Championing women in dentistry has been an important area of action for Dentsply Sirona for many years and a cornerstone of Dentsply Sirona’s sustainability strategy “BEYOND: Taking action for a brighter world”. As a result, the company once again fullheartedly supports International Women’s Day and hopes to help spread this year’s motto to “Inspire Inclusion” around the world.

Ahead of International Women’s Day on March 8, Dentsply Sirona, the world’s largest manufacturer of professional dental products and technologies, advocates for a greater focus on women’s equality, representation and inclusion in the dental industry. The company also reaffirms its own commitment to work towards more diversity, equity and inclusion both internally and externally.

“The world has come a long way since the beginnings of International Women’s Day over a hundred years ago, but we still have some distance to go,“ says Andrea Frohning, SVP, Chief Human Resources Officer at Dentsply Sirona. “In a time where more and more women are choosing to join dentistry, we all need to make sure that our industry offers them equal opportunities, values their expertise and recognizes their achievements.”

Inspiring inclusion throughout the industry

Recently named one of America's Greatest Workplaces for Diversity in 2024 by Newsweek, Dentsply Sirona has long been a champion of gender equality in the dental industry, launching and supporting initiatives designed to further inclusion and to increase the representation of women in educational programs, events and case studies to best reflect the makeup of the collective dental industry.

Dentsply Sirona’s relaunched Smart Integration Award is one such initiative. The award honors innovative female dentists and dental technicians for their visionary ideas in digital dentistry, including areas such as digital clinical workflows, patient, community and educational impacts, as well as sustainability practices.

Dentsply Sirona also sponsors a global women speaker development program called "First to 50" which aims to elevate the voices of accomplished female dental professionals and enable more women in dentistry to be represented through speaking opportunities. The program provides access to structured speaker trainings for all levels of experience. Over the years, “First to 50” has grown steadily, with the number of participants per year more than doubling since inception.

Additionally, Dentsply Sirona goes beyond by supporting the “She’s Prime” program in Latin America. Named after the company’s Prime Solutions*, the program aims to help women in the region establish leadership skills and technical knowledge in digital dentistry. The company is empowering the group by providing mentorship, education, and increasing awareness of the important role women play in the dental industry.

Furthering diversity, equity and inclusion internally

Internally, Dentsply Sirona strives to reach global gender pay parity as well as gender parity by 2025 – five years ahead of the 2030 goal set by the Paradigm for Parity initiative, a coalition to which Dentsply Sirona is a signatory. Furthermore, the company has successfully implemented, amongst other things, trainings focused on eliminating hiring bias, mentoring, coaching and leadership programs.

A large role in helping create a supportive and growth-promoting environment at Dentsply Sirona is played by "DS Women", an Employee Resource Group (ERG) that works to elevate female talent through professional development, offering women opportunities to take center stage in the company. It is the biggest ERG at Dentsply Sirona and boasts more than 1,200 members in 40 countries.

Furthermore, Dentsply Sirona recently received a certification for its gender equality measures and practices in Italy as part of a national drive to battle low female employment and close the gender pay gap. To achieve this certification, Dentsply Sirona Italy was thoroughly audited by Bureau Veritas, an independent company providing inspections, conformity checks and certifications. The audit evaluated Dentsply Sirona’s internal gender equality measures based on six key indicators: culture and strategy, governance, human resources processes, opportunities for growth and inclusion of women in the company, remuneration equity by gender, protection of parenthood and conciliation between work and family life.

“As a leader in the dental industry, Dentsply Sirona is committed to driving the movement for gender inclusion and equity in dentistry. We take this responsibility seriously and are working hard to help build a better, more inclusive world for women,” says Andrea Frohning. “We are delighted and grateful for every company and every dental professional who joins us and takes action for more inclusion and more gender equality.”

To learn more about Dentsply Sirona’s DE&I efforts, please visit https://www.dentsplysirona.com/en-us/company/our-company/diversity-inclusion.html

* Dentsply Sirona Prime Solutions: a comprehensive end-to-end offering that enables dental practitioners to focus on treating their patients while leveraging communication and cooperation with dental labs and partners, powered by the cloud-based platform DS Core. Prime Solutions includes Primescan, Dentsply Sirona’s easy-to-use, fast and accurate intraoral scanner; Primeprint, a medical-grade 3D printing system optimized for dental applications and that can run the entire printing process including post-processing, andPrimemill, a 0.5 mm wet/dry grinding and milling unit, highly accurate and ideal for chairside production, reliably delivering first class clinical results.

