I have kind memories of the old days in dentistry. There was no HIV-AIDS. Gloves were optional, and masks were mostly unthought of. My father owned one periodontal probe he had received in dental school, and the sum total of knowledge about gum problems was neatly compacted into a one eighth inch thick pamphlet. I'm talking about the dentists' knowledge, not just a patient brochure.
When I graduated from the University of Detroit Dental School in 1983, that small pamphlet of facts on gum disease became three hard covered books an inch and a half thick on the principles of periodontal diseases. We certainly had more to know, but the treatments for periodontal disease were essentially the same. Unfortunately, until about 5 years ago, the only difference in treatment procedures for gum disease was that dentists and hygienists were greater proponents. There was greater emphasis on the diseases, but most treatments remained the same.
Enter 2009 - with the advent of DNA testing and bacterial testing for periodontal bacteria, we have turned a new page in the treatment and responsibility for treatment of periodontal diseases. When our patients reported for their dental cleanings in the past, we may have noticed that they had swollen gums or bleeding when we probed their gums. Our general solution was to scold them that they had to floss more and see us more regularly. Most people were agreeable, as they weren't really flossing like they should have. Six months later, they would return with the same problem.
Really bad cases got sent to the gum surgeon. The usual procedure there was to cut away some of the swollen gum tissue, put the patient on more frequent maintenance appointments, and to scold them that they had to floss more. Every five to ten years the surgery might be repeated as long as they still had some teeth left.
Newsflash: I've tested several hundreds of these so called non-flossers over the past year for the possibility that they might be actually infected by a known badly pathogenic bacteria. Results of these tests have confirmed harmful bacteria present in all but one case. Eyeopener #2: I've tested about 21 couples or family groups in the past 3 months, and have found that each group shares an almost identical amount and type of harmful bacteria in their mouths.
No longer are we able to treat our patients with periodontal disease as individuals. There is such a strong correlation between close individuals and their periodontal bacteria, that we now need to look past just the individual.
With Knowledge comes responsibility! When I see Mr. Jones' bleeding, swollen gums, I have to take into account the health of Mrs. Jones. The children of parents with gum diseases need to be watched more closely. As dentists and hygienists, we can no longer deny the health of other family members in making treatment decisions.
Except for the introduction of technology like lasers and ultrasonic scalers, many of our periodontal treatments remain the same. However, the emphasis on who we treat has moved past the individual in the dental chair at the time. We all know to change our toothbrush after we get over a cold or the flu. It's not as easy to change a spouse, partner, or child just because they are infected with one or more of the harmful periodontal bacteria.
Will dentistry move toward the model of "group therapy?" I propose that this may be what we find in our future. More on this as it develops.
Saturday, May 9, 2009
Thursday, April 9, 2009
Allison Requests Oral Cancer Info
"Dad, you should write something about oral cancer. My friends are interested in it, and they want to know what's new." This text message came to me from my daughter Allison who is presently serving in Peace Corps Jordan. She had heard about the VELScope examination we do at our office and was interested in passing on some of the newer information to her friends. Well, here's the latest:
Oral cancer kills one person every hour, 24 hours a day in the United States.
Oral cancer is one of the human cancers that is not decreasing in occurence in the last few years. The incidence of oral cancer is about twice that of skin cancer and about three times that of cervical cancer in women. Oral cancer is the sixth most common diagnosed cancer in the U.S. According to the American Dental Association, oral cancer strikes an estimated 34,360 Americans each year. Approximately 7,550 people (5,180 men and 2,370 women) will have died of these cancers in 2007. African-Americans are especially vulnerable; the incidence rate is 1/3 higher than whites and the mortality rate is almost twice as high (American Cancer Society statistics).
Tobacco and alcohol combined account for about 75% of oral cancers, while the segment of the U.S. population growing disproportionately in new oral cancers is women under 40 years of age. It is speculated that this newer group is related to HPV-16 or one of the forms of human papilloma virus. Human papilloma virus is a sexually transmitted virus, infecting about 40 million Americans, and also causing an increased risk of cervical cancers. The HPV affects tissues that have direct contact with a lesion or sore, and does not circulate through a person's system.
