The GLP 1 Effect: From Medical Trend to Dental Risk - Julie Goldberg, DDS, CCDS July 2026 E NEWS

The GLP 1 Effect: From Medical Trend to Dental Risk

Author: Julie Goldberg, DDS, Professional Dental Risk Specialist at PMIG

GLP 1 receptor agonists, commonly prescribed for type 2 diabetes and weight management, are now encountered routinely in dental practice. While not dental medications, GLP 1s introduce emerging professional liability exposures; these exposures extend beyond sedation and anesthesia to include xerostomia, caries progression, periodontal concerns, treatment planning complications, and potential informed consent gaps. This article will explore how a failure to account for GLP-1 medication effects may be cited in malpractice allegations and will offer strategies to mitigate the likelihood of such allegations.

Sedation and Procedural Risks

GLP 1 receptor agonists are associated with delayed gastric emptying, increasing the risk of:

• Residual gastric contents despite fasting
• Regurgitation and aspiration
• Nausea and vomiting during procedures

These risks are most relevant for patients undergoing:

• IV sedation
• Oral sedation
• General anesthesia
• Lengthy or invasive dental procedures

Aspiration events, while uncommon, are high severity claims with substantial exposure.

• Post event allegations commonly include:
• Failure to identify GLP 1 use
• Proceeding with sedation despite increased aspiration risk
• Inadequate informed consent
• Deviation from accepted safety practices

Oral Health–Related Risks

GLP 1 use has also been associated with side effects that directly affect dental outcomes, including:

• Xerostomia (dry mouth)
• Dietary pattern changes
• Enamel erosion secondary to nausea
• Increased caries and periodontal risk

When these factors are not identified, documented, and addressed, dentists may face allegations of:

• failure to diagnose,
• failure to warn, or
• failure to modify care despite identifiable risk factors.

Risk Management Strategies

1.         Improve Medical History Processes

• Update intake forms to specifically ask about injectable and weight loss medications
• Train staff to flag GLP 1 drugs
• Reconfirm medications prior to sedation or major procedures

2.         Identify and Manage Xerostomia

• Assess salivary flow during examinations
• Document findings and patient counseling
• Adjust preventive plans (fluoride, recalls, saliva support)

3.          Individualize Sedation Decisions

• Account for GLP 1 use when selecting sedation type and timing
• Use caution during early therapy or dose escalation
• Delay elective sedation when risk assessment is unclear

4.         Strengthen Informed Consent

• Discuss medication specific risks when relevant
• Document patient understanding and questions

5.         Coordinate Care and Document Reasoning

• Communicate with prescribing clinicians when medication issues affect care
• Document clinical rationale when proceeding, modifying, or postponing treatment
• Maintain flexible protocols that allow individualized judgment

GLP 1 receptor agonists represent a multifaceted and evolving professional liability exposure for dental practices. Practices that proactively identify medication use, assess oral side effects, individualize care decisions, and document clinical reasoning are best positioned to reduce claim exposure and enhance defensibility.

For questions related to dental risk management, contact Dr. Julie Goldberg, Senior Dental Risk Specialist with PM Dental Protect, PMIC. julie.goldberg@phmic.com.

This information is intended to provide general information only on specific risk management topics. It is not intended to provide coverage determinations or coverage positions, nor is it to be construed as legal, medical, or professional advice in any form whatsoever. 

5th Annual Oregon Oral Cancer Foundation Walk/Run - Kyle Isaacs BHS, RDHEP - CCDS July 2026 E News

5th Annual Oregon Oral Cancer Foundation Walk/Run September 12 Corvallis

Kyle Isaacs BHS, RDHEP

Greetings all dental professionals! Preparations are now underway for the 5^th annual Oregon Oral Cancer Foundation walk/5K run and oral cancer screening. This year almost 58,500 Americans will be diagnosed with oral and oropharyngeal cancers, and these diseases will result in 13,500 deaths, killing roughly 1 person per hour, 24 hours per day. Unfortunately, the 5-year survival rate for those newly diagnosed is about 57%, a statistic that has not improved significantly in decades. Oral and oropharyngeal cancers have a higher death rate than many other cancers, but not a lot of people know about or have them on their radar. This is partly why I have dedicated my time and energy to organizing these events, to raise more awareness and to raise much needed funds to support education, research, and to help survivors and their loved ones.

I talk to many people who are newly diagnosed, survivors of several years, family members of survivors and those who have succumbed to the disease. Overwhelmingly, I hear the same story, “I had never heard about this cancer before my diagnosis.”  It is my hope that we can continue to increase awareness to not only the disease, but also the importance of annual thorough screening and early diagnosis for best outcomes for patients.