Since Forward Science's FDA Clearance of SalivaMAX on December 23, 2015, the company has consistently demonstrated the product's effectiveness through multiple clinical studies. Forward Science has partnered with oncology centers showing the benefit of SalivaMAX for cancer patients, along with public health centers to showcase its impact on overall oral health. New data from a study conducted at The University of Colorado’s School of Dental Medicine shows SalivaMAX’s benefits extend beyond soft tissue. See Clifton M. Carey. Remineralization of Early Enamel Lesions with Apatite-Forming Salt. Dent. J. 2023, 11(8), 182; https://doi.org/10.3390/dj11080182

"SalivaMAX has been one of those products that has proven to have many different uses for patient's oral healthcare" shares Forward Science's Chief Scientific Officer Dr. Brian Pikkula. "Our continued support for additional research shows our ongoing commitment to science-based outcomes for our products." Forward Science continues to partner with clinicians to prove the efficacy of its product line. In addition to its current products, Forward Science’s R&D team is actively innovating current technologies to create more cost-effective solutions for better patient outcomes.

To read this study and other research regarding SalivaMAX, please visit https://forwardscience.com/research#salivamax-research

Contact Forward Science here to learn more about partnering with the company.

medmix Switzerland Ltd. continues to enforce its rights as Kettenbach/Xinial is legally prevented from manufacturing or offering its infringing mixing system for sale in Germany, as well as to recall and destroy its infringing mixing system

medmix has won a major victory in the German patent infringement litigation against the Kettenbach/Xinial dental mixing system. The Düsseldorf Higher Regional Court (OLG Düsseldorf) announced on February 1, 2024, in an appeal judgment, that the Kettenbach/Xinial dental mixing system infringes the German part of medmix’s European Patent EP2485852B1 (docket no.: I-15 U 17/23). This judgment is a milestone in the patent dispute which started after the launch of the Kettenbach/Xinial dental mixing system in 2021.

German Injunction – Enforceable Now

The German patent infringement judgment rendered against Kettenbach GmbH & Co. KG and XINIAL Systems GmbH & Co. KG is provisionally enforceable now and provides for an immediate injunction prohibiting Kettenbach/Xinial from manufacturing in Germany the infringing dental mixing system (cartridges and mixing tips) and from offering and selling the infringing system in or from Germany. Therefore, Kettenbach and Xinial are also unable to manufacture the infringing mixing system in Germany not only for local customers but also for export to international customers in other countries.

According to the German judgment announced on February 1st, Kettenbach/Xinial must also render a detailed accounting of the infringing acts, must recall the infringing dental mixing system from all of its German and international commercial customers, and Kettenbach/Xinial must also destroy these infringing products in their possession. The court further ordered Kettenbach/Xinial to pay damages for these infringements. An appeal on points of law was not permitted by the Düsseldorf court. However, Kettenbach/Xinial appealed by filing a complaint against denial by the Court of leave to appeal (“non- admission complaint”).

The validity of medmix’s European Patent EP2485852B1 was already confirmed to-date by the European Patent Office (EPO) in opposition and in appeal, and by judgment of the German Federal Patent Court (BPatG). The latter judgment is under appeal by Xinial.

US Case – Ongoing

medmix also filed a lawsuit in New York against the Kettenbach/Xinial dental mixing system. The New York case is expected to go to trial in early 2025 to address false advertising claims made by Kettenbach and trademark infringement committed by Kettenbach/Xinial. Xinial filed a separate invalidity case at the USPTO against medmix’s US patent. medmix has filed an appeal of the US invalidity case decision.

medmix Switzerland Ltd. operates globally in the field of static mixing tips, cartridges and dispensing devices for the dental sector. Genuine MIXPAC tips can be identified by the MIXPAC™ name stamped on the retaining ring and the CANDY COLOR Quality Seal.

