By CDR
Dan

Hickey
, DDS


PHILADELPHIA

BOUND!


The Commissioned Officers Association 2005 Public Health
Professional Conference will convene June 6


9, 2005 at the
Wyndham Fra
nklin Plaza in historic Philadelphia,
Pennsylvania, birthplace of the United States Public Health
Service. The Dental Category 2005 COA Planning Committee
invites you to join us for four days of thought
-
provoking and
informative educational sessions with r
enowned national and
international speakers discussing emerging trends and
important issues in public health care.


As in past conferences, there will be both pre
-

and post
-
agenda
events, a full day of profession
-
related topics, general and
tracked session
s, the Luther Terry lecture, plenty of exhibitors,
the formal banquet, ample time for socializing, and more!
There will be Basic Officer Training Courses available both
before the Conference (June 3


5) and after (June 10
-
12).
The Surgeon General’s 5K Ru
n/Walk will be conducted in
Fairmont Park on Wednesday, June 8
th

at 7:00 PM (tentative).
In conjunction with the Run/Walk, the OFRD Annual Physical
Fitness Test will be offered to all officers.


For the first time ever, VADM Richard Carmona will host a
pre
-
conference “Global Health Summit” on Sunday, June 5
th
.
An array of distinguished international public health experts
will be present to witness the unveiling of the Surgeon
General’s Call to Action on Global Health


a preface to his
upcoming “Report on
Global Health.” All PHS officers are
encouraged to attend this discussion of the collaborative
actions needed by national and international stakeholders to
advance the health of the citizens of the world community.


In a departure form the usual format, th
e Oral Contributed
papers will be presented the day before the Category
-
specific
day. Dental papers will be featured on Monday, June 6
th
, and
the Dental Category day will transpire on Tuesday, June 7
th
.
Category day will begin with an address by the Chief

Dental
Officer, RADM Dushanka Kleinman. A USPHS Force
Readiness panel will highlight senior and junior officers’
experiences in recent deployments, discuss the status of the
Office of Force Readiness and Deployment in light of the
transformation of the Co
rps, and include the dental
educational perspective in this era of homeland security.
Another panel will discuss the Surgeon General’s Call to
Page
12



USPHS Dental Newsletter February 2005


Action for Oral Health, and elaborate on each of the five
“Actions” in the report. CAPT Kevin Hardwick of NIH wil
l
present an overview of international dental health, and our
David Satcher Keynote Speaker will be Dr. Marjorie Jeffcoat,
Dean of the University of Pennsylvania School of Dental
Medicine. The day will conclude with a Dental Town Hall
Meeting, whereby offi
cers will engage in a question
-
and
-
answer session with the Dental Category leadership.


The Category Day Luncheon will be highlighted by
presentation of the Robertson, Buell, and Senior Clinician
Awards. Distinguished guests attending include ADA
Presiden
t Dr. Richard Haught, AGD President Dr. Thomas
Howley, ADA District Trustees Dr. Ronald Gross (Third
District) and Dr. Bernard McDermott (Fourth District), and
PDA President Dr. Dr. Craig Eisenhart. Plans are also
underway for a social event that evening!


In the City of Brotherly Love, be prepared to put on your
walking shoes and explore the colonial landmarks that include
Independence Hall, The Liberty Bell (housed in a brand
-
new
glass pavilion), the Betsy Ross House, and more. Check out
Rittenhouse Squar
e, the Old City, Chinatown, Chestnut Hill,
South Street, and University City. Philadelphia is home to a
huge variety of museums: the Philadelphia Museum of Art,
the Franklin Institute Science Museum, the African
-
American
Museum in Philadelphia, the Nationa
l Museum of American
Jewish History, the Mutter Museum at the College of
Physicians of Philadelphia, the Rodin Museum, and many
more. Hungry? The Philadelphia area is a veritable United
Nations of dining. Or go to South Philly for a cheese steak at
Pat’s,
Geno’s, Rick’s, or Jim’s (when they ask “with or
without?” they are referring to the onions). The nightlife
includes world
-
class theatre, concerts, Broadway revues; head
down to the outdoor clubs at the waterfront for live music and
DJs spinning tunes.


So
… come to the premier public health conference in the
Nation, and visit the celebrated city of Philadelphia! Register
early to get a room reservation! Check the COA website for all

Annual meeting



October 30


November 4, 2005,
Nashville, Tennessee. For

more information, check
AMSUS website


www.amus.org

periodically







By CDR
Robin Scheper



Recent meetings and attendance by PHS officers

There was a meetin
g in June in San Diego. CDR Robin
Scheper was the lone PHS officer in attendance.




Any current issues of which DePAC might have an
interest:
They have a recruitment program into the
ADA/CND, with materials that can be provided to
‘recruiters’ who go to
dental schools. CDR Scheper
has copies of these materials.



The current number of PHS officers that are
members

Unknown, will report at a future date.



Upcoming meetings

ADA 19
th

New Dentist Conference


June 23
-
35,
2005, Chicago, Illinois. It is at that t
ime that the
Uniformed Services give their reports. The CND
also have a meeting in January, that the district
representatives attend
-

but no reports are given. For
more information on the meeting, go to:
http://www.ada.org/prof/events/featured/newdent/ind
ex.asp
.



Other issues

In a report to the ADA CND last June, CDR Scheper
mentioned the long
-
term training and loss of ASP
(which the DOD mentioned, as well), and to have the
stude
nt loan repayment (IHS.) be tax
-
free.
the details (
www.coausphs.org
). The 2005 COA Planning
Committee hopes to see you there!





By CAPT
Deborah Noyes, D.M.D., M.S




Re
cent meetings and attendance by PHS officers

November 14
-
19: Annual Meeting attended by
CAPT Deborah Noyes and at least 4
-
5 other PHS CC
dentists



Any current issues of which DePAC might have an
interest:
Planning committee for next year’s meeting
is for
ming, no issues yet



The current number of PHS officers that are
members:
Unknown at this time



Upcoming meetings





By CAPT
Patrick

Blahut
, DDS, MPH



Annual meeting
-
National Oral Health Conference:

May

1

6, 2005, Pittsburgh, Pennsylvania. For more information,
go to the AAPHD web site
-

http://www.aaphd.org/default.asp?page=meetings.h
tm
.


This year's theme is "
Confluence of Research, Education and
Practice"
.


We are looking forward to an exciting conference
-

the more people involved in presenting and sharing
information, the better the meeting.


See you in Pittsburgh
where the three
great rivers converge!!


Dues Reminder
-

Membership Dues for the 2004
-
2005 fiscal
year were due and payable as of October 1, 2004.


According
Page
13



USPHS Dental Newsletter February 2005


to the AAPHD Bylaws, non
-
payment of dues by December
31, 2004will result in members being dropped from the active
membership database. Joining AAPHD or paying of dues may
now be done on
-
line at
www.aaphd.org
.