Last year we had 130 people in attendance with three survivors and a family of a young person who succumbed to oral cancer. Katelynn Romviel, a young tongue cancer survivor shared her journey with oral cancer, how it changed her life, and how coaching a teen dance troupe helped save her life. I think I can say, most of us did not have dry eyes.  Back by popular demand, we will Brenda Cortez will be creating amazing face art with paint, there will be more amazing raffle prizes, and lots of yummy snacks. As of now we have: $200 Amazon card from Cloud Dentistry, a 6-month family membership to the YMCA in Albany, worth more than $600, two water flossers, an electric toothbrush, a massage, a beautiful, framed photo of the Mission Mountains in Montana and more.

We have already raised $5600 with our goal to raise $15,000 through sponsorship from Corvallis Dental Group, CariFree, Capitol Dental, Willamette Dental, Elevate Oral Care, BioGaia, and Aseptico. We would be grateful for any sponsorship or donations you would like to make which are 100% tax deductible.

At the event there will be a contest for the biggest team, the person who raises the most money, and the team that raises the most money. We will again be doing free head and neck screenings and will enjoy a beautiful walk/run along the Willamette River in Willamette Park. So, don’t hesitate, register now and save the date, Saturday September 12^th. You can contact Kyle at 541-740-4694 or kjulin@gmail.com

List of raffle items:

1. $200 Amazon gift card

2. $50 to Top Golf in Hillsboro

3. $100 gift card to Mary Ruth's

4. $20 Book bin gift certificate

5. Private tour and wine tasting with cheese plate for upto 6 people at Willamette Valley Vineyards ($300 value)

6. Massage at Certifiably Serene ($120 value)

7. Quip electric toothbrush, toothpaste and whitening strips

8. Sonic fusion waterflosser

9. Private wine tasting for 4 with charcuterie board at Bluebird Hill 

10. One free acupuncture visit with Corvallis Community Acupuncture

11. Kaady car wash ( 5 free washes, $75 value)

12. 2 Framed photos of the Mission Mountains by Becky Basl

13. One free craniosacral therapy with Becky Bricker, RN

14. 2 tickets to the Oregon Aquarium ($59.85 value)

 

     

Coastal Cascades Dentist Society Update - CCDS July 2026 E NEWS

 

Coastal Cascades Starts Meetups

CCDS started “meetups” in June. Meetups are an informal way to gather, where RSVPS are welcome but not necessary. You can just show up, and if there is a cost, you would pay your own way.  Our first meetup was on June 13^th and was at Mt. Pisgah. Hiking Dentists and Staff gathered and hiked up the mountain. Our next meetup is at PLAY arcade in Eugene on August 11^th. Dentists are welcome and bring staff and/or family, hang out and have fun with other people in the dental community who enjoy games. There is also Bingo on Tuesday nights, so you could get lucky!  We also have another hike scheduled for October 10^th. We will have more details about that event coming soon.

Old Timers Luncheon Met in June

A retiree luncheon was held on the second Tuesday in June. Every year it is on the second Tuesday, so planning ahead is easy!  This year, it was at Roaring Rapids Pizza in Eugene. Attendees included Dr. Bob Carmichael, Dr. James Gant, Dr. John Robinson, Dr. Cedric R. Hayden, Dr. Cedric L. Hayden, Dr. Lohring Miller, and Dr. Lawrence Raugh.  Another retiree luncheon will be held on the Second Tuesday in December, in Corvallis or Albany (TBD). We will have two luncheons a year so retirees can have two opportunities to connect with old friends and make new ones! We are hoping to make this a very special event and look forward to sharing more information soon.

September Social and Partnership with Lane Community College

September 17^th will be our 3^rd Social at Lane Community College in the Healthcare Professionals Building. This gives dentists the Opportunity to mix and mingle with dentists and with dental instructors at Lane Community College. The Lane Community College Foundation cohosts the event.

There are two LCC dental program scholarships that are set up and can be donated to through the LCC Foundation. The Jan Malone Dental Assisting Scholarship was established in 2004 in honor of Jan Malone, who served as the Executive Secretary for 27 years. This scholarship covers the cost of national certification exams for LCC Dental Assisting students. The Jen Helling Memorial Scholarship was established after Jen, a LCC dental hygiene graduate. She was diagnosed with melanoma during her second year in the program. Cancer claimed her life three years after she graduated. This scholarship is for dental hygiene students in their second year.