About medmix

medmix is a global leader in high-precision delivery devices. We occupy leading positions in the healthcare, consumer, and industrial end-markets. Our customers benefit from a dedication to innovation and technological advancement that has resulted in over 900 active patents. Our 14 production sites worldwide together with our highly motivated and experienced team of around 2,700 employees provide our customers with uncompromising quality, proximity, and agility. medmix is headquartered in Baar, Switzerland. Our shares are traded on the SIX Swiss Exchange (SIX: MEDX). www.medmix.swiss

Since the dawn of the dental profession, dentists, surgeons and hygienists have agonized over how to relieve back pain caused by uncomfortable and awkward positions leaning over patients. According to a study* published in 2022 of an analysis on neck and low back pain among dental practitioners, nearly 89% of them experience neck and back pain while working. Now, the world's first multi-posture ergonomic chair has been designed to provide needed relief: The Edge Gemini. With kneeling a key position option for users, back pain is brought to its knees, kicked to the curb, and with a one-way ticket outta here.

Created by the team behind The Edge Desk System, the first ergonomic kneeling desk launched in 2016 and sold in 42 countries, The Edge Gemini chair is a three-in-one solution for slumping. A chair perfectly poised for the posterior and knees, allowing for easy position changes during long – or short – procedures. It’s the panpharmacon for poor posture.

The Edge Gemini has:

(1) Normal upright seated position, feet on ground.

(2) Seat tilted forward, feet on ground.

(3) And the superior position for relief: seat tilted forward and user in kneeling position, with Core Activating Technology™.

With easy position change, comfort and stability to the chair’s user, it’s the kneeling position that activates the body’s core, relieving pressure from the back.

“The chair is revolutionary,” according to Robert B. Mongrain, DMD, Director of Clinical Advocacy for Digital Clinical Technologies, Scanners and Labs, Heartland Dental, the nation's largest dental support organization affiliated with doctors in over 1,700 locations. “It’s truly like nothing I have ever experienced before in my 43 years of clinical dentistry. Kneeling is believing.”

The Edge Gemini has height, angle and sacral adjustments, postural seat tilt, multiple armrest settings and multiple kneeling positions to ensure sitting and kneeling are tailored to an individual’s body.

“The ability to change positions from sitting to kneeling during long procedures offers great benefits for posture, comfort and overall well-being,” said Gary A. Morris, DDS, prosthodontist and clinical assistant professor at Southern Illinois University’s School of Dental Medicine. “I’ve seen all the different chairs in the dental market, and the unique thing about The Edge Gemini is it wraps them all in one.”

U.S. and China patent pending, and made of medical grade material for easy cleaning, The Edge Gemini’s kneeling position distributes the user’s weight taking pressure off the back, neck and shoulders. This allows the body to rest in a comfortable natural position with relaxed shoulders.

According to University of Southern California’s Clinical Assistant Professor of Physical Therapy, Dr. Jared Vagy, PT, DPT, OCS, CSCS, “When you transition from the sitting to the kneeling position, the brain sends a message to your core to engage and stabilize your body. It’s activating the muscles in the abdomen and lower back, holding the spine in a neutral position. This is truly the first core activating seating solution.”

“Creating The Edge Gemini was the natural evolution from The Edge Desk,” according to Marc Rosenberg, The Edge founder and CEO. “We’ve all heard for years how sitting too long in one position is bad for overall health, and that includes being bad for the back and posture. The three positions of the chair address this issue with seamless transition between sitting and kneeling modes. But then we found it allows for precise positioning over a patient while staying in perfect focal length for loups. We knew then, this was something the dental world in particular needed.”

Hundreds of dental professionals have sat in the chair, and when in the kneeling position the anecdotal response has been an overwhelming, “Whoa,” as they immediately felt back pressure relieved.

“Using The Edge Gemini daily, I’ve found at the end of the day I’m not complaining that I’m tired, and I don’t feel the back and neck pain I was feeling in the past. And when I’m in the kneeling position, I can swing my leg out to use a pedal and not need to change positions,” remarked Dr. Morris.

The Gemini Edge makes a believer of those who experience it. The chair is the right option for anyone who sits for hours on end and wants, and needs, the transforming seating settings and the accompanying sigh of relief. This includes a wide range of professionals, including eye surgeons other medical professionals, even gamers.

Cancel the chiropractor, forget the acupuncturist, buy the chair.

For more information and to pre-order The Edge Gemini, email: marc@theedgedesk.com.

* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9469284/

With spring break, wedding season, prom, and graduation all around the corner, ensure that your patients are ready for the photo ops and precious moments these special events will create with a white smile that stays fresh. The all-new Arm & Hammer Toothpaste Plus TheraBreath Breath Fresheners can do both.

This game-changing toothpaste not only fights bad breath bacteria, but it also gently whitens teeth, deep cleans teeth and gums, and protects against cavities. The secret is in the innovative formula that gives users the confidence to know that their breath is fresh by providing a teeth-cleaning experience that is smoother and better tasting than ever. Additional Arm & Hammer Toothpaste Plus TheraBreath Breath Fresheners benefits include:

1. Removes up to 3x more plaque in hard-to-reach places compared to a leading toothpaste.

2. Gently whitens with the natural power of baking soda plus TheraBreath™ breath fresheners.

3. Provides 4 benefits in 1: Cavity protection, deep cleans teeth & gums, fights bad breath, and enamel-safe whitening.

Visit the Arm & Gammer store on Amazon for more information.

The Denobi Awards, an industry-wide dental awards program celebrating outstanding individuals and dental teams, held its fourth annual red-carpet gala today and named 10 individuals and two dental teams as recipients.

The Denobi Awards Gala is the premier celebration recognizing and honoring excellence in dentistry and is focused on honoring “unsung heroes” from all roles in dentistry – those who’ve made outstanding contributions to the world-wide dental industry. With the 2024 gala exclusively sponsored by John Stamper Media, hundreds of nominations were received and a shortlist was released in January. In partnership with the National Mobile & Teledentistry Conference, the prestigious gala took place on March 2, 2024 in Dallas, TX.

"Denobi Shortlisters and Winners have gone on to do amazing things around the world! For some, it's been instrumental in advancing their careers. For others, it's helped them launch organizations, kickstart initiatives, receive funding and work toward legislative and industry change,” stated Melissa Turner, co-founder. “Big things are on the way for The Denobi Awards program, and we're excited to make an even bigger impact in the future!"

This year’s gala was hosted by industry leaders Katrina Sanders and Dale Stewart and introduced a new award, the Speaking Consulting Network Rising Star Award. The evening culminated with the presentation of the Dr. Lou Shuman Denobi Pinnacle Achievement Award, the program’s highest honor recognizing an individual whose leadership and ongoing contributions have dramatically impacted the profession. The recipient of the 2024 pinnacle award is Noah Levine, Editorial Director at MJH Life Sciences.

"Winning a Denobi Award is unlike anything else in dentistry as winners join an elite group of leaders at the forefront of change and innovation. We're proud this is not a popularity contest, “ stated Sonya Dunbar, co-founder. “Instead, the program is focused on giving honor where honor is due and bringing awareness to the outstanding initiatives the nominees are taking part in."

Congratulations to the following 2024 Denobi Award winners:

Allison Norris, Founder & CEO (SCN Rising Star Award) – Founder & CEO, Dentele Group

Amy Wood, HCISPP – CEO, Copper Penny Consulting

Brian Colao, Director – Member & Director of the Dental Service Organizations Industry Group at Dykema

Christy Jo Fogarty, BSDH, MSOHP, LHD, ADT – Founder, Fogarty Dental Services

Dana Watson, BSE, FAADOM – Practice Manager, Midtown Smiles

Jonathan Bonanno, Ph.D. Candidate – Founder, Chief Psycho; CTO, Clinical Excel Computech

Noah Levine, Editorial Director (Dr. Lou Shuman Pinnacle Achievement Award) – Editorial Director at MJH Life Sciences

Noel Paschke MS, RDH – Founder & President, Ultrasonics Plus

Shavonne R. Healy, MSDH, RDH – Founder & CEO, A Higher Learning

Whitney Dietz, DDS and Julie Bostwick, CDT – Aspen Dental

Children’s Volunteer Health Network (Team Award) – Santa Rosa Beach, Florida

Smile America Partners (Team Award) – Farmington Hills, Michigan

Tickets are on sale now for the fifth annual Denobi Awards Gala on March 8, 2025. Nominations run from October 1 – December 31, 2024.

To learn more about The Denobi Awards and watch highlights, visit www.DenobiAwards.com.

To learn more about the National Mobile & Teledentistry Conference, visit www.nmdconference.com.

