Guest column: Coping With Conflict – Part Two

A Layperson’s guide to resolving conflict in the office

By Daniel A. Bobrow, MBA

President, American Dental Company

Part two in a series of two articles

In last issue’s article, we discussed models and tenets used to resolve conflict. In this part, I’ll go over the skills necessary that, once mastered, can greatly assist you in managing and resolving conflict in your office.

Active Listening

Truly listening and showing with your body language a sincere desire to know what the person is saying is vital. A person must feel that they are being heard for any resolution of any conflict or problem to occur. This can be further demonstrated by some of the points below.

Mirroring

Restating conceptually what is said to you to confirm your understanding. Care should be taken to “neutralize” statements by eliminating or changing words that are emotionally charged or are accusatory.

Pacing

Another method has to do with understanding and matching the tone and pacing of a person’s speech pattern, and, if needed slowing it down. The goal being to calm the person so a more productive conversation may take place.

BATNA

This is an abbreviation for Best Alternative To a Negotiated Agreement. It involves asking the person to consider what the best possible outcome will be if a mutually agreeable settlement can not be reached. An example of the use of BATNA is: “Joseph, I know you don’t like making reactivation calls in the evening. But you’re the only one on our staff who is capable of doing so. And you remember the mess we were in before we brought you on. What do you think will happen if we just stop doing this?” Embedded in this sentence is another technique called stroking (see below).

Reality Test

Similar to BATNA, reality testing attempts to get the person to see that his or her proposed solution is unrealistic, or at least, not optimum.

Blame Yourself, Not Others

A great way to neutralize tension during the mediation session is for the mediator to take responsibility for any misunderstandings or uncomfortable situations that might arise. For example, if a party grows impatient while the other party is speaking, you might say “I’m sorry for not giving you an opportunity to speak, Sam. Just as soon as Bill finishes, you’ll have your chance.”

Ask “Harmless” Questions

Ask “leading” questions: especially when the parties seem to have reached an impasse, ask “safe” questions that get the parties talking again. For instance, you might say “Whose turn is it to get lunch today? I’m starving!” or “By the way, did I remember to thank you both for helping me juggle those four patients this morning? I owe you for that one!”

Stroking

Let the parties know that they’re doing a great job in the mediation, and you really appreciate their willingness to sit down and talk things over. It’s too bad more people are not willing to talk and listen.

The goal of all the above techniques is to get people to see for themselves why resolution of the conflict is in everyone’s interest, including theirs. If someone feels that they are being manipulated, or that a solution is being forced upon them, the parties to the conflict will be less likely to adhere to the proposed agreement. Remember that agreement is not the sole criterion of success. In fact, if either party feels the agreement is “forced on them,” it may do more harm than good.

An Ounce of Prevention

One way to deal with conflict is to create an environment where it is less likely to arise. One way to do this are to anticipate the kinds of conflict between staff members, doctors, and patients, then implement systems and training to prevent these situations from arising. Examples include:

“Personality Conflicts” between staff

Implement some form of compatibility assessment into your employee screening procedure, as well as for current employees. Doing so can help you understand who is most suited for working with whom. Employ active listening and caucus tools (see part 1, last issue).

“Trust is an essential ingredient of a productive and profitable environment,” says Dr. Ira S. Wolfe, DDS, president of Success Performance Solutions. “The willingness of people to exchange ideas and collaborate is thwarted when people are selected and promoted on the basis of skills and experience alone. ” People have to be able to get along with their co-workers in order to have a winning team environment. Wolfe’s SMARRT management process encourages and facilitates matching people who are compatible with the job, the team, and the practice culture. There are also testing procedures that help choose the right person for the right job and assesses their potential compatibility with other staff. Find some technique, test, or company who has experience and proven results in this area to help you with this. Doing this properly will result in less conflict and stress, and higher practice productivity.

