Lip Repositioning / Gummy Smile Seminar

Paula and I had an enjoyable visit with our son and daughter-in-law recently while in Chapel Hill, NC.  I spoke at the University of North Carolina School of Dentistry on the subject of Lip Repositioning and management of a gummy smile.  It was enjoyable to share my novel technique of Reversible - Trial Lip Repositioning Surgery with a group of Oral Surgeons, Periodontists, and Prosthodontists. 

My next presentation on Lip Repositioning Surgery will be in Washington, DC at the American Academy of Cosmetic Dentistry Annual Session. 

Bryan and I are excited to see the next couple of issues of The Journal Of Periodontics And Restorative Dentistry.  Our article on Lip Repositioning has been accepted for publication there, and it will present a case series of patients I treated with my technique of the Reversible - Trial Lip Repositioning Surgery.

Proud Father and Mother

Last Saturday, Paula and I had the honor of attending a luncheon of the American College of Dentists in Boston at the Yankee Dental Congress Meeting. Our son Bryan Jacobs was presented with a distinguished student award for ethics and leadership in dentistry. The award was introduced by the Dean of Bryan's Harvard School of Dental Medicine, R. Bruce Donoff, DDS, MD.

In attendance were the deans of 4 dental schools, the president of the ACD, the executive director of the American Dental Association, past presidents of the ADA, among others.

Bryan has worked hard and persevered through the demands of dental school at Harvard. He has kept his sights on the goal of completing a quality education in dentistry. He is passionate about his profession and I know he will continue his lifelong quest for learning.

Bryan will soon be the fourth generation of dentists in our family. He will be the first Harvard grad. Paula and I are so proud of him - almost as much as we love him. His grandparents are so proud of him. All of his family, friends, cousins, neighbors, even Linda (soon to be Dr. Linda) are proud of him. What a great example. Way to go Bryan!

Experience the Difference

Zig Ziglar once said that there is something that millions of Chinese schoolchildren can do that you and I can't. Namely, speak Chinese! That doesn't make them smarter than us, it just demonstrates that they have had different experiences than us.

Recently I was visited by a young adult from Minnesota who was interested in Invisalign. She had been to a dental school in Minn. in hopes of getting her teeth straightened, but was left undecided after hearing the differing opinions of the dentists at the school. There are many smart people teaching in professional schools, but there are as many different ways to approach dental problems as there are dentists.

After evaluating this young lady, I realized there was more to her problem than just straightening her teeth. The confounding situation for the dentists who had seen her before was that she had developed a compensating bite, commonly referred to as a "Sunday bite". She would push her lower jaw out forward so it looked like she had a better bite relationship than she actually did. Her teeth did not fit well together in this position, but because of having done this for so many years, her teeth didn't fit well together in a retruded position either. Consequently, she was getting headaches and jaw aches frequently.

From my experience, I know that orthodontic treatment could be the attempted treatment for this, OR it could seal the deal on capturing this problem for a long time. From my experience, I felt that she first needed to have her jaw joint and muscles neutralized and in harmony, and then her bite stabilized in some position before beginning Invisalign treatment.

Invisalign is on hold temporarily, and she has been started on NTI appliance therapy. I met the inventor of the NTI appliance Jim Boyd, DDS years ago while attending a dental conference with him in Hawaii. I remember Jim making this appliance for other attendees who had headaches daily. The next day at the seminar, these people were interviewed and explained that the majority of their headache and neckache problems had dissipated almost immediately.

Now, this NTI appliance is a good treatment, but not for all cases. Dentists still need the experience to know when it will help, or when it could cause more difficulty.

I recieved an email yesterday that our patient is having changes for the better almost immediately. She wore the appliance on her way home to Minn. while driving, and told her mother that she already was feeling positive differences. I'll see her again in a couple of months, and hopefully we can start to stabilize her bite and eventually get her the straight teeth she wants.

More later, as the story develops.

Love it to Death

I talked to Bryan last night (Harvard School of Dental Medicine 2010) and he had an interesting case. He had recently restored a tooth for one of his patients, and the patient returned with much sensitivity. On evaluation, Bryan noticed that the new filling was showing signs of wear already. He asked the patient when it bothered her and she replied that it hurt when she flossed around it. "How do you floss?" he asked. She replied that she occasionally wrapped the floss all the way around the tooth like a lasso. Since she was having a little sensitivity in that new filling, she was not only wrapping the floss completely around the tooth, but she was also "crossing" the floss and then stripping it back and forth. This was remarkably like using one of those pocket chain saws that you can buy in Cabellas for removing small limbs from a tree in a minute! Bryan told her to stop abusing her tooth that way, before she had worn the tooth out completely.

I told Bryan "she was loving it to death". He chuckled, but that is how I have described this phenomenon over the years. I will frequently have a dental patient that presents to the office with a complaint of a severely receding gumline on one or two teeth. For some unexplained reason, the gum tissue continues to move further and further away from the tooth. I have learned over the years that when someone focuses on a percieved problem, they may concentrate all their efforts on it. When questioned, the patient usually relays that they are concerned about the recession and that they are "cleaning it really good several times a day so that it doesn't get worse." I tell them that they might be "loving it to death." In their attempt to keep the area healthier, they are in effect causing great damage and trauma to themselves. They think that more is better, but in these cases they need to stay away from the area to let it heal.

I cared for a man about 20 years ago who was losing weight at an alarming rate. His doctors were dumbfounded and couldn't explain why this man was dying a slow inevitable death. He told me that he was a religious man, and that he had visited Lourdes France a couple of years before to pray for good health. He had believed that the healing waters of the fount were alkaline like peroxide water, and thought that the healing waters were not of God so much as they were in the chemicals in the water.

He said, " I use that water every day, and I'm still losing weight. I can't figure it out?" I asked what he meant by using the water every day? He explained that he was mixing up some peroxide and water every day, and bathing in it like at Lourdes. He was also drinking a quart of that peroxide water every day. "I am consumed by this healing water, so I have to get better soon."

I told him that this was not healthy, and that if he kept drinking this water every day like this, he would do great damage to his body. I spoke with his wife, and she also had been trying to tell him this - to no avail.

God rest his fragile body. He loved himself to death.

Destiny: Dentistry

At the mature age of 3, I remember accompanying my father to his dental office on Saturday mornings and waiting impatiently while he treated a dental patient or two. To help the time pass, he would drill little holes in plaster teeth and let me fill them with amalgam. When my younger brother was old enough to come along, Dad would let me drill the holes and let him fill them. When I was twelve years old, I worked in Dad's orthodontic office doing all the tasks that I could legally perform. I fabricated plaster models of teeth and orthodontic retainers. I hand drew cephalometric tracings on lateral head x-rays, and wrote out long hand diagnoses of orthodontic treatment plans. My great uncle was a dentist, my father, my uncle, my cousin, and subsequently, my brother became dentists. I was destined to become a dentist. I never considered another vocation. Luckily for me, I LOVE dentistry. I am passionate about it. I always have loved it. What better subject to write about than your passion?

My son Bryan is in his third year of dental school. I hope that he has the same passion and understanding of dentistry that I have enjoyed. My hopes are that this weblog will serve as an encouragement to him about the beauty and enjoyment of the practice of dentistry. My additional goal is that this blog may enrich the life of some young dentist, or quell the fears of an anxious dental patient. My plan for this blog is to bring insight into dentistry for all who have dentistry as an interest. As a third generation dentist, who is looking forward to seeing the fourth generation around the corner, I'd like to give all an inside view into that love that we call dentistry.