U.S. Oral Surgery Management (USOSM) Chief Operations Officer Alisa Ulrey and USOSM Chief Human Resources Officer Annette Igl will be panel speakers in the upcoming Empower and Grow conference, presented by Women in DSO, a nonprofit dedicated to the advancement of women leaders in the dental industry.

The conference will be held March 6-8 at Conrad Las Vegas Resorts World, located at 111 Resorts World Avenue. Ulrey will be speaking on March 7 at noon on the topic Eliminate Decision Drowning: Discover Proven Systems. Igl will be speaking on March 7 at 4 p.m. on The Art of Attraction: Mastering Culture and Talent Retention.

The annual conference aims to help women in dental specialties to grow their companies and empower their professional development. The event is designed to celebrate women’s achievements in dentistry, foster networking and propel DSO innovation and collaboration forward.

“Women in DSO is an important resource and I’m both honored and excited to be a part of their upcoming Empower and Grow conference,” said Ulrey.

As COO of USOSM, Ulrey oversees daily operations, designs and implements business strategies, sets performance and growth goals, and establishes policies that promote company culture and vision. She is a seasoned executive with more than 30 years of experience shaping two of the nation’s largest, Fortune 500 companies. Prior to joining USOSM, Ulrey was president and COO of the Center for Autism and Related Disorders (CARD).

At CARD, Ulrey built strategies to drive performance and manage operations, with responsibility leading field operations, as well as, human resources, talent acquisition, compliance and new business development. Prior to that, Ulrey spent several years in various leadership roles for CVS Health and Target. Ulrey is a graduate of Ball State University with a bachelor’s degree in marketing and business management.

Igl has more than 25 years of experience as a senior-level, human resources (HR) executive. At USOSM, Igl develops and implements HR initiatives for USOSM and its 230+ surgeon partners. Her HR-business partner approach has made her a skilled leader in leading transformation, driving organization effectiveness and ensuring employee engagement and retention.

Prior to USOSM, Igl was the senior director of HR for Beauty Systems Group, a division of Sally Beauty Holdings. In this role, she managed the HR integration of numerous acquisitions across the United States and Canada. In addition, she directed activities for employee relations, talent development, succession planning and training. Igl also has experience as senior director of learning and development for Sally Beauty Holdings and director of HR for Aerial Beauty Company. Igl is a graduate of the University of Wisconsin with a bachelor’s degree in business administration and a focus in HR management.

“Company culture is the main focus of my panel, and it is such an important part of what we do. It is essential to the hiring process, because it can help you determine which candidates are the best fit,” said Igl. “It’s also vital for productivity and talent retention.”

Headquartered in Irving, Texas, USOSM sets the standard for oral and maxillofacial surgery management. A management services organization spanning 26 states, USOSM has built a best-in-class network of premier oral and maxillofacial surgeon partners. USOSM provides operational, financial and administrative support services to fuel clinical excellence, innovation and wealth-creation. Visit: https://www.usosm.com.

PDS has a longstanding commitment to supporting dental assistants and dental assisting students, providing opportunities for advancement, growth, and learning.

Pacific Dental Services® (PDS), one of the nation’s leading dental and medical support organizations, is joining the American Dental Assistants Association (ADAA) in celebrating the annual Dental Assistants Recognition Week, taking place March 3 to 9, 2024. With a steadfast commitment to supporting dental assistants, PDS recognizes their significant contributions to quality dental care and enhanced patient health. To honor its dental assistants and support those aspiring to join the field, PDS is collaborating with dental assisting schools nationwide and hosting various events.

“Each year, Dental Assistants Recognition Week gives us the opportunity to highlight the essential role fulfilled by dental assistants and express our gratitude for their unwavering dedication to patient care,” said Stephen E. Thorne IV, Founder and CEO of Pacific Dental Services. “Their ongoing dedication to patient safety, quality care, and oral health education is truly commendable. Dental assistants are integral members of our healthcare team – we acknowledge and celebrate their impactful role in creating healthier, happier patients while also making valuable contributions to the broader dental field.”

“This week and every week, our team of dental assistants demonstrate their collective passion for delivering exceptional oral healthcare to the communities we serve,” said Rose Olague, RDA, Director, Dental Assistant Programs and School Relations at Pacific Dental Services. “Our dental assistants provide unwavering support to both clinicians and patients, offering their services with the highest degree of dedication, compassion, and professionalism.”