Don’t miss your next
issue of the
Journal of Public Health Dentistry

or
Communiqué
.


Call For
Volunteers

-

The AAPHD Membership Committee
is looking for new volunteers to help achieve our strategic
goals related to membership
-

increasing the membership
database, building partnerships, increasing membership value.
If you are interested in joining t
his active committee co
-
chaired by Jim Sutherland and Mary Foley, please contact
Pam Tolson by e
-
mail at
natoff@aaphd.org
!










By CDR
Renée Joskow, DDS, MPH, FAGD



Recent meetings



1)

September 17, 2004:

The "Disaster" Role of the General
Dentist and Your Professional Image:

Sending the Right
Messages" was held in

Northbrook, IL.


2)

First Wednesday
-

Web Cast CE Study Club for Women,

By Women at 9PM EST

October 6,
Dr. Lynn Jones,
on "Simple and Elegant Direct
Restoratives."


November 3
rd

Dr. Jennifer Cha,
on "Implants for the General
Practitioner."






December 1,

Dr. Cherilyn Sheets on
"Zirconium
-
based
Crown and Bridge Materials."




Any current issues of which DePAC might have an
interest

AAWD has a "Smiles For Success program to

offer
cost
-
free dental care to women graduates of
accredited job readiness and placement programs, or
other community
-
based agencies, religious
institution
s or rehabilitative systems. This "gives
participants a competitive edge in the job market by
enhancing their appearance and helping to improve
their self
-
image."


Any dentist can volunteer to
participate in the program
at:

http://www.smilesforsuccess.org/volunteer.cfm



The current number of PHS officers that are
members

Uncertain, but AAWD has a total of 20 Uniformed
Service dentists, and at leas
t 3 confirmed PHS
dentists



Upcoming meetings

For more information on these events, go to:
http://www.aawd.org/HomePage.htm
.


Date

Location

Event Title

1/5/05 Web Cast
Dr. Rhonda Savag
e
"Restoration and


Retention of Severely Resorbed


Anterior Teeth"

2/2/05

Web Cast

Robin Wright
"Improving


Communication in the Dental Offi
ce"


2/19/
05

Houston, TX
Norma Olvera, DDS

“Treatment


Planning for the General Dentist in


Implant Dentistry

3/2/05

Web Cast

Dr. Lynn Jones

"Perfect



Provisionals:


First Time, Every Time"















By CDR
Gail

Cherry
-
Peppers, DDS



CDR Gail Cherry
-
Peppers is the PHS Liaison to the
NDA.


She has attended 3 Board Meetings this year, as well as the
Annual Meeting held in Los Angeles (Aug 2004).


No other
PHS officers attended meetings this year.


CDR Sweeting
attended the NDA Annual Meeting 2 years ago.


CAPT
DeBerry
-
Sumner and CAPT Ha
rris attended meetings 3
-

4
years ago, but have maintained their membership.


Upcoming meetings


Mid
-
Winter Meeting

-

February 10
-
13, 2005; Double Tree
Hotel
-
Coconut Grove, 2649 South Bayshore Dr., Miami, Fl
33133; 1
-
800
-
222
-
8733


92 Annual NDA Convent
ion
-

July 29
-

August 3, 2005
,
MGM Grand Hotel & Casino
,
3799 Las Vegas Blvd.
,
1
-
877
-
313
-
5757


National Dental Association Meeting Summary 2004


The meeting was very productive, informative and well
attended. It was held at the Century Plaza Hotel in Los
A
ngeles, California.


The theme for the year was “Building the Future of the NDA
through Education and Partnerships; A broad range of clinical
topics were presented at the meeting, in addition to skills
building and hands
-
on clinical workshops; Over 600 att
endees
were afforded the opportunity to learn from attending
Hispanic Dental Association 13
th

Annual Meeting

The 13
th

Annual Hispanic Dental Association Meeting will
be held November 17
-
19 at the Hyatt Regency in
SanAntonio, Texas. Watch the HDA news and reports for
updates or visit
www.
hdassoc
.org.

Page
14



USPHS Dental Newsletter February 2005


numerous innovative, scientific, and clinically pertinent dental
and general sessions.

The major issues this year were:


♦Amalgam and its daily use as a safe mercury
-
containing product; The NDA sided with the ADA’s
position that amalgam has been and still is the
restorative material of choice for many dentists
nationally.

♦ The NDA was charged with the issue of declining
enrollment of minorities in dental schools. Several
recruitment projects emerged from this meeting.
African American Fraternities have started a National
recruitment effort to reach minorities in their
communities at the early college, high school and
jun
ior high school level. There was a request made
for members to participate in health fairs and
community events to disseminate materials and
heighten awareness of dentistry as an excellent career
choice;



The activities were concluded with a round
-
table
di
scussion on building numerous partnerships with
community
-
based organizations, educational entities,
other health care organizations, and state and Federal
governments;


The 2005 National Dental Association meeting will be held
July 29
th



August 3
rd

in La
s Vegas.
NDA website:
http://www.ndaonline.org/
.












By CAPT
James Lipton, D.D.S., PhD



Three PHS dental officers, CAPT Jim Lipton, CAPT Robert
Selwitz and CAPT Raymo
nd Lala, attended the Federal
Services Dental Educators meeting in San Antonio, Texas,
January 24
-
28, 2005.
This was the third year that the PHS
participated with chiefs of the advanced dental training
programs from the Air Force, Army, Navy and Veterans
Administration. The goal of the meeting was to produce an
optimized model of education for the various dental
specialties. To do so, attendees sought to (1) determine the
total number of dental residents required for the combined
federal services; (2) de
velop a plan for an integrated training
system and resultant reduction in total number of advanced
dental education programs across federal services; (3) identify
professional staffing requirements to support the number of
required residents; and (4) propo
se how to transition from the
current model of service
-
specific staffing to an integrated
federal services staffing model that is supported by
ADA/CODA accreditation standards. Suggestions will be
brought to the Corps Chiefs for each service for their
con
sideration and recommendations. Preliminary d
iscussions
were held with the Air Force, Army and Navy regarding: a
c
oordinated effort for selection of residents for available slots
in residency programs; a proposed future rotation of residents
and clinician
s between Navy and PHS (especially in dental
public health and pediatric dentistry); establish
communication between PHS and other federal services about
continuing education courses currently offered by the Indian

Health Service; and new approaches for t
raining in dental
public health. A more detailed discussion of these issues will
be forthcoming on the USPHS Dental Discussion List.










