The Year in Review
Tumult and change lead to energy and hope.

Perhaps a Greek chorus would be appropriate, or maybe a single, strolling minstrel spouting Shakespearean verse.

Maybe this was one for a contemporary eye and voice -- Bruce Springsteen, maybe.
Or it could be that the whole thing is best considered by friends sharing a jar or two at the local alehouse.

"Nineteen ninety-eight," they could intone, shaking their heads and cracking rueful smiles. "Now THAT was some year."

How true, and for so many reasons.

For the California Dental Association, 1998 was quite a ride. It started as an uncertain, bumpy gambol over a pitted road and ended as a fairly smooth cruise over new asphalt. With some fancy stunt driving in between.

In essence, it was a year of uncertainty, hope, tragedy, renewed hope, accomplishment and, ultimately, satisfaction, relief and growing energy.

Backdrops for CDA's year varied. Much of the significant action was within the association's headquarters, where a true drama played out, resulting -- finally -- in the ascension of a hopeful, strong staff leader in the wake of nearly two years of change. At the Capitol, the association enjoyed its second year of notable success in helping form legislation and guide it through to the governor's signature. Two dental professionals were elected to the state Legislature for good measure. Statewide, fluoridation became a reality in a growing number of communities. A large member dues increase was defeated at the ADA House, and a moderate boost was passed by the CDA House. The association's Scientific Sessions weathered a year of bad traffic and parking in Anaheim and looked ahead to innovative ways to deal with similar challenges this year.

And the association is getting its day in court following a Supreme Court decision to hear CDA's appeal of lower court ruling in the case brought by the Federal Trade Commission.

Meet the New Boss

Timothy F. Comstock became CDA executive director on July 30, and he quickly established himself as formidable leader and communicator.

Comstock, 52, an administrator, educator and author with deep roots in Sacramento, took over for acting Executive Director Eugene Sekiguchi, DDS, the former CDA president who was appointed to the temporary post in October 1997.

Comstock became the fifth person to be named the association's exec in two years. Longtime Executive Director Dale F. Redig, DDS, retired in June 1996 after 18 years of service. He was replaced by Kenneth L. Zakariasen, DDS, who served until resigning in October 1997. Sekiguchi served from October until April 30, 1998, the day before Thomas P. Nagle was to take over. But Nagle died May 1, sending shock waves through the association and leading Sekiguchi to serve as acting executive director while another search was done.

That search produced Comstock, whose ready smile, considerable wit and direct style already has become part of the association's fabric.

"I do not want 'yes people' running around in my shop," he said. "I want to be challenged by my staff. I am successful because I know I don't have all the answers.

"CDA is a marvelous enterprise, with a talented and creative staff and a dedicated roster of volunteers."

Donning Another Hat

Comstock's entrance was just part of the drama; Sekiguchi's exit was another.

The longtime volunteer from the San Gabriel Valley most likely spent more time at CDA's Sacramento headquarters than any volunteer -- ever. He was in the final quarter of his run as association president when the Executive Committee asked him to assume the top staff position when Zakariasen resigned.

Initially, Sekiguchi was to be in the office one or two days a week, but quickly it became evident that a full-time presence was necessary. Sekiguchi responded by leaving his private practice to his two dentist children and setting up shop in Sacramento. There, he endured lingering and understandable staff unrest and volunteer concern while helping keep member programs moving forward.

"Gene is truly appreciated and greatly thanked for what he did," said 1998 CDA President Kenneth E. Lange, DDS. "His dedication has been unwavering."

In May, Sekiguchi was nominated to be the 13th District trustee to the American Dental Association, and the ADA House elected him to that four-year post in October.

Looking back on his adventure, Sekiguchi said, "We are not defined by doing only the things that are easy or popular. If you do your job well, there are many opportunities where you are at risk."

Drinking In the Success

Efforts that in some cases began more than three decades ago began paying off as several cities -- including Los Angeles -- showed their political will and decided to fluoridate their water supplies.

Those decisions came in different forms, some administrative, some at the ballot box. The results are the same, however: potential improvement in the oral health of more California citizens.

In the small Northern California town of Yuba City, the City Council decided to fluoridate, acknowledging the ongoing efforts of organized dentistry and grassroots support.

It was a team approach, with people in our society, local citizens, and many others, said Robert L. Ripley, DDS, president of the Butte-Sierra District Dental Society. "It's the kind of team effort that is needed for success."

More significant is that the fluoridation affects 8,900 water rate-payers, below the threshold of 10,000 set by AB 733, the legislation calling for fluoridation of community water supplies in California.

A month later, Los Angeles -- which, like Yuba City, had fought the fluoride war since the early 1960s -- announced its plans to fluoridate. Announced by staunch proponent Councilwoman Ruth Galanter, the move in Los Angeles became possible when the Los Angeles Department of Water and Power identified in its budget money that could be used for the project. That budget was adopted by water and power commissioners with the fluoridation provision.

The move was hailed for its statewide significance and for the behind-the-scenes work done by a varied group, including the Los Angeles Dental Society.

Finally, in a significant election outcome, voters in the Bay Area community of Mountain View approved an advisory measure that supports fluoridating their municipal water supply.

Considered a lynchpin community, the outcome may lead to approval for fluoridation for the rest of the 1.7 million residents of Santa Clara County.

CDA provided about $50,000 in support for the campaign to get the Mountain View measure passed.