With over 5,600 dental assistants nationwide, PDS remains committed to supporting their advancement and development. Recently, the organization invested $5 million in compensation and specialized training for its dental assistants. In addition, the PDS College Advancement Program, launched in 2022, provides team members, including dental assistants, 100% college tuition coverage for an undergraduate degree, allowing them to advance their careers debt-free, while remaining employed full-time. Last year, PDS celebrated its first dental assistant graduate from the program.

Furthermore, PDS continues its commitment to the dental assistant profession by supporting the PDS Foundation’s Dr. Carolyn Ghazal Dental Assistant Scholarship. These quarterly educational scholarships offer financial aid, mentorship, and on-the-job training to dental assisting students in need, shaping the future leaders of the dental industry. The application deadline for the next dental assistant scholarship is May 1; visit pdsfoundation.org/programs/scholarships to apply.

For those interested in joining the PDS dental assistants team, details can be found at pacificdentalservices.com.

Strategic cooperation encourages dentists to thrive personally and professionally as they move toward financial freedom

Productive Dentist Academy (PDA), the nation’s leading dental consulting and marketing firm, is excited to announce its collaboration with Financially Led (formerly Cash Flow Coach USA), a pioneer in personal finance optimization. This collaboration aims to elevate the financial success of dental professionals, which aligns with PDA’s mission to empower dentists to build Investment Grade Practices™ while enjoying a fulfilling life.

“Productive Dentist Academy believes in fostering an environment where dentists can thrive both personally and professionally,” says PDA Co-founder Dr. Bruce B. Baird. “Our collaboration with Financially Led represents a shared commitment to supporting dental professionals on their journey toward financial independence and practice optimization.”

Founded by Dr. Howard Polansky, Financially Led offers a unique approach to personal finance, focusing on alleviating the burden of managing expenses and optimizing cash flow. Unlike traditional financial strategies that solely emphasize asset growth, Financially Led’s methodology centers on managing liabilities effectively, to enable dental professionals to maintain their lifestyle while building sustainable wealth.

“The key to financial success lies in strategic debt management and disciplined cash flow allocation,” says Dr. Polansky. “By working alongside Productive Dentist Academy, we aim to equip dental professionals with the tools and knowledge necessary to achieve financial freedom, so they can focus on what truly matters in their lives.”

Through a structured three-step process, Financially Led guides clients in lifting the burden from fixed debt payments, expanding cash reserves, and deploying surplus funds into assets. Dentists experience an average annual cash flow increase of more than $65,000 (or $5,500/month), and other dental team members benefit from an average impact of more than $36,000 per year (or $3,000/month).

“Ninety-five percent of dentists cannot retire and maintain their lifestyle, and that’s not fair,” says Dr. Peterson. “Both Productive Dentist Academy and Financially Led are dedicated to empowering dentists to live their best lives today while building toward generational wealth.”

For more information about Productive Dentist Academy, visit https://productivedentist.com, and for more information about Financially Led, visit https://www.financiallyled.com.

Spear Education is pleased to announce its strategic partnership with the American Association of Dental Office Management (AADOM) as a corporate level sponsor for 2024. This collaboration underscores the shared commitment of both organizations to advancing education within the dental industry.

"At Spear, we recognize the integral role dental office managers play in the business of dentistry," says Amy Morgan, Vice President for Practice Growth Strategy at Spear Education. "Our mission has always been centered around providing top-tier education to dental professionals, and this partnership with AADOM allows us to extend that commitment to the vital segment of office management."

AADOM, with its unwavering dedication to the education and professional development of dental office managers, has been a driving force in enhancing the efficiency and effectiveness of dental practices across the nation. The partnership with Spear Education will further amplify the impact of education in this critical aspect of dental business operations.

Dental office managers are the linchpin of successful dental practices, overseeing administrative tasks, patient communication, and practice efficiency. Recognizing their significance, this collaboration seeks to empower office managers with the knowledge and tools they need to navigate the dynamic landscape of dental management successfully.

For more information about AADOM and the valuable resources they offer, please visit their website at https://www.dentalmanagers.com.

As Spear Education and AADOM join forces, the dental community can anticipate a heightened emphasis on education and support for dental office managers, ultimately contributing to the overall success and growth of dental practices nationwide.