Oral sex is also being tagged as a cause of oral cancer because of contact with HPV lesions. "There is absolutely a link between oral sex and oral cancer," said Dr. Ellen Rome, of the Cleveland Clinic. Although no proof exists yet, there is a chance that HPV can be transmitted mouth to mouth.
NON-smokers and people who are not in traditional risk groups are also experiencing an increase in oral cancer rates. Researchers are still working on finding out what these new risk factors may be.
Oral cancers start as a small white or red spot or sore anywhere in the mouth or on the lips. Other signs of oral cancer could be: a sore that bleeds easily or does not heal; pain, tenderness or numbness that doesn't heal; or difficulty chewing, swallowing, speaking or moving the jaw or tongue. Prolonged exposure to the sun can increase the risk of lip cancer.
Half of the people who are diagnosed with oral cancer die within five years. This is mostly due to the cancer being undetected until it is too large to treat easily. Early detection and intervention allows nearly 90% of all cases to be treated.
Detection of oral cancer starts at the dentist's office. A careful visual examination is performed at least annually. The dentist may use an adjunctive screening tool like the VELScope we have in our office. The VELScope shines a blue light into the mouth, and normal healthy cells fluoresce and appear green while looking through a filtering lens. Suspicious cells look jet black or darker through the scope. Final confirmation or diagnosis of cancer can only be accomplished by biopsy or removal of the lesion for microscopic examination. Many more lesions can be detected by using the VELScope than can be seen with the unaided eye.
Studies suggest that diets high in fruits and vegetables may prevent the development of potentially cancerous lesions. Yes, your mother was right again!
Allison, I hope this helps. Let me know if you need more specifics. Also, text your Dad sometime, and we can discuss that "budget thing."
Oral cancer kills one person every hour, 24 hours a day in the United States.
Oral cancer is one of the human cancers that is not decreasing in occurence in the last few years. The incidence of oral cancer is about twice that of skin cancer and about three times that of cervical cancer in women. Oral cancer is the sixth most common diagnosed cancer in the U.S. According to the American Dental Association, oral cancer strikes an estimated 34,360 Americans each year. Approximately 7,550 people (5,180 men and 2,370 women) will have died of these cancers in 2007. African-Americans are especially vulnerable; the incidence rate is 1/3 higher than whites and the mortality rate is almost twice as high (American Cancer Society statistics).
Tobacco and alcohol combined account for about 75% of oral cancers, while the segment of the U.S. population growing disproportionately in new oral cancers is women under 40 years of age. It is speculated that this newer group is related to HPV-16 or one of the forms of human papilloma virus. Human papilloma virus is a sexually transmitted virus, infecting about 40 million Americans, and also causing an increased risk of cervical cancers. The HPV affects tissues that have direct contact with a lesion or sore, and does not circulate through a person's system.
Oral sex is also being tagged as a cause of oral cancer because of contact with HPV lesions. "There is absolutely a link between oral sex and oral cancer," said Dr. Ellen Rome, of the Cleveland Clinic. Although no proof exists yet, there is a chance that HPV can be transmitted mouth to mouth.
NON-smokers and people who are not in traditional risk groups are also experiencing an increase in oral cancer rates. Researchers are still working on finding out what these new risk factors may be.
Oral cancers start as a small white or red spot or sore anywhere in the mouth or on the lips. Other signs of oral cancer could be: a sore that bleeds easily or does not heal; pain, tenderness or numbness that doesn't heal; or difficulty chewing, swallowing, speaking or moving the jaw or tongue. Prolonged exposure to the sun can increase the risk of lip cancer.
Half of the people who are diagnosed with oral cancer die within five years. This is mostly due to the cancer being undetected until it is too large to treat easily. Early detection and intervention allows nearly 90% of all cases to be treated.
Detection of oral cancer starts at the dentist's office. A careful visual examination is performed at least annually. The dentist may use an adjunctive screening tool like the VELScope we have in our office. The VELScope shines a blue light into the mouth, and normal healthy cells fluoresce and appear green while looking through a filtering lens. Suspicious cells look jet black or darker through the scope. Final confirmation or diagnosis of cancer can only be accomplished by biopsy or removal of the lesion for microscopic examination. Many more lesions can be detected by using the VELScope than can be seen with the unaided eye.