Patient Complaints about being kept waiting

Implement a policy of notifying patients in advance if the doctor is running late. Promote a “no waiting policy” as part of your mission statement or declaration of principles. When the occasional complaint does occur, be prepared to use disarming verbiage such as “The doctor asked me to apologize to you for not being able to see you. He is busy with a procedure that has proven more involved than we anticipated. He assures me he will do everything he can to see you as soon as possible. Is that acceptable to you Mr. Jones?” Doing so before the complaint arises in the first place is a great way to show your sincere concern for your patient and respect for their time.

Staff Member refusing to implement changes or “grow with the practice.”

Caucus with that person employing the techniques covered above. Through good communication and active listening you can get to the source of this team member’s unwillingness to work with the team. In many cases, you may discovering something more fundamental going on that has farther reaching implications for the practice.

Another way of preventing conflict is to hire, then educate and motivate staff members to recognize the value of the work they do, and the value of the practice to its patients and the community. Involvement in charitable groups, for instance, can give the practice team a sense of shared pride, and serve to put in perspective the disagreements as self-indulgent exercises that neither the practice nor staff members can afford.

As I am writing this, I am experiencing a poignant example of potential for conflict. I am working on my laptop on a return flight from a conference I’d attended. A rather ample gentleman was seated in front of me. As he reclines his seat, my laptop is thrust into my abdomen. I struggle in vain to position the laptop in a way that will not restrict my breathing. Out of desperation, I at last say, “excuse me sir, I’m sorry to distrub you, but I wonder if it would be possible for you to bring your seat back up just a little bit and still remain comfortable. I realize these seats were not designed with the use of a laptop in mind, but it would be a great help if I could continue working on this article as I am under somewhat of a deadline.” He was immediately accommodating.

In addition to my choice of words, the fact that I had earlier helped this same gentleman avoid a bump to his head by pointing out the open overhead cargo bay no doubt set the stage for his cooperation. As to what I said, I was careful not to use accusatory or demanding language that suggested blame or that I was entitled to anything. I also showed a respect for his comfort, and directed the cause for the situation to the design of the seats. Finally, I offered a reason why I needed to continue my work.

Final Thoughts

Remember, an agreement needs to last, especially if between staff members.

A number of resources are at your disposal if you would like to learn more about how alternative dispute resolution (ADR) can help you achieve more harmonious relations in your practice. Which are appropriate depends on factors such as the number of staff members and the types of conflict you experience. I invite interested readers to contact me if they would like to learn more about these powerful techniques.

Daniel A. Bobrow, MBA is president of the American Dental Company, a Chicago-Based Consultancy serving the dental profession. He has mediated and arbitrated various cases. He is also Executive Director of Climb For A Cause, a non-profit Foundation whose mission is to provide health care treatment and education to people in need worldwide. He may be reached at 312-455-9488 and

Dbobrow@AmericanDentalCo.com or

Director@ClimbForACause.org.

When the Doctor is Away

How you keep the office running

If you as the doctor/owner are planning to be away from the office – even for a day or two – the staff has some free time, too. The doctor/owner or office manager can make lists of things that need to be done.

Make sure that if your absence was somewhat unforeseen, provisions for referring emergency cases to other doctors have been arranged for, and that patients/clients have been rescheduled.

The doctor’s absence provides an opportunity to take care of matters that could not be conveniently handled on days when patients/clients are in the office. For example, this may be the time to have the walls repainted or to have equipment repaired. Of course, the owner should be consulted before this is organized.

The staff should take care of as many tasks as possible on their own, so that an insurmountable pile of unfinished business will not be waiting for your return. Mail should be opened, sorted, and placed in priority order. If any mail comes into the office that needs to be acknowledged, the office manager should send a letter informing the writer that the doctor is away, when he/she will be returning, and that the doctor will answer the letter when he/she returns. If the doctor is going to be away for a long time, a brief summary of the mail and phone calls can be mailed or emailed to him or her, or communicated over the phone.

This is a good opportunity to perform chart purges, contact patients/clients regarding their recall appointments, activate inactive patients/clients and get them scheduled, send out letters, and work on promotional projects.