Improve Patient Experience Dental Office Management Corner with Janette Douglas - Reprinted from LCDS & SWDS September/October 2024 Newsletter

Dental Office Management Corner with Janette Douglas 

Improve Patient Experience

I was in an office recently where a patient was asked about something that was a repeat of the prior week. She was visibly annoyed; the tone was set.

This could have been avoided by being prepared before the patient’s arrival. A checklist ensures that things aren’t missed. Equally important is a designated place to note that each has been addressed. Examples:

 • Unscheduled treatment

• Past due hygiene

• Unscheduled family members

• Outstanding balance due

These are a few crucial pieces of information that, with prior knowledge, will help your staff to know what they are doing and come across confidently. If that had been the case with the annoyed patient, the tone set for that entire visit would have been much different. The additional bonus is that your team member is prepared, so whatever needs attention, it will get resolved before the patient leaves the office.

Final tip: How do you feel when someone remembers your name? If you aren’t taking photos of your patients and entering them into the patient file, I encourage you to do so. A photo to look at before the patient arrives will help with recognition so they can be greeted by name.

In Memorium: Dr. Lewis Blue, Dr. G Franklin Day, and Dr. William B De Lage - CCDS June 2026 E News

 

Dr. Lewis Blue

June 9th, will be our retiree luncheon. This year we have a few dentists who are no longer with us. They will be missed.

Dr. Lewis Blue was instrumental in assisting with the annual 'Old Timers" luncheon. Every year he would help me spread the word about our get together. It was obvious about how much he cared for his dental friends. When I interviewed him for an article back in 2022, he expressed the importance of volunteering for the society, “I would like for an officer or some other respected dentist to call a dentist friend who hasn’t been involved in leadership and ask them to get involved, similar to the way I was prodded many years ago.” He notified me shortly before he passed that was unable make it this year due to being hospice care. Just a few days later I was notified that he had passed.  

Dr. G. Franklin Day spent a lot of time in the service of others. He was known for providing care to a lot of students who had dental issues without charging them. After retirement he taught at Lane Community College working with dental hygiene students. Outside of dentistry, he was very active in Kiwanis and his son's scout troop.

Dr. William B. DeLage was originally from Baton Rouge. He enjoyed hunting, fishing and blues music. He also served in the military and was stationed at Fort Lewis, assisting soldiers who were returning from Vietnam. 

 

Links to Obituaries Below:

Dr. G. Franklin Day          Dr. William DeLange          Dr. Lewis Blue

Is Interest Working for You or Against You? Financial Tip by Financial Freedom for Dentists - Reprinted July/August 2024 LCDS & SWDS Newsletter

Is Interest Working for You or Against You?

Financial Tip Provided by Financial Freedom for Dentists

Compound interest can be a key for dentists to generate long-term wealth, however, it can also be a hindrance to wealth generation when you take on large amounts of debt early in your career. Here are 5 ways to minimize the impact of interest on your debt:

1. Obtain a fixed rate. This eliminates the risk of rates continuing to rise.

2. Compare your Annual Percentage Rate (APR) and rate of compounding. This is how you can compare what you will be charged in interest rather than just looking at the simple rate.

3. Shorten loan terms. This will directly save money on interest, but payments may be higher.

4. Increase your payments. By making extra payments you will directly save on interest.

5. Pay with cash whenever possible. For example, buy cars with cash and carry credit card balances.

Read more about this and other strategies at www. financialfreedomfordentists.com/insights Advisory services are offered through Financial Freedom for Dentists, LLC, an SEC Investment Advisor. The information contained herein should in no way be construed or interpreted as a solicitation to sell or offer to sell advisory services where legally permitted.

All content is for information purposes only.

Shocked! Dental Office Management Corner with Janette Douglas - Reprinted July/August 2024 LCDS & SWDS Newsletter

 

Dental Office Management Corner with Janette Douglas

Shocked!

So many dentists I work with are shocked when I show them a “treatment not scheduled” report. They think they are doing great until they see the reality of how much treatment is not being scheduled.

Three tips to ensure your patients will schedule diagnosed treatment.

• Take intraoral photos – I can’t stress enough the impact on your patient of an enlarged photo of calculus or a broken filling. In my opinion, it’s the most valuable and impactful tool in your practice.
• Take your time and don’t act rushed when doing the exam. As Theordore Roosevelt said, “ No one cares how much you know until they know how much you care”. Make sure you have answered all questions to your patient’s satisfaction. Educating your patient is crucial to their proceeding with treatment.
• When presenting a treatment plan, point out the benefit of proceeding with treatment, not just what procedures need to be done. Examples of this would be eliminating pain, reduced risk of a more expensive procedure in the future, etc. Let your patient know they can choose to do nothing and explain the repercussions of that choice.