Studies suggest that diets high in fruits and vegetables may prevent the development of potentially cancerous lesions. Yes, your mother was right again!
Allison, I hope this helps. Let me know if you need more specifics. Also, text your Dad sometime, and we can discuss that "budget thing."
Thursday, March 12, 2009
Shirt Crazi
My father told me that it's human nature for people to perform as well as they feel, and that the way a person is dressed affects how they feel. It was always important for him as a practicing dentist to come to work each day looking his best. His shoes were always polished and his tie sported a distinctive symmetrical knot.
At the Jacobs Smile Center, we have a dress code that I feel contributes to a feeling of teamwork. Our clinical team coordinates their scrub and jacket combinations depending on the day of the week. Front office members wear either a coordinated business suit or our signature blue logo cotton blouse and dark dress pants.
Yesterday I found that this concept is thought important in the least likely of places. It was my day to volunteer as a dentist at the Care Free Dental Clinic, a volunteer clinic whose mission is to serve the homeless, low income and uninsured people of our county. Our fourth patient presented for treatment, sat in the dental chair, and said she was told by C. J. to say hello to me.
"Do you mean C. J. Skerbeck?" referring to the owner of our regional traveling carnival. "Yup, she's the one," the lady replied.
I asked, "what do you do for the carnival?" I was given a brief explanation of a job I had never heard of before. "I am the person who gives out the clean shirts every day to the carnival workers. You know, nobody gets a clean shirt unless they are wearing clean, dark bluejeans or black pants. They must be clean and in good condition. It's important that they look good everyday, because they are all representatives of our carnival. If I don't give them a clean shirt each day, they have to go home and change or they just plain-out can't work for us that day. Every day, every worker gets a fresh, clean shirt. I'm the one who washes every shirt. I'm the one who decides if they work today or not."
I thought for a moment. "Your job sounds important. What do the other carnival workers call you? Please don't use any words I can't repeat."
"They call me the Shirt "Crazi" she laughed. "I don't care. I make sure they all look good, and C. J. counts on me to make sure that's how it is. My second most important job that I do is selling tickets and handling the money." At this point I understood that the Shirt Crazi must be really important. I guess Dad was right, even the important people at the Skerbeck Carnival know that looks are important in your job.
At the Jacobs Smile Center, we have a dress code that I feel contributes to a feeling of teamwork. Our clinical team coordinates their scrub and jacket combinations depending on the day of the week. Front office members wear either a coordinated business suit or our signature blue logo cotton blouse and dark dress pants.
Yesterday I found that this concept is thought important in the least likely of places. It was my day to volunteer as a dentist at the Care Free Dental Clinic, a volunteer clinic whose mission is to serve the homeless, low income and uninsured people of our county. Our fourth patient presented for treatment, sat in the dental chair, and said she was told by C. J. to say hello to me.
"Do you mean C. J. Skerbeck?" referring to the owner of our regional traveling carnival. "Yup, she's the one," the lady replied.
I asked, "what do you do for the carnival?" I was given a brief explanation of a job I had never heard of before. "I am the person who gives out the clean shirts every day to the carnival workers. You know, nobody gets a clean shirt unless they are wearing clean, dark bluejeans or black pants. They must be clean and in good condition. It's important that they look good everyday, because they are all representatives of our carnival. If I don't give them a clean shirt each day, they have to go home and change or they just plain-out can't work for us that day. Every day, every worker gets a fresh, clean shirt. I'm the one who washes every shirt. I'm the one who decides if they work today or not."
I thought for a moment. "Your job sounds important. What do the other carnival workers call you? Please don't use any words I can't repeat."
"They call me the Shirt "Crazi" she laughed. "I don't care. I make sure they all look good, and C. J. counts on me to make sure that's how it is. My second most important job that I do is selling tickets and handling the money." At this point I understood that the Shirt Crazi must be really important. I guess Dad was right, even the important people at the Skerbeck Carnival know that looks are important in your job.