The owner and the office manager should meet prior to the scheduled absence and form a plan for what the staff should work on during that period. As unexpected absence of the doctor can occasionally occur, the owner and the office manager should determine the policy to govern such an instance which would define what the staff is to do during that time.

AMA Joins AVMA Initiative to Strengthen Medicine

AMA Joins AVMA ‘One Health’ Initiative to Strengthen Medicine by Working Together

The American Veterinary Medical Association (AVMA) announced today that the American Medical Association (AMA) has adopted a resolution calling for collaboration on a One Health Initiative.

The two national, medical organizations will work collaboratively on areas of mutual medical interest, such as pandemic influenza, bioterrorism risks, and biomedical research.

The AVMA One Health Initiative will take another major step forward at the AVMA Convention in Washington, DC, when the AVMA will announce the members of a One Health Initiative Task Force. The new AVMA One Health Initiative Task Force will be charged with developing strategies to promote collaboration among the various health science associations, colleges, government agencies and industries.

Dr. Julie L. Gerberding, director of the Centers for Disease Control and Prevention (CDC) said, “This is fantastic news. I am sure I speak for all of CDC in voicing my complete enthusiasm and support for the One Health Initiative. I appreciate the leadership that the AMA and AVMA are providing in creating this powerful network of health protection.”

AVMA President, Roger K. Mahr, DVM, who has championed the One Health Initiative at the AVMA, testified before the AMA in support of their participation in the Initiative.

“The convergence of animal, human, and ecosystem health clearly dictates that the ‘one world, one health, one medicine’ concept must be embraced. Together, we can accomplish more to improve health worldwide than we can alone,” Dr. Mahr testified.

“New infections continue to emerge and with threats of cross-species disease transmission and pandemic in our global health environment, the time has come for the human and veterinary medical professions to work closer together for the greater protection of the public health in the 21st Century,” said AMA Board Member Duane M. Cady, MD.

The AVMA One Health Initiative Task Force will be comprised of twelve thought-leaders representing various health science professions, academia (including two students), government, and industry.

The AVMA and its more than 75,000 member veterinarians are engaged in a wide variety of activities dedicated to advancing the science and art of animal, human and public health.

SOURCE American Veterinary Medical Association

Optometry Awards Contact Lenses With Seal of Acceptance

World Council of Optometry Awards UV Absorbing Contact Lenses With Global Seal of Acceptance

The World Council of Optometry’s (WCO) Global Seal of Acceptance for Ultraviolet Absorbing Contact Lenses was awarded to Johnson & Johnson Vision Care, Inc. The announcement was made at the annual meeting of the American Optometric Association in Boston.

“In awarding the Global Seal of Acceptance, the World Council of Optometry Global Commission on Ophthalmic Standards (WCO GCOS), which provides independent evaluation of ophthalmic related products, has determined that certain Johnson & Johnson Vision Care, Inc. contact lens brands meet established, recognized and accepted standards that are adopted by the WCO GCOS,” said WCO President Robert Chappell. “These include published standards of International Standards Organization (ISO) and American National Standards Institute (ANSI).”

The ISO and ANSI standards classify UV-blocking contact lenses into two groups based on the lens’ absorptive capacity at its minimum thickness. Class 2 UV-blockers must absorb at least 70 percent of UVA and more than 95 percent of UVB radiation. Class 1 UV-blockers must absorb a minimum of 90 percent UVA and at least 99 percent UVB radiation. Only products that meet these standards may claim to be UV blocking. All of the lenses previously received the American Optometric Association (AOA) Seal of Acceptance for Ultraviolet Absorbers/Blockers.

“Not all contact lens lines offer UV protection, and, of those that do, not all provide similar absorption levels,” explains Cristina Schnider, OD, Director, Medical Affairs, VISTAKON(R), Division of Johnson & Johnson Vision Care Inc.