By LCDR
Phillip

Woods, DDS




In January the Minority Affairs Subc
ommittee held an introductory meeting to provide an opportunity for the new chair, LCDR Phillip
Woods, and other subcommittee members to introduce themselves. A brief questionnaire was sent to members to gather informatio
n
regarding their areas of interest
, and potential projects for the 2005
-
year agenda. Two new members, LCDR Scott Brown and LCDR
Marlon Brown were added to the Minority Affairs roster. Following a review of the responses from the January Questionnaire, t
he
2005 agenda will be presented at t
he next meeting on February 18, 2005.


Participating Members for the 2005 Minority Affairs Subcommittee include CDR Wilnetta Sweeting, CDR Gail Cherry
-
Peppers, CDR
Alan Peterson, CDR Tameka Lewis
-
Baker, LCDR Scott Brown, LCDR Stephanie Burrell, LCDR Earlen
a Wilson, Dr. Jay Anderson
and LCDR Phillip Woods.




Page
15



USPHS Dental Newsletter February 2005




By CDR
Stephen

P. Torna, DMD,



The communications workgroup is planning to publish the
USPHS Dental Newsletter four times during 2005. Issues will
i
nclude Jan/Feb, May/June, Sept/Oct and Nov/Dec. Many
thanks to each and every newsletter contributor; your
continued support and participation is highly valued. The
quality of the articles that we receive is greatly appreciated.
The deadline for articles

for the May/June issue will be May
13.


Any officer that wishes to contribute to the newsletter, please
contact either
CDR Saville
ssaville@d11.uscg.mil

or
CDR Torna
Steve.torna@mail.ihs.gov
. Thoughtful and carefully written
articles describing activities, experiences, deployments,
clinical activities and research etc. are always needed.


Membership for the 2005 communications workgroup has
changed and increas
ed. Present members include CDR Torna
(chair and newsletter editor), CAPT Klevins (vice chair), CDR
Saville (newsletter editor), CDR Ricks (consultant), CDR Bird
(DePAC web site maintenance), CDR Mayberry
(member/contributor), LCDR Driscoll (member/contrib
utor).





By CDR
Renée Joskow, DDS, MPH, FAGD



CDR Tim Owen received confirmation by the DePAC as
Associate Recruiter (A.R.) and Lead A.R. There is a new ARP
Program Coordinator in OCCO, CDR Stephen Blackw
ell. He
joined our January RRA meeting along with CAPT Ames,
also from OCCO. CDR Blackwell currently has several
applications for A.R. that he will provide to the RRA chair.
CDR Blackwell provided procedural information for CDR
Owen’s appointment as A.R.

Just as we gain a new Lead
A.R., regretfully, CAPT Lozon has requested to step down
from his position as Lead A.R.. The Roles and
Responsibilities document has been drafted by the current
Lead A.R.s that designates 3 subject headings:
Responsibilities, R
esponsible Person, and Time
Frame/Frequency. CDR Schaeffer has maintained contact
information for A.R.s and their corresponding school
assignments. An update document on the Early
Commissioning Program was provided by OCCFM to CAPT
Lozon and the RRA workg
roup chair. Assignments were made
for task groups within the workgroup and subcommittees. The
new Dental Category CV format was made available on the
Dental Category website with accompanying instructions. A
Frequently Asked Questions document was made ava
ilable to
dental officers by CAPT Jackson. The workgroup discussed
the concensus and decision processes used for the
development of the new CV format. Further discussion
included creating a survey of the “ease of use” and estimates
of numbers of officers w
ho used the new CV format. There
was a report on the status of Career Development section of
the “Survival Guide”. A review of past exit surveys was
assigned to subcommittee members to assist in the evaluation
officer retention issues.







By

Mary

McEnery
, DDS



The paper "Attitudes and Perceptions about Recruitment and
Retention Issues among U.S. Public Health Service
Commissioned Corps Dentists" was prepared by
the DePAC
Women's Issues Subcommittee (WIS). The paper has been
reviewed by OSG senior management. OCCO activities of
relevance to the paper's recommendations include:




OCCO will be establishing mandatory EEO training
for all officers. OCCO will identi
fy online programs
about sexual harassment, ethnic discrimination and
EEO. This information will be posted in various
program sites.



OCCO will update the existing Q&A fact sheet about
EEO.



An article reviewing EEO policies in the PHS is
planned for the Fe
bruary issue of the CO Bulletin.



OCCO will be compiling data about diversity in the
Corps, number of EEO complaints and their
resolution.



Requests for a copy of the full paper should be made to CDR
Suzanne Saville,
ssaville@d11.uscg.mil
.






By
CDR
Robin Scheper



The DePAC has established a category specific Mentoring
Program. Whether a new Public Health Service dentist, or
considering retirement,

this Mentoring Program will give
officers the opportunity to grow personally and to help
strengthen the PHS Dental Category in future years.


Mentoring can be rewarding for both parties but doesn’t have
to be an overly time
-
consuming process. The objectiv
e of any
mentoring relationship is to give guidance on defining and
reaching goals or career paths, candid information and advice,
the “big picture” view, information on available opportunities,
and some honest discussion on tough issues. Partnerships are
developed over time and through communication. After the
first few initial discussions covering the basics, the direction
and frequency of discussions is dictated by the needs of the
Page
16



USPHS Dental Newsletter February 2005


protégé. Participation in the mentoring program has the
potential to make

the careers of all involved fuller and more
satisfying.


For further information or an application, please check the
PHS Dental Category Web Page at
http://www.phs
-
dental.org/depac/newfile14.h
tml

or you may contact CDR
Robin Scheper at
rscheper@tracencapemay.uscg.mil







By CDR
Renée Joskow, DDS, MPH, FAGD



Fourteen dentists have deploye
d to Camp LeJeune since
October. Four more Officers are scheduled to deploy
providing support through mid
-
February. OFRD Chairperson
has provided three pre
-
deployment briefings for Officers
deploying to Camp LeJeune.


OFRD provided first time pre
-
deploym
ent training for all roles
deployed for the Inauguration. One hundred and sixty
-
five
officers attended the hands
-
on and didactic training. In
addition, role dependent read
-
ahead materials and online
training sessions were provided prior to the two
-
day tr
aining.
Seventeen officers (Nurses, Physicians, Environmental Health,
Biomedical engineering, and Mental Health Providers) have
deployed on the USNS Mercy in support of the Tsunami relief
effort.


Three dentists were deployed for the 2005 Inauguration.
Two
served as tent (Aid station) Leaders and one served as the
Surveillance/Epi/ and Assessment Team Leader and Training
officer. A total of 183 officers were deployed for the
Inauguration.







By CDR
Robin Scheper


This workgroup has been tasked with developing input from
DePAC to assist in implementation for the National Call to
Action to Promote Oral Health.
A

National Call to Action to
Promote Oral Health
, referred to as the
Call to Action
, ref
lects
the work of a partnership of public and private organizations
who have specified a vision, goals, and a series of actions to
achieve the goals.