Saturday, March 7, 2009
Gumdog Millionaire
What do the slums of Mumbai, India and your mouth have in common? Beside the fact that they can both be dirty places, your mouth is also a place inhabited by mostly "good" residents. Like the occupants of the Mumbai slum in the recent award winning movie Slumdog Millionaire, your mouth also may house some really "bad" characters.
Dental research has identified nearly 700 different bacteria living in the human mouth, most of them "good". Newer technology has allowed us to identify with great accuracy thirteen "bad" pathogenic bacteria believed to be involved with degenerative periodontal (gum) infections. My first exposure to this technology was through a course I took by Lou Graham, DDS about 3 years ago. In the past year I have sampled about 200 people with signs of periodontal disease or infection looking for these horrible critters.
Analyzing these bacterial test results has been a large eye opener for my dental team and for me. We have found many more "Gumdog Millionaires" than I could ever had imagined. I see a gumdog millionaire as a person who is rich indeed. Rich and teeming with microorganisms too nasty to inhabit the slums of Anymouth, USA. Of all the bacterial tests I have done to date, only one person had a test returned with no periodontal pathogens. I even had to do a free retest to confirm to myself that this could have occured. Now keep in mind that I am only testing people with evidence of periodontal infection or disease, but impressive none-the-less!
Where, why, how? Research is still out on the final answer to these questions, but this is what we know so far. Periodontal pathogenic bacteria are probably passed from a caregiver to a child in a family setting at an early age - coughing, sneezing, kissing, tasting off the same spoon, drinking out of the same cup, sharing a straw. People with a stronger immune system are less likely to take on the new bugs, while those with lesser immunity will begin to host the bugs earlier.
As a person ages or their immune system is challenged, the "bad" bugs may overgrow, now showing the signs and symptoms of gum infection or periodontal disease. Present in larger quantities, these bacteria are next passed through saliva again to the person's spouse or partner.
Most recent shocking findings in my dental office are that married couples that we have tested in the past 4 weeks have all shown the same combination of pathogenic bacteria present in their mouths, and we have even found these bugs in the same quantity in each partner. I have tested about 6 couples and 1 family unit to date. Father, mother, and child demonstrated the same bacteria!
At a recent course sponsored by Hain-Diagnostics, I learned that four of these bacteria (called red complex) predispose people to a 700% greater chance of having heart disease. People with two other (called green complex) bacteria are more prone to diabetes. Orange complex bacteria can be related to inflammatory diseases such as rheumatoid arthritis. The presence of these bacteria shows a risk factor, not necessarily causal. Research is beginning to point to a causal effect, though in some cases.
These bad bacteria are difficult to get rid of, but it can be done. Removing pathogenic bacteria may not eliminate things like heart disease, cancer, diabetes and arthritis, but it will definitely remove some of the risk factors. The earlier in life that bad bugs are detected and treated, the greater chance of having a healthy adulthood, continuing into the "golden years".
Oh, yea - don't be kissing your dogs on the face either. Last Monday's patient informed me that he was taking his dog to the vet for periodontal treatment. The vet said that the dog would get heart disease if this kept up! Another dentist I met recently had a woman's dog tested for periodontal bacteria. Amazingly, the dog and owner shared the identical bad bugs. The dog's better now, by the way. The woman finally tested clean after the dog was treated.
"Now Jamal, your final question is worth a staggering 20 million rupees! Which periodontally pathogenic bacteria can raise your risk of heart disease by 700%? Is it A: Aggregatibacter actinomycetemcomitans? B: Porphyromonas gingivalis? C: Tannerella forsythia? or D: Treponema denticola? . . . . What is your final answer?"
"I know the answer is all of the above," spats Jamal, "as I have been a Gumdog Millionaire!"
Dental research has identified nearly 700 different bacteria living in the human mouth, most of them "good". Newer technology has allowed us to identify with great accuracy thirteen "bad" pathogenic bacteria believed to be involved with degenerative periodontal (gum) infections. My first exposure to this technology was through a course I took by Lou Graham, DDS about 3 years ago. In the past year I have sampled about 200 people with signs of periodontal disease or infection looking for these horrible critters.