Please, run a report today, so you have a clear picture of how much diagnosed treatment is not scheduled. You may be as shocked as they are!

Janette Douglas is the owner of JD Dental Consulting. Douglas’ extensive background in practice management led to her passion for helping dental practices by identifying challenges and implementing solutions. She can be contacted at
Janette@JDDentalConsulting.com.

Best Practices for Dental Unit Waterlines - Reprinted from July/August 2024 LCDS NEWSLETTER

                                                   

Best Practices for Dental Unit Waterlines

The tragic incident in Anaheim, California in 2016 brought attention to the crucial issue of maintaining dental unit waterlines. This distressing event occurred at a pediatric dental office, where contaminated water was unknowingly used during procedures, including pulpotomies, on young patients. As a result, numerous children suffered from severe infections, leading to the necessity of strong antibiotics, multiple surgeries, excruciating pain, and the potential for facial disfigurement.

Dental unit waterlines (DUWLs) are crucial components in dental care settings, ensuring the delivery of water for various procedures. However, if not properly maintained, they can harbor harmful microorganisms, posing a risk to both patients and staff. Here are some best practices to keep your DUWLs safe and clean.

The Risks

Dental unit waterlines can become breeding grounds for biofilms, thin layers of bacteria that adhere to surfaces. If contaminated water is used during dental procedures, these biofilms can lead to infections. Therefore, regular maintenance and monitoring are essential to prevent microbial contamination.

1.    Waterline Cleaners

Routine use of chemical cleaners (germicides) specifically designed for DUWLs is a key practice. These cleaners help to break down and remove biofilms. Follow the manufacturer’s instructions for the correct dosage and frequency.

2.    Regular Flushing

Daily flushing of waterlines is an effective way to reduce the accumulation of bacteria. It is recommended to flush each waterline for 20-30 seconds between patients and for a longer duration at the beginning and end of each day.

3.    Water Quality Testing

Regular testing of water quality is essential to ensure it meets the safety standards. The American Dental Association (ADA) recommends testing at least once per quarter.  Water used in dental treatment should meet the Environmental Protection Agency (EPA) standards for drinking water, which is less than 500 colony-forming units (CFU) per milliliter of heterotrophic water bacteria.

Testing the water quality at the output of each waterline is crucial. While some dentists assume that ensuring clean water enters the system is sufficient, it's essential to recognize that biofilm frequently develops within the waterline tubing itself.

4.    Use of Sterile Water for Surgical Procedures

For surgical procedures involving the exposure of bone or sterile tissues, use sterile water or saline delivered through devices designed for such procedures. This significantly minimizes the risk of infection.

5.    Installation of Anti-Retraction Devices

Anti-retraction valves or devices prevent the backflow of oral fluids into the waterlines, which can contaminate the water supply. Ensure these devices are installed and functioning correctly on all dental units.  Regular flushing of waterlines is still recommended even when using these devices.

6.    Adherence to Manufacturer’s Instructions

Follow the dental unit manufacturer’s instructions for the maintenance and care of DUWLs. This includes understanding the specific requirements for the use of chemical agents and the recommended maintenance schedule.

7.    Standard Operating Procedures and Staff Training

Establish and follow written standard operating procedures for infection control of dental unit waterlines. Train all dental staff on the importance of maintaining these waterlines and ensure they fully understand the cleaning and testing protocols. Regular training sessions and updates are essential to maintain high standards of waterline hygiene.

8.    Documentation and Monitoring

Keep detailed records of all maintenance activities, including cleaning, flushing, and water testing results. Regular monitoring and documentation help in tracking the effectiveness of your infection control measures and ensure compliance with safety standards.

Conclusion

Maintaining clean and safe dental unit waterlines is critical for patient safety and the overall success of dental practices. By following these best practices, dental professionals can minimize the risk of infection and provide a safe environment for their patients. Regular maintenance, proper training, and adherence to guidelines are the pillars of effective DUWL management.

Implementing these practices not only enhances the quality of care but also ensures compliance with health and safety regulations, protecting both patients and dental healthcare providers.

 

Kelli Ngariki, Owner

Healthcare Compliance Associates

Coastal Cascades Dentist Society Hosts Green Dentistry Event At Oregon Coast Aquarium - CCDS June 2026 E News

As Coastal Cascades continues to reach out to dentists in more remote areas, it has also reached out to another group, pre-dental students. University of Oregon Pre-Dental Students excitedly traveled to the Oregon Coast Aquarium on May 9th, not only to enjoy exhibits, but to learn about sustainable strategies they can use in their future practices. Dr. Lohring Miller, who lives near Newport, enjoyed interacting with the students and sharing his knowledge throughout the course.