Three of the highlighted agencies thus far are the Indian
Health Service, the Health Resources and Ser
vices
Administration, and the Centers for Disease Control and
Prevention. Here are examples of what the three agencies are
currently doing:


I.H.S. Volunteer Program/Co Step Program
-

The I.H.S. is
currently bringing dental students to reservations to prov
ide
oral health care while on rotations from school.

Oral Health in Primary Care
-

Three of the four HRSA bureaus
have programs that address the issue of educating other health
professional about oral health care.

State Oral Health Cooperative Agreement P
rogram
-

CDC is
providing funding to12 states and the Republic of Palau to
strengthen their oral health programs and reduce inequalities
in the oral health of residents. In addition to core awards, four
states are receiving additional funding to support
de
velopment/enhancement of community water fluoridation
and school
-
based/
-
linked dental sealant programs.


For further information on the National Call to Action, please
visit the following web site:
http://w
ww.phs
-
dental.org/ncta/
.

For further information on the Call To Action Subcommittee,
please contact CDR Robin Scheper at
rscheper@tracencapemay.uscg.mil
.







By CDR
Jose

Rodriguez
, DDS




The year ended with the nomination process for the 2005
DePAC Awards for the Buell, Robertson and Senior Clinician.

At the present time the membership of the DePAC forw
arded
their selection for the 2005 Senior Clinician Award. The

selected award recipient name has been forwarded to the
Executive Committee of the DePAC, as well as to RADM
Kleinman.


We are awaiting the final selection for the Robertson and
Buell Awards
by RADM Kleinman. The names will be
forwarded to COA Dental Category Planning Committee for
inclusion on the 2005 COA meeting. Names will be
announced during the COA meeting and posted on the list
serve and the various agencies mailing systems for wide

dissemination.


The workgroup will be starting its monthly conference calls at
the end of the month. Some of the multiple items to be
addressed this year include: new awards, awards time cycle,
restructuring the awards workgroup section of the DePAC
Byla
ws, addressing the “Special Assignment Award” for
DePAC members. The committee will appreciate any
suggestions for civil service related awards.


We are awaiting confirmation on two potential workgroup
members. This will bring the workgroup total to eig
ht.





Page
17



USPHS Dental Newsletter February 2005








LT
Jane

Bleuel
, DMD




JOAG Meeting
was

December 10, 2004. The following is a
summary of our discussion with CAPT Furman:



6
th

Precept


Last year

a policy was created that a “6
th

precept” would be
held around assignments. This precept recognizes hard to fill
duty assignments. CAPT Furman emphasized that this is NOT
a mobility precept, but is intended to capture the additional
value an officer bring
s to the Corps while working in difficult
duty assignments. The decision points that must be addressed
include the following questions:



What types of assignments qualify as “hard to fill”?
How far back does credit for these assignments go?
What length of t
he assignment is required for it to
qualify? Should promotion scoring include prior
service in qualifying assignments (former service for
example). How many points should an officer
receive for these assignments? Should the promotion
boards be able to ar
bitrarily assign value for the
criteria, or should the process be standardized and
automated?


The 6
th

precept will not be part of the 2005 promotion
benchmarks, but will be phased in by the 2006 boards. During
the 2005 Boards, OCCFM will model how the add
ition of the
6
th

precept would impact the rank order of officers for
promotion.

Issues raised by Junior Officers:

We hope the focus on benchmarks, particularly deployments
and mobility, does not diminish the value placed on expertise
and being an expert in

one’s field. This is especially true of
experts cultivated within a single agency. JOAG would like to
see more discussion on the issue of agency career paths to
address this concern.

What was the impetus of this precept? To level the playing
field with re
gard to credit given in other benchmarks that may
disadvantage officers in hard to fill assignments. CAPT
Furman discussed that many officers in hard to fill
assignments had concerns regarding deployments and whether
some officers are advantaged or disadva
ntaged because of
their assignment. While the workgroup is NOT counting
deployments as part of the 6
th

precept, allotting credit for the
6
th

precept may help balance out credit officers may lack in
other areas because they are unable to participate in othe
r
Corps activities, service groups, etc.


Force Readiness


As you know, immunizations requirements have been waived
for the 2005 promotion year. However, officers in the
high
-
risk

groups identified by CDC should consider getting the
vaccine.

CDC has issued

a recommended immunization schedule.
Based on this, OCCFM may change the current required
immunization schedule.


MC 377 is providing direction on readiness issues.



Warrant Officer Corps

The USPHS has the authority to initiate a Warrant Officer
Corps, s
ince we have no “enlisted corps”. An advisory group
has been formed to discuss draft regulations and policies that
will govern this new corps of officers, which should be
drafted by late spring/early summer. A pay system must also
be created.

OCCFM anticip
ates that the first Warrant Officer will be
brought on board in January 2006.

The Warrant Officer Corps was conceived as a group of
technicians to fill the need for
technical expertise

we do not
currently have.

The qualifying degree for Warrant Officers i
s an associate’s
degree, and will include such disciplines as: RNs,
paramedics, lab techs, and x
-
ray techs.


Issues brought up by Junior Officers:


Whether or not any current Commissioned Officers would be
converted to Warrant Officers; the answer: NO.

Whe
ther or not there are any current professional
disciplines

that may be commissioned as a Warrant Officer; answer: NO.
This concern stems from the Nurse Category. Of all the
uniformed services, only the Army commissions Warrant
Officers with an associate’s
degree, and these officers do not
stay on extended active duty. At this point, there is a serious
nursing shortage, and the Corps wants and needs to draw
additional nurses in.



JOAG Website

www.joag.org

Membership info
rmation will be updated every 3
months

Uniform FAQ


has been developed, still needs
approval from OCCO and OCCFM


JOAG meetings are always on the second Friday of the
month at 1300 EST.


Call Number
: 888
-
807
-
8641 Pass code:
11247







Page
18



USPHS Dental Newsletter February 2005









CHILDHOOD

DIABETES

ACANTHOSIS NIGRICANS OBESITY AND
INSULIN RESISTANCE


By CDR
Stephen P. Torna, DMD, Editor



Since the 19
th

century Acanthosis Nigricans has been known
to be associated with gastric adenocarcinoma a
nd other types
of cancer. In 1976 it was shown that Acanthosis Nigricans
(AN) is also associated with insulin resistance, and since then,
AN has served as a screening tool for type 2 diabetes mellitus.
Acanthosis Nigricans is a condition marked by hyper
-
pigmented areas of skin on specific parts of the body including
the back of the neck, axillae, groin, elbows, and abdominal
skin folds. The pigmented areas have been described as thick
brown velvety plaques and in some situations; multiple
pigmented tissu
e tags may be a manifestation of this
condition. Acanthosis Nigricans may serve as an important
screening tool for childhood risk for diabetes. Early
identification and intervention for those at risk for diabetes is
critical as the morbidity and mortality

associated with diabetes
mellitus is well established.