Analyzing these bacterial test results has been a large eye opener for my dental team and for me. We have found many more "Gumdog Millionaires" than I could ever had imagined. I see a gumdog millionaire as a person who is rich indeed. Rich and teeming with microorganisms too nasty to inhabit the slums of Anymouth, USA. Of all the bacterial tests I have done to date, only one person had a test returned with no periodontal pathogens. I even had to do a free retest to confirm to myself that this could have occured. Now keep in mind that I am only testing people with evidence of periodontal infection or disease, but impressive none-the-less!
Where, why, how? Research is still out on the final answer to these questions, but this is what we know so far. Periodontal pathogenic bacteria are probably passed from a caregiver to a child in a family setting at an early age - coughing, sneezing, kissing, tasting off the same spoon, drinking out of the same cup, sharing a straw. People with a stronger immune system are less likely to take on the new bugs, while those with lesser immunity will begin to host the bugs earlier.
As a person ages or their immune system is challenged, the "bad" bugs may overgrow, now showing the signs and symptoms of gum infection or periodontal disease. Present in larger quantities, these bacteria are next passed through saliva again to the person's spouse or partner.
Most recent shocking findings in my dental office are that married couples that we have tested in the past 4 weeks have all shown the same combination of pathogenic bacteria present in their mouths, and we have even found these bugs in the same quantity in each partner. I have tested about 6 couples and 1 family unit to date. Father, mother, and child demonstrated the same bacteria!
At a recent course sponsored by Hain-Diagnostics, I learned that four of these bacteria (called red complex) predispose people to a 700% greater chance of having heart disease. People with two other (called green complex) bacteria are more prone to diabetes. Orange complex bacteria can be related to inflammatory diseases such as rheumatoid arthritis. The presence of these bacteria shows a risk factor, not necessarily causal. Research is beginning to point to a causal effect, though in some cases.
These bad bacteria are difficult to get rid of, but it can be done. Removing pathogenic bacteria may not eliminate things like heart disease, cancer, diabetes and arthritis, but it will definitely remove some of the risk factors. The earlier in life that bad bugs are detected and treated, the greater chance of having a healthy adulthood, continuing into the "golden years".
Oh, yea - don't be kissing your dogs on the face either. Last Monday's patient informed me that he was taking his dog to the vet for periodontal treatment. The vet said that the dog would get heart disease if this kept up! Another dentist I met recently had a woman's dog tested for periodontal bacteria. Amazingly, the dog and owner shared the identical bad bugs. The dog's better now, by the way. The woman finally tested clean after the dog was treated.
"Now Jamal, your final question is worth a staggering 20 million rupees! Which periodontally pathogenic bacteria can raise your risk of heart disease by 700%? Is it A: Aggregatibacter actinomycetemcomitans? B: Porphyromonas gingivalis? C: Tannerella forsythia? or D: Treponema denticola? . . . . What is your final answer?"
"I know the answer is all of the above," spats Jamal, "as I have been a Gumdog Millionaire!"
Sunday, January 25, 2009
Two Left Shoes
Yesterday was an amazing day. I had the first massage of my life at age 50. The entire experience was incredible except for a minute detail which will forever cast a toothpick of a shadow on this near perfect day.
Paula and I treated our office team to a Friday seminar which was followed by a "spa" experience. After the seminar, our team had their hair done professionally for dinner that night. The dinner was at one of the finest restaurants in this Midwestern town. It was a true moving culinary experience. This pampering set the stage for the following morning which was our day at the spa.
I was told to arrive promptly at 11:15 am, which I did. I was greeted by a pleasant young lady behind a counter who gave me a form to fill out, a robe to carry and a pair of shower shoes. "You can go through the door at the left into the men's locker room, and then continue on to the sanctuary where you'll have time to fill out the form." I found my locker, removed my street shoes, readied into my spa robe and sat down to put on the shower shoes I had been given. Nice shoes, I thought, even had little nubs on the foot side to give a little pre-massage for my feet. On with the left, and then - - another left? No problem. I opened the velcro strap, placed the second left shoe on my right foot, and it seemed to work well enough. And, I had already decided that it was no big deal and that it was just more work than I needed to think about going back out in to the crowded salon area and try and explain my dilemma.