Experts say the effects of UV radiation are cumulative and can do irreversible harm to all structures of the eye and surrounding tissue that are left unprotected or under-protected. Certain conditions, such as age-related cataract, may not manifest for years at which point the damage is already done and it is too late to reverse the effects of the sun. “That’s why it is important to get maximum protection beginning in childhood,” advises Dr. Schnider. “The most complete measure of UV protection can be achieved with a combination of UV-absorbing sunglasses, a wide-brimmed hat, and UV-blocking contact lenses.”

Because they cover the entire cornea and limbus, UV-blocking contact lenses offer an added level of protection when worn with UV blocking sunglasses. While many sunglasses block UV rays that enter through the lenses, most do not prevent unfiltered rays from reaching the eyes through the sides, as well as the top, and/or bottom of the glasses. Due to their inability to block these peripheral rays, some sunglasses block as little as 50 percent of all UV radiation from reaching the eyes.

“It is just as important to block these peripheral UV rays,” warns Dr. Schnider. “UV-blocking contact lenses provide added protection by effectively blocking sunlight that may enter the cornea from the top, bottom, or sides of the glasses.” Although UV-blocking contact lenses provide important added protection for patients, they should not be viewed as a stand-alone solution. Contact lenses should always be worn in conjunction with high-quality UV-blocking sunglasses and a wide-brimmed hat for maximum UV protection for the eyes.

The World Council of Optometry is an international organization dedicated to the enhancement and development of eye and vision care worldwide. Representing over 200,000 optometrists from 75 member organizations in 41 countries, WCO serves as a forum for optometric organizations to respond to public health needs and opportunities around the world. The WCO is a member of the International Agency for the Prevention of Blindness and maintains official relations with the World Health Organization.

SOURCE: PR Newswire

New Law Requiring Eye Exams for Missouri Children

Optometry Backs New Law Requiring Eye Exams for Missouri Children

With the support of the Missouri Optometric Association, Gov. Matt Blunt today signed Senate Bill 16 into law, requiring comprehensive eye examinations for children entering kindergarten or first grade in Missouri public schools. Local doctors of optometry and the bill’s sponsors, Sen. Delbert Scott (R-Lowry City) and Rep. David Pearce (R-Warrensburg), met with Jefferson City teachers and students in the governor’s office to support this important new law.

“Clear and comfortable vision is essential for learning, and this new law will help Missouri children succeed and reach their full potential,” Gov. Blunt said. “In its first year alone, we expect that this measure will help more than 136,000 children read and see chalkboards more clearly. All Missouri children deserve the tools they need to fulfill their potential, and our students will benefit from this law.”

The new law also requires vision screenings for students beginning first and third grades. Students identified as needing further care will be required to see an eye doctor for a comprehensive exam. The law takes effect July 1, 2008, requiring eye exams for students starting school in the fall.

“Eye exams are still the best way to diagnose eye and vision problems in children early, before they interfere with a child’s ability to learn,” said Thomas Greene, O.D., president of the Missouri Optometric Association (MOA). “The MOA is proud to support true leaders like Gov. Blunt, Sen. Scott and Rep. Pearce in the effort to make children’s vision and classroom learning a top priority.”

Missouri joins Kentucky as the second state in the nation requiring eye exams for children entering public schools. In a survey conducted following the enactment of the Kentucky mandatory children’s eye exam law, 14 percent of the more than 5,000 children entering the school system in 2000 needed corrective lenses, and hundreds of children were diagnosed with eye diseases.

“Vision disorders are considered the fourth most common disability in the United States, though many vision problems in children are preventable or treatable if caught early on,” said C. Thomas Crooks, III, O.D., president of the American Optometric Association, a St. Louis based organization representing more than 34,000 members. “With nearly 25 percent of school-age children suffering from vision problems, this law is necessary to help treat and prevent diseases that can cause vision loss.”

Ten million children suffer from vision disorders, according to the National Parent Teacher Association. Nationally, about 86 percent of children entering first grade do not receive an eye exam. Comprehensive eye exams for children entering school are critical for the early intervention needed to treat diseases and disorders such as amblyopia (“lazy eye”), strabismus, retinoblastoma and other serious and potentially blinding problems that can lead to poor school performance that can ultimately affect quality of life.