In a 1976 article from the New England Journal of Medicine,
Ronald Kahn first reported an association between Acanthosis
Nigricans and insulin resistance.
1

In this study, Kahn reported
6 cases invol
ving females, each with varying degrees of
insulin resistance and concomitant Acanthosis Nigricans.
Kahn described 2 syndromes involving adults and younger
patients. The older patients had severe insulin resistance,
Acanthosis Nigricans, and signs of immu
ne disease while the
younger patients had insulin resistance, Acanthosis Nigricans,
hirsutism, and polycystic ovaries. In each of the 6 patients a
decrease in receptor insulin binding was noted. Kahn
observed that as insulin resistance decreased, the pres
ence of
Acanthosis Nigricans also declined.


Acanthosis Nigricans (AN) has served as an indicator and
screening tool for many diseases including cancer. The
association of cancer and AN long precedes that of AN and
diabetes and actually dates to the late

19
th

century. Malignant
Acanthosis Nigricans is a name given to a type of AN that is
associated with malignant neoplasms. Hyperpigmentation and
thickened skin in areas including the axillae and neck and in
rare cases, the palms of the hands (tripe palms)
, is a warning
sign that an underlying neoplasm may be present. Although
AN is most often associated with gastric adenocarcinoma,
Acanthosis Nigricans is documented to have occurred in


conjunction with stomach, lung, bladder, renal and breast
cancer as wel
l as many other forms of malignancy.
3,4,6

Additionally, AN has been associated with pituitary disease,
hypothyroidism, Addison’s disease, and various syndromes.
Histologically and clinically, cancer associated AN is
generally indistinguishable from benig
n AN (non
-
malignancy
associated AN). Acanthosis Nigricans that accompanies
malignancy, arises more suddenly and is more extensive than
benign AN, and malignant AN is typically associated with
particularly aggressive forms of cancer.


Type 2 Diabetes Melli
tus (DM) has historically been an adult
disease. Presently type 2 DM is becoming more prevalent
amongst children. Insulin resistance is seen among children of
all races and ethnic backgrounds but is most frequently
encountered in African American, Mexican,

and Native
American children. The presence of AN in these populations
is also markedly higher than in other ethnic groups.
4,8,9

Acanthosis Nigricans is associated with insulin resistance in
up to 90% of children with type 2 DM.
4

The prevalence of
Type 2

Diabetes Mellitus among the Southwestern Pima
Indians is the highest in the world and exceeds 50% of the

adult population.
4

Among members of the various Montana
and Wyoming tribes, it is estimated that the incidence of
diabetes among children is more th
an twice that of the general
population.
5


In a 2001 study involving 139 African American and white
children, AN was associated with high insulin levels and
obesity, and was found to be present in 50% of the African
American children compared to 10% of the

Caucasians in the
study. However, AN in these groups was not exclusively
associated with insulin resistance. AN was present in both
obese and non
-
obese children who were not insulin resistant.
This study showed that obesity was a more reliable marker for

insulin resistance than was AN. Obese children demonstrated
higher fasting insulin levels regardless of the presence or
absence of Acanthosis Nigricans.
7

Similar studies involving
adults show the same positive correlation between insulin
resistance, Aca
nthosis Nigricans and obesity.
11

In the United
States it is estimated that 34% of the adult and 14% of the
childhood population is overweight. Insulin Resistance
syndrome (metabolic syndrome or syndrome X), described as
involving obesity, hyperinsulinemi
a, cardio vascular disease,








Page
19



USPHS Dental Newsletter February 2005


and type 2 diabetes is becoming more common and is
increasingly seen in children. Children often carry their
obesity into adulthood and as such risk premature heart
disease, stroke, kidney disease, and a plethora of other
probl
ems and diseases. Acanthosis Nigricans, polycystic ovary
syndrome, and cancer have also been linked to obesity and
insulin resistance in children.
9,10,11


Although genetics and familial tendency play a major role in
obesity and diabetes, weight reduction,
proper nutrition, and
exercise are critical for children. Insulin resistance is
observed more and more frequently among children, and
apparently minority children are at the greatest risk. Genetic,
socioeconomic, race, age, and gender are factors that in
fluence
the propensity for insulin resistance. Acanthosis Nigricans and
obesity may serve as markers to aid in the identification of
children that are at risk for type 2 diabetes mellitus. A
relationship between obesity, hyperinsulinemia, and
Acanthosis Ni
gricans is well established but complex and
somewhat unclear. It is evident that obesity may be the most
important sign for identifying children at increased risk for
diabetes.


Diabetes is emerging as a major public health issue. Early
intervention is

the key to preventing the disease and it’s
potential morbidity and mortality. The dental community is in
a unique position to initiate the intervention process.
Childhood obesity, Acanthosis Nigricans, and the presence of
tissue tags may serve as marker
s for medical referral and
evaluation for diabetes risk.


REFERENCES


1.

Kahn CR, Flier JS, Bar RS, et al. The syndromes of
insulin resistance and acanthosis nigricans. Insulin
-
receptor disorders in man. New Engl J Med. 1976;
294:739
-
745.

2.

Stuart CA, Smith MM
, Gilkison CR, et al.
Acanthosis nigricans among Native Americans: An
indicator of high diabetes risk. Amer J Public Health
1994; 84: 1839
-
1842.

3.

Sharon JL, Taylor JS, Kennedy A, Nurko S. J Amer
Acad Dermatol 2003; 49 (3):541
-
543.

4.

Arslanian S. Type 2 diabet
es mellitus in children:
pathophysiology and risk factors Pediatr Endocrinol
Metab 2000; 13 Suppl 6:1385
-
94.

5.

Moore KR, Harwell TS, McDowell JM, et al. Three
year prevalence and incidence of diabetes among
American Indian youth in Montana and Wyoming,
1999
to 2001. J Pediatr 2003 Sep; 143(3):368
-
71.

6.

Pentenero M, Carrozo M, et al. Oral Acanthosis
Nigricans, tripe palms and sign of leser
-
trelat in a
patient with gastric adenocarcinoma. Int J Dermot
2004 Jul; 43(7):530
-
2.

7.

Nguyen TT, Keil MF, Russel DL, et al. R
elation of
Acanthosis Nigricans to hyperinsulinemia and insulin


sensitivity in overweight African American and white
children. J Pediatr 2001 April; 138(4):474
-
80.

8.

Cruz M, Torres M, Herrera B, et al. Type 2 diabetes
mellitus in children an increasing healt
h problem in
mexico. J Pediatr Enocrinol and Metabol 200

9.

4; 17:183
-
190.

10.

Ten S, and Maclaren N. Insulin resistance syndrome
in children. J Clin Endocrinol and Metabol 2004;
89(6):2526
-
38.

11.