Through the next door into the "sanctuary" I was pleasantly surprised to see Paula and three of our team lounging in quiet, near darkness on soft leather chairs and sofas. Curved walls, green trees, and soft music supplemented by the sound of trickling water from a large fountain began to set the mood for time of relaxation. Paula looked up, "what do you think?" I told her that it seemed pretty neat, but that I had something she didn't have. "Look, two left feet." Everyone chuckled. I explained that they were still comfortable, but there was sure to be a lesson there for us all.
After drinking copious amounts of fresh water in champagne glasses, Paula and I were ushered deeper into the confines of this quiet place by our two massage therapists. They introduced themselves, confirmed that we were there for our "signature full body massages," and left the room briefly while we made ourselves comfortable on our massage tables. I removed both of my left shoes, and climbed onto the massage table. Under warmed blankets, I began to realize Paula was right that this would be the experience of a lifetime.
Our therapists returned to the room, and proceeded to provide a life-changing massage. She knew where every sore spot was, and claimed that in time she could even get my dentist's rolled shoulders to sit flat on the table. The hour passed quickly, and we were released back into the sanctuary to sip more fancy water with some other members of our team who were between spa services. "Nice shoes," one of the ladies quipped. "Thanks." They're special.
I have had few experiences in my life that were as relaxing and invigorating as my first massage treatment. I would return to this spa, because the people were very talented, attentive, and nice. We had, however, learned the day before about the importance of our team at the front desk of the dental office paying attention to detail. They are the front line in helping establish good relationships with our patients. They set the stage for the total experience that our patients remember in our office. We need to be vigilant to carefully avoid handing out two left shoes at the front counter or over the phone. We could be the greatest dental team in the world, but it won't help us one bit if we become known as the "two left shoes" smile center.
Paula and I treated our office team to a Friday seminar which was followed by a "spa" experience. After the seminar, our team had their hair done professionally for dinner that night. The dinner was at one of the finest restaurants in this Midwestern town. It was a true moving culinary experience. This pampering set the stage for the following morning which was our day at the spa.
I was told to arrive promptly at 11:15 am, which I did. I was greeted by a pleasant young lady behind a counter who gave me a form to fill out, a robe to carry and a pair of shower shoes. "You can go through the door at the left into the men's locker room, and then continue on to the sanctuary where you'll have time to fill out the form." I found my locker, removed my street shoes, readied into my spa robe and sat down to put on the shower shoes I had been given. Nice shoes, I thought, even had little nubs on the foot side to give a little pre-massage for my feet. On with the left, and then - - another left? No problem. I opened the velcro strap, placed the second left shoe on my right foot, and it seemed to work well enough. And, I had already decided that it was no big deal and that it was just more work than I needed to think about going back out in to the crowded salon area and try and explain my dilemma.
Through the next door into the "sanctuary" I was pleasantly surprised to see Paula and three of our team lounging in quiet, near darkness on soft leather chairs and sofas. Curved walls, green trees, and soft music supplemented by the sound of trickling water from a large fountain began to set the mood for time of relaxation. Paula looked up, "what do you think?" I told her that it seemed pretty neat, but that I had something she didn't have. "Look, two left feet." Everyone chuckled. I explained that they were still comfortable, but there was sure to be a lesson there for us all.
After drinking copious amounts of fresh water in champagne glasses, Paula and I were ushered deeper into the confines of this quiet place by our two massage therapists. They introduced themselves, confirmed that we were there for our "signature full body massages," and left the room briefly while we made ourselves comfortable on our massage tables. I removed both of my left shoes, and climbed onto the massage table. Under warmed blankets, I began to realize Paula was right that this would be the experience of a lifetime.
Our therapists returned to the room, and proceeded to provide a life-changing massage. She knew where every sore spot was, and claimed that in time she could even get my dentist's rolled shoulders to sit flat on the table. The hour passed quickly, and we were released back into the sanctuary to sip more fancy water with some other members of our team who were between spa services. "Nice shoes," one of the ladies quipped. "Thanks." They're special.