Approximately 70 percent of children are insured for comprehensive eye exams through private insurance, Medicaid, S-CHIP or other state or federal programs. Optometrists, ophthalmologists and local charitable organizations have provided ongoing assistance for families in need.

SOURCE: PR Newswire

Expanding Eye and Vision Care in Medically Underserved Areas

Legislation to Expand Access to Eye and Vision Care in Medically Underserved Areas

The American Optometric Association, the voice of 34,000 frontline providers of eye and vision care in communities across America, declared its support for legislation introduced in Congress by Reps. Bart Gordon (D-Tenn.) and Joe Pitts (R-Pa.) aimed at expanding access to eye and vision care in medically underserved communities across america.

Reps. Gordon and Pitts, leaders in Congress on health care access issues, introduced HR 1884, the “National Health Service Corps Improvement Act of 2007.” The bill seeks to build on a successful federal incentive program to develop new links between highly qualified doctors of optometry and communities in rural and urban areas with limited access to eye and vision care services.

“The exclusion of optometrists from the NHSC student loan program has resulted in severely restricted access to primary eye care services,” Rep. Gordon said.

Rep. Pitts agreed, saying, “This legislation corrects this error and ensures that families already struggling with spiraling health care costs can see a local eye doctor when they need to.”

The NHSC provides access to quality health care services for millions of Americans who might otherwise be forced to do without. As part of this mission, the NHSC student loan repayment program helps bring together dedicated health care providers with the rural and urban community health centers that need their services.

The program provides financial support specifically aimed at easing the debt burden associated with a professional education, and allows carefully selected clinicians — including primary care physicians, nurse practitioners, dentists, mental and behavioral health professionals, physician assistants, certified nurse-midwives and dental hygienists — to undertake an extraordinary, multi-year commitment to safeguarding public health.

“Reps. Bart Gordon and Joe Pitts are committed to ensuring that Americans in medically underserved areas, including our seniors, veterans and children, are able to get the eye and vision care services they need and deserve,” said C. Tommy Crooks, O.D., president of the AOA. “Optometrists across the country are proud of Rep. Gordon’s and Rep. Pitts’ strong leadership on health care access issues, and are ready to meet the challenge to get care where it is needed most.”

Since the NHSC student loan repayment program was restructured in 2002, it has been made far less effective by the exclusion of doctors of optometry, the nation’s frontline providers of eye and vision care. Today, only about 17 percent of community health centers have an optometrist on staff, which severely restricts access to primary eye care services, including comprehensive eye exams; detecting and diagnosing eye diseases like glaucoma, cataracts, retinal disorders and eye infections; treating eye diseases and evaluating and treating presbyopia and other vision conditions.

“Including optometry students in the National Health Service Corps Program will help expand the public’s access to preventive eye care services in underserved areas while offering students needed scholarships and loan repayment opportunities at a time of rising student debt,” said Dr. Hector Santiago, president of the Association of Schools and Colleges of Optometry.

In addition to backing from the AOA, HR 1884 is also supported by the Tennessee Optometric Association, the Pennsylvania Optometric Association, the American Optometric Student Association and the Association of Schools and Colleges of Optometry.

Source: PR Newswire/American Optometric Association

Developing Job Descriptions for the Staff

Ensuring Staff Know What They Are Responsible For

Having complete job descriptions act as policy for a practice. When a staff member is given a job to do that is not within the purview of their job description, it can create confusion within a practice. Approved job description manuals act as written arbiters of what a staff member should or should not be doing as related to his or her position. Disagreements can be easily addressed simply by referring to the respective job description manual. Bearing that in mind, it becomes very important to invest sufficient time to creating and editing the manuals to ensure the descriptions do match the job.