Sampiolo P, Livieri C, Montanari L, et al. Precosious
signs of polycy
stic ovaries in obese girls. Ultrasound
Obstet Gynecol 1994 Jul 1; 4(4):310
-
5.

12.

Hud JA, Cohen JB, Wagner JM et al. Prevalence and
significance of Acanthosis Nigricans in an adult
obese population. Arch Dermot 1992 Jul; 128:941
-
44.

13.

Knowler WC, Pettitt DJ, Sa
ad MF, et al. Diabetes
mellitus in the pima Indians: incidence risk factors
and pathogenesis. Diabetes Metab Rev 1990; 6:1
-
27.










By CDR
Christine

Heng, DDS



CAPT Clemens started his PHS career as a junior CO
STEP
student in the Crow Agency, MT. Upon graduation from the
University of Illinois in 1980, he joined the IHS, serving his
first three years in Fairbanks, AK. He says those years were
very enjoyable, including many trips in small airplanes to
distant
villages to work on adults and children with portable
equipment. He then became chief of the Choctaw Clinic in
Philadelphia, MS. He broke away from the PHS, returning to
his home in Bloomington, IL to buy and operate a solo private
practice in 1983. Af
ter five years of private practice
pressures, the adventure of Alaska called him back. He sold
the practice and moved to Kodiak, AK in 1988.


In 1990, CAPT Clemens joined the BOP to become the Chief
Dental Officer at FCI Oxford, WI. During this time, a

new
regional dental laboratory was set up at FCI Oxford, and he
assumed the collateral duty as the North Central Regional
Dental Lab Director. In 1996, he became the Deputy Chief
Dentist of the BOP. Although CAPT Clemens is a clinician,
he has contribut
ed in many different ways to the BOP and
PHS.


In the BOP, CAPT Clemens is often called upon to do
program reviews and peer reviews. Additionally, he helped
revise the Health Services Manual and edit the guidelines for
both program review and peer review
to meet JCAHO and
ACA standards.


Page
20



USPHS Dental Newsletter February 2005


CAPT Clemens was the PHS alternate delegate and later the
delegate to the ADA House of Delegates from 2000 to 2003.
During this time, he worked with interested parties and
reported to DePAC on the happenings in ADA. A
t ADA
Annual Conferences, he deliberated in the reference
committee meetings and cast his votes in the House to further
the interests of the PHS. Additionally, CAPT Clemens is a
“regular” at the Chicago Midwinter Meetings where he has
coordinated recruiti
ng efforts every year for the last eight
years.


In 1996, CAPT Clemens became the Chairperson of the then
CCRF dental workgroup. In 1999, he coordinated the
deployment of dentists to Fort Dix, NJ for the Kosovo
refugees. More remarkably, he was deployed

to the WTC
after the 9/11 attack to identify remains using dental evidence.


In Wisconsin (WI), CAPT Clemens is looked upon as the
Public Health expert for the dental community. He was on the
panel of experts in a referendum to fluoridate Lake Delton,
WI
in 1994/95. Presently, he is part of the Emergency
Preparedness Task Force
-

a response effort of the WI State
Dental Society to current geopolitics.


Outside work, CAPT Clemens unwinds with his love for
sports and traveling. He completed the 90 km

Vasaloppet ski
race in Sweden in 2000; completed the 50 km Birkebeiner ski
race many times; competed in the Ultimate Athlete
Competition
-

a competition in 12 sports
-

multiple times,
winning first place in 1999. As for his yearn to see other parts
of th
e world; it didn’t take much convincing from CDR Jeff
Gaskin to get Dave to join his Filling
-
a
-
Need mission to
remote villages in Suriname, S. America. CAPT Clemens
would readily share with anyone his experiences in Suriname
-

some of which are heart
-
warm
ing while others are hair
-
raising. His other voyages include dental missions to Goa and
Madhya Pradesh in India, and Sderot in Israel.



Editors Note:


Future senior and junior officer spotlight articles will include
dentists from all of the agencies.
Since Indian Health Service
has not recently been represented, we hope to include dentists
from that agency in the next newsletter. Subsequent
newsletters will spotlight other agencies within the USPHS
Commissioned Corps. Please contact
CDR
Suzanne

Saville

if
you want to spotlight an officer from your agency. Articles
should be concise and to the point. The article should high
light accomplishments and contributions through specific
examples.














By CDR
Christine

Heng
, DDS




I first met LT Leira Vargas
-

Del Toro at the Bureau of Prisons
Conference in San Antonio, TX in July, 2004. She impressed
me as a bright and friendl
y officer. Although a young, junior
officer, she is the Chief Dental Officer at FCI Texarkana, TX.


Dr. Vargas grew up in Quebradillas, Puerto Rico. She
graduated from high school with honors in 1994 and was a
member of the national honor society. LT Va
rgas attended the
University of Puerto Rico. As an undergraduate, she assisted
in research in Neurobiology, Chemistry and Electrochemistry,
and worked in multiple jobs
-

one of which was a tour guide at
the Cornell University’s Arecibo Observatory. She a
ttended
for three years before being accepted into dental school. She
received an Associate’s Degree in Natural Science with
Summa Cum Laude.


LT Vargas attended the University of Puerto Rico
-

School of
Dentistry. During a work fair on campus, she lea
rned of the
US Public Health Service. She subsequently became a
JRCOSTEP and then a SRCOSTEP. As part of her payback,
she was the Staff Dental Officer at FCI Greenville, IL, where
she worked under the able leadership of CDR Peter Preston.
Dr. Vargas qui
ckly went from a 0
-
3 billet to a 0
-
4 billet. She
contributed not only to the Dental Department but also to the
entire Health Services Unit. She performed multiple operation
reviews and quality assurance activities for the larger Health
Services Departmen
t. She was recognized with a Unit
Commendation and Citation while serving at FCI Greenville.
LT Vargas has completed both the BOTC and IOTC. In May
2004, she moved to Texas and became the Chief Dental
Officer in a 0
-
5 billet at FCI Texarkana, TX. Local
ly, she has
performed multiple leadership roles
-

serving as the Chair of
the Controlled Substances Inventory Committee, Chair of the
Tissue Committee and, more remarkably, Acting Health
Services Administrator. As a solo dentist, she manages a large
clini
c which once kept two dentists busy. The demands are
immense but she manages well, keeping complaints to a
minimum.






By CAPT
Monina Klevens, DDS, MPH


CDC offers excellent training opportunities for dental offi
cers
through the application of public health principles. These
require a Masters degree in public health in addition to
credentials in dentistry.



The Dental Public Health Residency is a one
-
year
program designed to provide dentists with a diverse
Page
21



USPHS Dental Newsletter February 2005


experie
nce in dental public health. Residents work
on projects with experienced public health dentists at
CDC conducting various epidemiologic studies and
surveillance and program activities. Completion of a
residency in dental public health is a requirement fo
r
board certification in dental public health. For
information contact CAPT Scott M. Presson,
skp4@cdc.gov

or 770
-
488
-
6056.