I have had few experiences in my life that were as relaxing and invigorating as my first massage treatment. I would return to this spa, because the people were very talented, attentive, and nice. We had, however, learned the day before about the importance of our team at the front desk of the dental office paying attention to detail. They are the front line in helping establish good relationships with our patients. They set the stage for the total experience that our patients remember in our office. We need to be vigilant to carefully avoid handing out two left shoes at the front counter or over the phone. We could be the greatest dental team in the world, but it won't help us one bit if we become known as the "two left shoes" smile center.
Sunday, January 11, 2009
Awakening Times Three
I got hit on the side of the head last night. It started when one of my celebrity patients got hit on the side of the head. After her daughter got hit on the side of the head.
After an enjoyable dinner with friends last night, I had the pleasant opportunity to visit with one of my celebrity patients. "I just love my smile, but you don't know what happened the other day." She went on to say that her daughter saw her Murano Veneers TV commercial for the first time. In the commercial, Paris (name changed) gives heartfelt testimony that she has spent most of her life taking care of the needs of her husband and children, but having smile improvement with murano veneers is finally something she has decided to do for herself.
"Mom, did you really say that?" her daughter asked. "Why did you say that?"
Paris, in astonishment, relays to her daughter that she gave this testimonial because it was true.
At this point, Paris explained to me that she could see puzzlement in her daughter's facial expression. Paris did not need to explain any further, and within seconds her daughter realized for the first time that her mother had sacrificed much of her life for her family. An awakening!
Immediately, the second awakening occured as Paris came to terms with the fact that her daughter had no idea of the sacrifices Paris had made for the family over the years. The good news was that Paris also understood that she and her daughter were on the precipice of newfound understanding of love and appreciation for each other.
After their discussion, Paris took her daughter to the Jacobs Smile Center website and they looked at the before and after photos of her. Neither Paris or her daughter could even remember what she looked like before her transformation. It was as if they had both shut out the memory. Paris relived once again how painful it was for her to smile before she entered her new life. "People stop me everywhere. I know what they are going to ask. " "Can I see your smile?" Each time it gets easier, and more fun, and more special for Paris to have become the beautiful, confident celebrity that she is today.
Paris thanked me again, and of course it was only my pleasure. What a wonderful feeling to know that Paris's new smile has not only given her the celebrity of familiarity within her community, but more importantly (and surprisingly) the satisfaction in knowing that her family now appreciates her more for the great sacrifices she has made for them. What great love does a mother have for her children, but what great rewards when she knows they "get it."
Thanks, Mom!
After an enjoyable dinner with friends last night, I had the pleasant opportunity to visit with one of my celebrity patients. "I just love my smile, but you don't know what happened the other day." She went on to say that her daughter saw her Murano Veneers TV commercial for the first time. In the commercial, Paris (name changed) gives heartfelt testimony that she has spent most of her life taking care of the needs of her husband and children, but having smile improvement with murano veneers is finally something she has decided to do for herself.
"Mom, did you really say that?" her daughter asked. "Why did you say that?"
Paris, in astonishment, relays to her daughter that she gave this testimonial because it was true.
At this point, Paris explained to me that she could see puzzlement in her daughter's facial expression. Paris did not need to explain any further, and within seconds her daughter realized for the first time that her mother had sacrificed much of her life for her family. An awakening!
Immediately, the second awakening occured as Paris came to terms with the fact that her daughter had no idea of the sacrifices Paris had made for the family over the years. The good news was that Paris also understood that she and her daughter were on the precipice of newfound understanding of love and appreciation for each other.
After their discussion, Paris took her daughter to the Jacobs Smile Center website and they looked at the before and after photos of her. Neither Paris or her daughter could even remember what she looked like before her transformation. It was as if they had both shut out the memory. Paris relived once again how painful it was for her to smile before she entered her new life. "People stop me everywhere. I know what they are going to ask. " "Can I see your smile?" Each time it gets easier, and more fun, and more special for Paris to have become the beautiful, confident celebrity that she is today.