CDA's support was absolutely essential to the victory," said Joseph Simitian, a Santa Clara County supervisor and strong proponent of fluoridation. "It allowed us to do a full-fledged campaign that was very focused on the simple message that fluoridation is safe, effective and economical."

Another Banner Year

In a virtual repeat of the previous year's success, CDA's 1998 performance at the Capitol was another boost for dentistry.

Led by the Council on Legislation and the Government Relations Office, the association worked a winning program through the state's lawmaking labyrinth, finding Gov. Pete Wilson's signature on all but one of the association-backed bills that went through the Legislature.

The success was another example of how CDA's pursuit of bipartisan backing and support is translating into effective lawmaking.

"We certainly worked with all members of the Legislature on our proposals, from both political parties," said COL Chair William J. Emmerson, DDS.

Passed into law was a bill requiring health insurers and plans to cover general anesthesia services in hospitals or surgery centers for dental patients whose clinical status or underlying medical conditions warrant it.

"It took a lot of negotiation and discussions with health insurers and plans and the administration to get this bill enacted," said Liz Snow, director of the Government Relations Office.

Also signed, among others, were bills dealing with the regulation of silver waste; a BDE certification process for certain types of sedation on minor children; adding a dentist to the Healthy Families Program Advisory Panel; and permitting for MD anesthesiologists providing anesthesia services in dental offices where the practicing dentist does not have a permit.

"Our track record is remarkable," Comstock said of the continuing legislative success.

Ready to Serve

As expected after their impressive primary victories, two California dental professionals were elected to the state Assembly.

Republicans Sam Aanestad, DDS, a Grass Valley oral surgeon, and Charlene Zettel, RDH, a Poway school board member, beat their respective opponents handily to give the Legislature some additional expertise on dental and health care issues.

Aanestad won the 3rd District seat with about 61 percent of the vote. Zettel got 64 percent of the vote in taking the 75th District seat.

"There are very few people who get to go to Sacramento and vote yes or no on things that affect our lives and the lives of our children," Aanestad said. "It's a compelling part of the job."

Zettel said, "I'm looking forward to working closely with CDA and see what kid of efforts we can do to work together to reform the system and help provide even better health care for citizens."

Road to Improvement

Plans already are under way to deal with a whole city's worth of headaches faced by the association's Spring Session in April 1998. As usual, CDA's annual showpiece was a thing of precise beauty on the inside, but extensive construction work made getting to and from the Anaheim Convention Center a pain for many.

The road work will continue during the 1999 Session, April 8-11, but the association's Council on Scientific Sessions and the Sessions Department staff have been working to ease the challenges faced by motorists trying to attend.

Along with regular bus service and off-site parking, the convention will take advantage of other facilities to offset work being done to upgrade the Convention Center.

To help attendees find the most-effective routes to the show, CDA's Sessions and Publications staffs will work together to present a comprehensive picture of the Spring Session through a series of articles and graphics in CDA Update.

Harvey Barish, DDS, chairman of the Council on Scientific Sessions, said that by remaining in Anaheim during the period of construction, CDA will maintain a higher priority status than organizations that moved out of that city during the work.

ADA Marketing Proposal Fails

ADA delegates defeated a proposed national public awareness campaign during their annual House Oct. 24-28 in San Francisco.

They turned down a proposal which if passed would have required members to pay $304 annually for three years to support the $90 million marketing campaign.

Instead, delegates approved a substituted resolution that will cost members $10 per year. It provides an avenue for some state dental societies to use materials already created for the public awareness campaign in their local efforts.

Even many delegates who opposed the campaign said they supported the concept but resisted the way it was funded. One oft-voiced argument was that the relatively high price tag associated with the program would drive away members and, in turn, drive up the price of the program to remaining members.

CDA Dues Increase Succeeds

Heeding the new executive director's call for passage of a 1999 budget that included a $44 annual dues increase, delegates at the 1998 CDA House did him a buck better, approving a budget featuring a $45 increase.

The result was widely seen as a vote of confidence in Comstock, who asserted that the increase was necessary for the association if it was to maintain current programs. Comstock also vowed that a thorough association-wide program assessment will be completed in 1999 and that the results of that assessment will be a critical part of putting together future budgets.

The increase was the second in two years for CDA, which since the early 1980s held firm against dues increases, opting instead to utilize windfalls and other non-dues revenue to augment yearly operating budgets. With those sources bearing less fruit each year, the hard choice became clear: Cut programs or boost dues.

Awash in the positive atmosphere surrounding the new executive director, delegates in effect made a good-faith gesture -- with the full expectation that specific price tags will accompany all programs included in the budget.

Going to The Show

In a move that could end a long-running legal battle, the U.S. Supreme Court agreed to hear the case between CDA and the Federal Trade Commission.

Oral arguments were scheduled to be heard Jan. 13. Peter Sfikas, the ADA's legal counsel, will argue on CDA's behalf. CDA chief legal counsel Raoul Renaud will also be in Washington representing the association.

The outcome is expected to determine whether the FTC has jurisdiction over a nonprofit association's right to restrict advertising by its members.

"The decision (to hear the case) means that the court will review the two issues we've asked it to consider: whether the FTC has jurisdiction over nonprofit professional associations; and whether the commission properly applied the antitrust laws to the activities of the CDA," Sfikas said.

The confrontation began in 1985 when the FTC began investigating advertising restrictions appearing the CDA's Code of Ethics that prohibit false and misleading advertising relative to cost and quality of service.

"The end of that long journey is now approaching," Renaud said, "and I am confident that it will be proven a worthy effort."