The Epidemic Intelligence Service (EIS) is a two
-
year postgraduate program of service and on
-
t
he
-
job
training for health professionals of different
disciplines interested in the practice of epidemiology.
Officers select an assignment from across all
programs at CDC, from infectious diseases to
maternal health. A cadre of experienced
epidemiologist
s throughout CDC and in state and
local health departments serves as day
-
to
-
day
mentors or primary supervisors to EIS officers.



The CSTE/CDC Applied Epidemiology Fellowship
Program is a two
-
year program, where fellows
receive on
-
the
-
job training at a sta
te health agency
under the guidance of an experienced mentor. The
goal of the fellowship is to provide a high quality
training experience and secure long
-
term career
placement for fellows at the health agencies to which
they are assigned.


Information abo
ut these programs and application materials
are available at:
http://www.cdc.gov/phtrain/

Staff positions are frequently available after completing one of
these programs at CDC. For questions about CDC experienc
es
for dental officers, please contact CAPT R. Monina Klevens at
404
-
498
-
1213.











By CDR

Jim Schaeffer, DDS


The Dental Associate Recruiter Program (ARP) is getting
back into full swing with the start of the dental school
academic year and the ne
w government fiscal year. Recently,
the dental ARP mailed letters cosigned by RADM Dushanka
V. Kleinman and Dr. Rick Valachovic of the American Dental
Education Association to all dental school deans. These
letters requested their school’s participation

in a new
recruiting relationship with the USPHS Dental Category.
Each dean was asked to designate a school faculty member
who will serve as a recruitment contact for students. Dental
Associate Recruiters are matched to work with each school
and its “
facu
lty recruiter
” to provide a source of information
about the USPHS, including student externship opportunities,
loan repayment, and career opportunities. Our goal is to make
students in each school aware that the USPHS offers training
and employment opport
unities in unique settings with
competitive pay and benefits. In order to prepare Dental
Associate Recruiters to get our message out accurately and
effectively, quarterly dental recruiter training sessions will be
conducted by conference call. The first s
uch session was held
on August 18.


Coinciding with the new 2005 fiscal year, the dental ARP has
requested funding and is making plans to place a recruiting
booth at the
ADA’s Annual Session

in Orlando, the annual
convention of the
Hispanic Dental Societ
y

in San Juan, PR
(October 15
-
16, 2004), and at the
Western Regional Dental
Convention

in Phoenix, AZ (March 10
-
11, 2005). Additional
recruiting efforts will take place at the annual
AMSUS
Meeting

in Nashville, TN (October 30
-

November 4, 2005),
the annu
al
Chicago Midwinter Dental Meeting

in February
2005 (sponsored by the FBOP) and at the annual
ASDA
Convention

in August 2005 (sponsored by the IHS). Dental
Associate Recruiters should periodically sign onto the

Recruiting Events
” link of the IHS Dental

Web page
(
http://www.dentist.ihs.gov/
) for current recruiting event
listings, and to coordinate their efforts at dental schools with
CAPT Tim Lozon’s recruiting schedule. Volunteer Dental
Associate Recruiters
are needed for all of these category
-
recruiting events. To volunteer or inquire, contact our
category ARP leads: CAPT Tim Lozon (
tlozon@na.ihs.gov
),
CDR Jose Rodriguez (
jrodiguez@abr.ihs.gov
), or CDR Jim
Schaeffer (jschaeffer@mail.cc.nih.gov).









Page
22



USPHS Dental Newsletter February 2005





Name

Grade/

Rank

DePAC Role

Term

Expires

Agency/

OPDIV

Mailing Address

Phone
Number

E
-
mail

Andrews
,

Arlan, DDS

O
-
5,

CDR

Voting member

Awards Workgroup Member

Commu
nications Workgroup
Member

2006

IHS

Alaska Native Medical Center

4215 Diplomacy Drive

Anchorage, AK 99508

907
-
729
-
2035

aandrews@scf.cc

Bajuscak
,

Ronald E.,
DMD, MS

O
-
6,

CAPT

Voting member

Immediate Past DePAC
Chair

Organization Liaison

2005

BOP

FCI Tucson

8901 South Wilmot

Tucson, AZ 85706

520
-
574
-
7159

rbajuscak@bop.gov

Bird
,

George G.,
DDS

O
-
5,

CDR

Voting member

2005 Executive Secretary

Communications Workgroup
Member

20
07

IHS

Tanana Chiefs Conference

122 First Avenue

Faribanks, AK 99701

907
-
452
-
8251

Ext. 3081

birdindorf@yahoo.com

Burrell
,

Stephanie,
DDS

O
-
4,

LCDR

Voting member

Recruitment/Retention/Appoi
ntments

Workgroup Co
-
Chair

2007

IHS

Oneida Comm. Health Ctr.

P.O. Box 365

Oneida, WI 54155

920
-
869
-
4856

Sburrell@oneidanation.org

Catelli
,

William F.,
DDS

O
-
5,

CDR

Voting member

Recruitment/Retention/Appoi
ntments

Workgroup C
o
-
Chair

2007

USCG

HSD/ISC Kodiak

P.O. Box 195002

Kodiak, AK 99619
-
5002

907
-
487
-
5757

Ext. 158

WCatelli@CGAlaska.uscg.mil

Christianse
n,
Richard
L., DDS,
MSD

Retired

Ex
-
officio member

Retired Officer

-

Retir
ed

Corps

University of Michigan

Room B497, School of Dentistry

Ann Arbor, MI 48109
-
1078

734
-
936
-
3621

vista@umich.edu

Gettleman
,
Lawrence
M., DMD,
MSD

O
-
4,

LCDR
(Reserve)

Ex
-
officio member

Inactive Reserve
Represent
ative

-

Inactive

Reserve

University of Louisville SOD

501 South Preston Street

Louisville, KY 40292
-
0001

502
-
852
-
1185

Gettleman@louisville.edu

Halliday
,
Christopher
G., DDS,
MPH

O
-
6,

CAPT

Ex
-
officio member

Indian Health Service
Representative

-

IHS

IHS Division of Oral Health

801 Thompson Ave., Suite 300

Rockville, MD 20852

301
-
443
-
1106

challida@hqe.ihs.gov

Joskow
,

Renee, DDS,
MPH

O
-
5,

CDR

Voting member

Recr.
/Ret./Appts. Workgroup
Chair

OFRD Workgroup Chair

2006

OFRD

OFRD

12300 Twinbrook Pwy, Ste. 360

Rockville, MD 20857

240
-
453
-
6103

Rjoskow@osophs.dhhs.gov

Kleinman
,

Dushanka
V., DDS,
M.Sc.D.