Paris thanked me again, and of course it was only my pleasure. What a wonderful feeling to know that Paris's new smile has not only given her the celebrity of familiarity within her community, but more importantly (and surprisingly) the satisfaction in knowing that her family now appreciates her more for the great sacrifices she has made for them. What great love does a mother have for her children, but what great rewards when she knows they "get it."
Thanks, Mom!
Tuesday, January 6, 2009
Seeing is Believing
Brenda (name changed) was in to see me today, and we started fabrication of a new denture for her. She had previously been having severe facial pain, headaches, muscle aches, and was unable to get comfort even during her sleeping hours. Today Brenda is pain free, and ready to anxiously receive the smile of her dreams.
Three months ago, Brenda came into my office, and I could tell by her negative attitude and the deep anguish lines carved into her face, that she was in great pain. She explained that she had seen several doctors and two dentists trying to find a solution to her facial pain. Her doctors had tried putting her on some medication for headaches, and she got some minimal relief from that. She didn't like the way the medications made her feel, though. The dentists she saw recommended that they might be able to alleviate her pain through making her a new set of dentures, but she was not convinced that was the solution.
Understanding that the dentists she had seen were good dentists, and probably right, I immediately told her that this may be the needed solution for her. My approach to the situation was slightly different, though. I knew that she needed new dentures, and that her old dentures had worn excessively to the point that her nose and chin were closer together. Some people refer to this as "overclosure". This will occasionally cause sore jaws, ringing in the ears, and other facial pain problems. Before I would fabricate a new set of dentures for Brenda, I was sure to let her know that I couldn't guarantee that the problem would be solved, but that I would be able to let her see for herself if increasing the thickness of the dentures would make a difference.
At a subsequent appointment, I placed a temporary liner in her dentures, but did not alter her denture at all. If this wouldn't have helped, the liner could be stripped out, and she could continue with her dentures as they were. In this case, there was no risk for me or for her. Two weeks later, Brenda returned and was elated to tell me that she no longer had any facial pain. Confident that this overclosure was her ultimate problem, and after two more confirmation visits, she is well on her way to recovery.
Our paradigms can sometimes hinder us from accepting the cause of our problems. Many times we look for a complex solution to a simple problem. Allowing Brenda to see for herself that her problem was being caused by her dentures, allowed us to continue on with confidence. I didn't have to be a better or smarter dentist to treat Brenda, I just had to listen to her needs and help her find her way around the mental block that kept her from getting better.
Three months ago, Brenda came into my office, and I could tell by her negative attitude and the deep anguish lines carved into her face, that she was in great pain. She explained that she had seen several doctors and two dentists trying to find a solution to her facial pain. Her doctors had tried putting her on some medication for headaches, and she got some minimal relief from that. She didn't like the way the medications made her feel, though. The dentists she saw recommended that they might be able to alleviate her pain through making her a new set of dentures, but she was not convinced that was the solution.
Understanding that the dentists she had seen were good dentists, and probably right, I immediately told her that this may be the needed solution for her. My approach to the situation was slightly different, though. I knew that she needed new dentures, and that her old dentures had worn excessively to the point that her nose and chin were closer together. Some people refer to this as "overclosure". This will occasionally cause sore jaws, ringing in the ears, and other facial pain problems. Before I would fabricate a new set of dentures for Brenda, I was sure to let her know that I couldn't guarantee that the problem would be solved, but that I would be able to let her see for herself if increasing the thickness of the dentures would make a difference.
At a subsequent appointment, I placed a temporary liner in her dentures, but did not alter her denture at all. If this wouldn't have helped, the liner could be stripped out, and she could continue with her dentures as they were. In this case, there was no risk for me or for her. Two weeks later, Brenda returned and was elated to tell me that she no longer had any facial pain. Confident that this overclosure was her ultimate problem, and after two more confirmation visits, she is well on her way to recovery.
Our paradigms can sometimes hinder us from accepting the cause of our problems. Many times we look for a complex solution to a simple problem. Allowing Brenda to see for herself that her problem was being caused by her dentures, allowed us to continue on with confidence. I didn't have to be a better or smarter dentist to treat Brenda, I just had to listen to her needs and help her find her way around the mental block that kept her from getting better.
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