The Office Manager is responsible for seeing to it that every staff member has a full written job description manual that would contain:

1. Mission Statement of the practice

2. Office Policies/Practice Rules and Level of Discipline

3. General Staff Member duties and responsibilities

4. Specific duties list and descriptions of how to perform the functions of their position.

Each practice is unique. The job descriptions in one practice can vary from those in another practice. So it is up to each practice to develop job descriptions that truly parallel the functions in that practice.

Developing job description manuals for every staff member is not an overnight process. But if it is addressed methodically, it can be done. Following are steps to follow as you are working to develop the full job descriptions for each position:

1. List out all of the positions within your office.

2. Set up a binder for each respective position in the practice, and work out the duties of each position, including your own, ensuring that they are specific to the position. The binders should include a-d above.

3. List out other areas as they occur to you that should be written out for your job description manual.

4. Present these “rough” drafts to each staff member for the respective position that they hold.

5. Have each staff member go through the descriptions you’ve created and add anything you might have missed.

6. Have the staff members return the drafts to you. From what you get back, now determine what the write-ups are that will need to be completed by the staff members for the positions that they hold. Give them a specified due date to return this to you.

7. There are going to be quite a few detailed descriptions of duties that will need to be done, but don’t try to have them all done at one time. This is going to be an ongoing project that will take teamwork.

8. Determine what the write-ups are that you or your OM should finish..

9. Set up a written project plan that lists out what is to be written up and when it is to be completed.

10. Distribute that plan to each staff member and have him or her proceed to get them finished.

11. Remember not to overwhelm yourself or the staff by setting deadlines that are unrealistic for completing this project.

12. Consider having “get-togethers” where you can all work on the write-ups together. Some offices have organized week-ending potluck “work parties” as they embark on this project.

13. Keep yourself and your staff motivated on this project, reminding one another how helpful it is going to be to the practice as a whole to get all of these job descriptions fully developed.

14. Consider having a “wrap” party once the project has been completed. That will help to provide incentive for everyone to keep pushing on getting this done.

15. Plan to have these job descriptions fully done in about 6-8 weeks.

New Hope for Pets with Chronic Kidney Disease

A new product available only through veterinarians has been shown to reduce the toxins that build-up in dogs and cats with chronic kidney disease (CKD) and may help improve the quality of life for affected pets – and possibly extend their longevity.

“By removing toxins from the system, the supplement performs similarly to kidney dialysis but makes it possible to do so by administering a capsule,” Dr. Eric Linn, director of scientific affairs for Vetoquinol USA, Inc. says of the product, called Azodyl(TM).

“Previously, the only treatments for uremia have been kidney dialysis or transplant, which are impractical for pets and cost-prohibitive for owners,” he said.

CKD is a progressive, incurable disease and a leading cause of death in dogs and cats. It can occur at any age, but is especially common in older cats. There are many causes, ranging from old age to kidney tumors. Signs of CKD include increased thirst and urination, weight loss and lethargy, Linn says.

“The kidneys clear the body of waste via urine, but when they fail to function properly, waste accumulates in the system, circulates through the body and the pet becomes ‘uremic.’ Pets with CKD are essentially poisoned by toxins, which cause the signs of the disease,” he explains.

Azodyl contains Kibow Biotics , a patented formulation of “friendly” bacterial organisms that target and metabolize uremic toxins as they pass through the bowel. The bacteria and toxins are then excreted.

In an independent study, Azodyl reduced signs of uremia in 100 percent of cats with CKD and the patients experienced “improved health and vitality,” reports a California veterinarian who published his results recently in the Journal of the American Holistic Veterinary Medical Association.

The same supplement as Azodyl is being developed for human CKD patients. Product research has been funded in part by the National Institute for Diabetes, Digestive and Kidney Diseases of the National Institutes of Health.

Azodyl capsules are administered in pet food or a treat.

Source: PR Newswire/Vetoquinol USA

From the Editor: Office Basics

Maintaining Stability in your practice

At The Practice Solution Magazine, we are constantly doing surveys of health care professionals to help determine what type of information to provide in our upcoming issues. The interviews we do often paint a vivid picture of problems indigenous to doctors in any profession. This quarter’s edition of The Practice Solution contains articles that address ensuring your practice becomes more stable through written communication that provides common policies for all members of your staff.