Brittany Cox, MA. RDH was the speaker on Green Dentistry. She has worked with dental practices and manufacturers to set new ecofriendly standards that can improve oral health outcomes. During the presentation, she not only discussed how important it is to minimize waste and pollution in dental practices, but also how doing so by using sustainability concepts can optimize operations and reduce costs. Some of these concepts involve inventory management and preferences for eco-friendly care.

The classroom was set inside the Aquarium and had a glass wall that looked into the shark tunnel exhibit.  Throughout the presentation, sharks swam in the background, reminding attendees of the importance of our oceans and the animals that live there. After the class, everyone was able to enjoy the rest of the aquarium.

The University of Oregon Pre-Dental Students are discovering the importance of dental societies in connecting with dentists, developing mentorship relationships, and learning more about their chosen profession. Coastal Cascades appreciates the enthusiasm and energy they bring to our events when they participate or volunteer.

    

Building a Strong Digital Presence: Social Media Strategies for Patient Engagement - June 2026 CCDS E NEWS

 

Building a Strong Digital Presence: Social Media Strategies for Patient Engagement

By Kayla Mauldin, Founder, Firelight Marketing
Former dental professional with 23+ years of industry experience

When a potential patient searches for a new dentist, finding your practice is only the first step. What they do next often determines whether they choose your office—or continue looking.

In many cases, that next step is checking your social media.

While social media is often associated with trends and entertainment, for dental practices it serves a different purpose. It acts as a window into your practice—helping patients get a feel for your environment, your team, and the level of care they can expect before ever picking up the phone.

Social Media Is Part of Your First Impression

Patients today are more informed and selective than ever. After finding a practice on Google, many will visit social media platforms like Facebook or Instagram to learn more.

They’re not necessarily looking for polished marketing—they’re looking for reassurance:

• Is this office clean and professional?
• Does the team seem approachable?
• Does this feel like a place I’d be comfortable visiting?

A well-maintained social presence helps answer those questions quickly and naturally.

Education Builds Trust Before the Appointment

One of the most effective uses of social media in dentistry is patient education.

Simple, informative content can go a long way in building trust:

• Explaining common procedures
• Answering frequently asked questions
• Sharing what patients can expect during a visit

This type of content helps reduce uncertainty and anxiety—two of the biggest barriers preventing patients from scheduling care.

When patients feel informed, they’re more likely to move forward with confidence.

Consistency Matters More Than Perfection

A common misconception is that social media requires constant posting or highly produced content. In reality, consistency is far more important than perfection.

An inactive page can create doubt. If a patient sees that the last post was several months—or even years—ago, it may raise questions about whether the practice is still active or engaged.

Maintaining a steady presence, even with simple updates, signals that your practice is current, attentive, and accessible.

What Should Dental Practices Post?

One of the most common questions is, “What should we actually be sharing?”

The answer is often simpler than expected. Patients are not looking for elaborate campaigns—they’re looking for authenticity and insight into your practice.

Some effective and approachable content ideas include:

• Celebrating team milestones such as birthdays or work anniversaries
• Sharing moments from team meetings, trainings, or continuing education (such as CPR certification or safety training)
• Highlighting office updates, new technology, or improvements
• Featuring behind-the-scenes moments that reflect your team culture
• Promoting seasonal reminders or relevant services (cleanings, whitening, back-to-school visits)

These types of posts help humanize your practice and show that your team is engaged, knowledgeable, and continually improving.

Real Content Builds Stronger Connections

Patients connect with authenticity. Real photos of your office, your team, and your day-to-day environment tend to resonate more than generic stock images.

Content that reflects your actual practice helps patients feel more familiar before they ever walk through the door. This sense of familiarity can make a significant difference in reducing anxiety and building trust.

When appropriate and with proper consent, sharing real patient experiences can also reinforce credibility and outcomes.

Social Media Supports the Patient Journey

Social media does not replace your website or your Google presence—it supports them.

A typical patient journey may look like this:

1. Search for a dentist on Google
2. Review ratings and location
3. Visit the website
4. Check social media for reassurance
5. Decide whether to call or schedule

Each step builds on the last. A strong social media presence helps confirm that the patient is making the right choice.

The Takeaway

For dental practices, social media is less about marketing and more about connection. It provides an opportunity to educate, reassure, and build trust before the first appointment.

A consistent, authentic presence can help patients feel more comfortable choosing your practice—making it an important part of a well-rounded digital strategy.