O
-
8,

RADM

Ex
-
offi
cio member

USPHS Chief Dental Officer

-

NIH

NIH/NIDCR

Building 31, Room 2C39

Bethesda, MD 20892

301
-
496
-
9469

Dk42p@nih.gov

Klevens,

R. Monina,
DDS, MPH

O
-
6,

CAPT

Voting member

Communications Workgroup
Co
-
Ch
air

2007

CDC

Div. of HC Quality Promotion

1600 Clifton Rd., Mail Stop E55

Atlanta, GA 30333

404
-
498
-
1213

Rmk2@cdc.gov

Lala
,

Raymond F.,
DDS

O
-
6,

CAPT

Voting member

Call to Action Workgroup
Co
-
Chair

Awards Workgroup C
o
-
Chair

2007

HRSA

BHPr/DMD/DSPB

Parklawn Bldg.,9A
-
21

5600 Fishers Lane

Rockville, MD 20857

301
-
443
-
1707

rlala@hrsa.gov

Makrides
,

Nicholas,
DMD, MA,
MPH

O
-
6,

CAPT

Ex
-
officio member

Bureau of Prisons
Representative

-

BOP

Bureau of Prisons

320 First St. NW, Room 1032

Washington, D.C. 20534

202
-
307
-
2867

Ext. 138

Bop2691@bop.gov

McEnery
,

Mary C.,
DMD

GS
-
13

Civil
Service

Voting member

Womens Issues
Subcommittee Chair

2006

IHS

Nor
thern Cheyenne Service Unit

Indian Health Center

Lame Deer, MT 59043

406
-
477
-
4425

MMcEnery@mail.ihs.gov

Nehring
,

Mark, DMD,
MPH

O
-
6,

CAPT

Ex
-
officio member

HRSA Representative

-

HRSA

MCHB

Parklawn Bldg.

56
00 Fishers Lane, Rm. 18A
-
39

Rockville, MD 20857

301
-
443
-
3449

mnehring@hrsa.gov

Noyes
,

Deborah,
DMD, MS

O
-
6,

CAPT

Ex
-
officio member

U.S. Coast Guard
Representative

-

USCG

USCG


Commandant

2100 2
nd

Street SW

Was
hington, DC 20593
-
0001

202
-
267
-
0801

dnoyes@comdt.uscg.mil

Pannabecke
r,

Gary L.,
DDS

O
-
6,

CAPT

Voting member

2005 DePAC Chair

2005

IHS

Blackfeet Community Hospital

P.O. Box 760

Browning, MT 59417

406
-
338
-
61
80

Gary.Pannabecker@mail.i
hs.gov









Page
23



USPHS Dental Newsletter February 2005


Ricks
,

Timothy L.,
DMD, MPH

O
-
5,

CDR

Voting member

2005 DePAC Vice
-
Chair

2006

IHS

Schurz Service Unit Dental

P.O. Box 227

Nixon, NV 89424

775
-
574
-
1018

Ext.
224

Tim.Ricks@ihs.gov

Rodriguez
,

Jose, DDS

O
-
5,


CDR

Voting member

Awards Workgroup Chair

2006

IHS

Pine Ridge Indian Hospital

P.O. Box 1201

Pine Ridge, SD 57770
-
1201

605
-
867
-
3078

jrodriguez@abr.ihs.gov

Saville
,

Suzanne K,
DDS

O
-
5,

CDR

Voting member

Career Development
Subcommittee Chair

2005

USCG

Ralph R. Nix Medical Clinic

599 Tomales Road

Petaluma, CA 94952

707
-
765
-
7516

ssaville@d11.uscg.mil

Scheper
,

Robin A.G.,
DDS

O
-
5,

CDR

Voting member

Call to Action WG Chair

Mentoring Workgroup Chair

2006

USCG

USCG Training Center

1 Monroe Avenue

Cape May, NJ 08204

609
-
898
-
6960

RScheper@tracencapemay
.uscg.mil

Torna
,

Stephen P.,
DMD

O
-
5,

CDR

Voting member

Communications Workgroup
Chair

2007

IHS

Crow Indian Hospital

Dental Department

Crow Agency, MT 59022

406
-
638
-
3472

Steve.torn
a@mail.ihs.gov

Webb
,

James, DDS

O
-
5,

CDR

Voting member

Operations Subcommittee
Chair

2005

IHS

PHS San Carlos Indian Hosp.

P.O. Box 208

San Carlos, AZ 85550

928
-
475
-
7354

James.webb@ihs.gov

Wisner
,

Stella L.
,
DDS

O
-
4,

LCDR

Voting member

Membership Workgroup
Chair

2007

BOP

MDC Los Angeles

535 North Alameda Street

Los Angeles, CA 90012
-
3045

213
-
485
-
0439

Ext. 164

swisner@bop.gov

Woods
,

Phillip D.,
DDS, MPH

O
-
4,

LCDR

Vot
ing member

Minority Issues
Subcommittee Chair

2007

BOP

FCI Phoenix

37900 North 45
th

Ave.

Phoenix, AZ 85086

623
-
465
-
9757

Ext. 159

PWoods@bop.gov














Organization

Meeting

Meeting
date

Location of
meeting

Fed
eral Dental Educators (FDEC)

FDEC Conference

Jan. 26
-
28

San Antonio, TX

National Dental Association (NDA)

Mid
-
Winter Conference

Feb. 10
-
13

Miami, FL

American Dental Education Association (ADEA)

Annual Meeting

March 5
-
9

Baltimore

International Associati
on of Dental Research

Annual Meeting

March 9
-
12

Baltimore

Academy of General Dentistry (AGD)

Strategic Futures
Conference

April 14
-
17

Rosemont, IL

American Association of Public Health Dentistry (AAPHD),
Association of State and Territorial Dental Direct
ors (ASTDD)

National Oral Health
Conference

May 1
-
6

Pittsburgh

American Dental Association Committee on the New Dentist (ADA
CND)

19
th

New Dentist
Conference

June 23
-
25

Chicago

Academy of General Dentistry (AGD)

Annual Meeting

July 13
-
17

Washington

Soci
ety of American Indian Dentists (SAID)

Annual Meeting

July 14
-
17

Albuquerque

American Association of Women Dentists (AAWD)

Annual Meeting

July 14
-
17

Washington

National Dental Association (NDA)

Annual Meeting

July 29
-
Aug. 3

Las Vegas

American Dental Ass
ociation (ADA)

Annual Meeting

Oct. 6
-
9

Philadelphia

Association of Military Surgeons of the U.S. (AMSUS)

Annual Meeting

Oct. 30


Nov. 4

Nashville

American Public Health Association (APHA)

Annual Meeting

Nov. 5
-
9

New Orleans

Hispanic Dental Association
(HDA)

Annual Meeting

Nov. 17
-
19

San Antonio