The key basics addressed in this issue are creating job descriptions, writing standard policies for your practice and implementing specific policy if you leave your practice for any period of time. You should find these useful

This issue additionally contains the final installment of a two-part series on conflict resolution by Daniel Bobrow, president of American Dental Company and founder of Climb For A Cause. As mentioned in our last issue, Climb For A Cause is a non-profit foundation, whose mission is to provide health care treatment and education to people in need worldwide. It seeks to encourage adventure travel, while emphasizing social action, responsibility and accountability. This year’s climb of Oregon’s Mt. Hood will be July 13, 14 and 15. While this year’s climb is now closed, if you’re interested in participating in the future, contact Mr. Bobrow using the contact information in the article he wrote for Solutions or go to http://www.climbforacause.org. Funds raised from this effort will be used to support dental education and treatment projects in both Guatemala and Cambodia.

Based upon interviews personally conducted on doctors all over the country, staff writer Ken DeRouchie has written an interesting piece on how to ensure you increase your collection percentages and create a higher standard for your practice.

In this issue we also have an assortment of news articles you may find of interest.

We hope you find the information in this issue informative and useful. And, if this is your first visit to our magazine, please take the time to look at some of our past issues for additional material that you may find helpful in the management of your practice.

Sincerely,

Ken DeRouchie

Managing Editor

The Practice Solution Magazine

Device screens patients in minutes for periodontal disease

A portable saliva test device developed by a University of Michigan School of Dentistry professor could tell patients in just minutes if they have periodontal disease, a hefty improvement over current methods which require hours of analysis at an off-site lab.

The saliva test device was developed jointly by University of Michigan’s Dr. William Giannobile and Dr. Anup Singh of Sandia National Laboratories. Testing with the kit has progressed to the point where a dentist would need only a drop of saliva from a patient and less than 10 minutes of time to analyze the sample to determine if the patient has periodontal disease. Current sample analysis requires hours of time at a laboratory away from a dental office.

Giannobile, director of the Michigan Center for Oral Health Research, said that in recent months MCOHR has been conducting tests that are adaptable to using microfluidic technology. “Using a miniaturized lab-on-a-chip approach, we have been able to separate and analyze proteins quickly, typically within minutes of sample separation,” he said. Established in 2003, MCOHR takes discoveries from research laboratories and attempts to find ways to use them to benefit oral health care professionals and their patients.

The saliva test kit measures a tissue-destructive enzyme, matrix metalloptoteinase-8, a molecule which is released from cells that tend to migrate to periodontal lesions.

“Using just a very small sample of saliva, we found our tests to be highly accurate in identifying patients with periodontal disease, without the need for a more time consuming and comprehensive clinical examination,” Giannobile said. “This method could one day be used to screen large patient populations which could have major implications for oral health.”

From late 2005 through 2006, 130 patients were tested at MCOHR clinics in northeast Ann Arbor.

Collaborating with Giannobile are Mark Burns, professor with the U-M College of Engineering, and Dr. Christoph Ramseier and Janet Kinney, both MCOHR research fellows. The National Institutes of Health provided funding for the test studies. The lab-on-a-chip technology was developed and manufactured by Sandia National Laboratories, which has major research and developmental interests in national security, energy, and environmental technologies.

The results of an analytical test appeared in the March 27 issue of the Proceedings of the National Academy of Sciences.

The University of Michigan School of Dentistry is one of the nation’s leading dental schools engaged in oral health care education, research, patient care, and community service. General dental care clinics and specialty clinics providing advanced treatment enable the school to offer dental services and programs to patients throughout Michigan. Classroom and clinic instruction prepare future dentists, dental specialists and dental hygienists for practice in private offices, hospitals, academia and public agencies. Research seeks to discover and apply new knowledge that can help patients worldwide. For more information about the School of Dentistry, visit: www.dent.umich.edu.

SOURCE: University of Michigan School of Dentistry