Tuesday, September 29, 2009

Who Shot the Sialolith?

"I shot the sheriff, but I did not shoot the deputy..." The song lyrics remind me somewhat of the photo I received recently from my brother Peter Jacobs, DDS. Pete practices near me in the small northern city of Manistique, Michigan.


You don't need to live in a large metropolitan area to see unique things in a dental office. This is one that I have never seen, so I thought it might be interesting to others. Pete sent me a photo of a sialolith, that is - a calcareous concretion or calculus of the salivary gland or duct. He had a patient come into his office with a swelling below his chin and under his tongue. On an xray examination, an artifact somewhat like a tooth was present. After some investigation, Dr. Pete made a small incision under the patient's tongue, and out popped what you see in the picture. The sialolith looks somewhat like a tooth that is tapered on each end. Over time, calcium deposits can build up in the salivary duct, and start to obscure it, causing a backup of saliva in the gland.


Note the size of the sialolith in comparison to the bullet laid alongside it in the photo. My brother is very passionate about hunting, and happened to have the bullet nearby to easily use as a size comparison. He says it's a 30.06 shell. I'm waiting for the deputy to confirm that!

Wednesday, August 19, 2009

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.

Saturday, August 15, 2009

100% Government Free Health Care

I just read a linked story on CNN about the current health care debate. People out West in Big Sky, Montana stated that they were concerned about government intervention in their health care coverage. They didn't want government to get too involved in their own choices and care. One person interviewed was at a low-cost dental clinic stating that government intervention was bad. The interviewer elucidated the fact that the U.S. government was financing about 50% plus of the costs of the clinic.

Wait a minute! It's obvious that another idea needs to get more press. Since January of 2008, the Care Free Dental Clinic, Inc. has been in operation in Delta County, Michigan. We have provided over 350,000 dollars in free dental services to over 1500 patients. The population we serve are the uninsured, homeless, and low-income residents of our county.

The Care Free Dental Clinic is unique. There are no paid employees. Rent, heat, and lights are donated. We don't even have a phone. The clinic is staffed by community volunteers. Eleven dentists donated their time to keep the clinic staffed for two half days every week. About 50 volunteers comprised of dental assistants, receptionists, and dentists work together to the common goal of serving others. "Nobody should seek his own good, but the good of others." is our motto.

Funding for the clinic is by private and individual donations. We have an annual fund raiser which raises much of the money for materials and disposables. Every dollar of money coming into our clinic goes directly to patient care. Our local St. Vincent DePaul Society has housed the clinic since its inception, and is presently adding on two new rooms for our clinic expansion.

Now, if this simple but effective clinic has demonstrated our community's ability to care for its own, why can't the idea spread to other areas. We know it can! It will take time. It will take good people. It will take miracles, but it can come to fruition. This idea is certified 100% Government Free. Pass it on.

We The People must be the answer to our own problems. Let's not wait for someone else to take care of us. Let's not wait for someone else to solve the problem. Let us do as our forefathers did and take ownership for our own problems. Encourage others around you to get involved. Keep an open heart and mind when people around you try to do good for others. Donate to a cause. Your monies will come back ten times to you.

Share this miraculous, encouraging story with others. Please forward this to your friends in the hope it may inspire someone else to join in the fight to continue our independence from government intervention. Together we can care for each other, save our American way of independent living, exercise the freedoms we are so blessed to enjoy, and not just sit back and wait for someone else to throw small coins into our laps.

We are also encouraged by the possibility that our potential Surgeon General is aware of the power of volunteerism. (Read also: Sherpa Nell.) Dr. Regina Benjamin has also given selflessly of herself in tending to the needs of her patients in Alabama, many times donating her services.

For further information on the Care Free Dental Clinic, Inc. or to learn how you can help support the growth of clinics like this, contact Paula Jacobs, R.N. at pjacobs@hughes.net.

Friday, July 17, 2009

Sherpa Nell

I was destined to meet two extraordinary people in the fall of 1993.


My favorite holiday - Thanksgiving would have to arrive in the States without my presence. I had given up my annual duck hunting trip, and the warmth and comfort of our usual family turkey and stuffing fest to participate in a much needed Christian mission trip to Flores, Honduras. Separation from Paula and Bryan and Allison was troubling to me, as our children were only 10 and 8 years old, but I was compelled by the dental need I had heard about in Honduras.


On arrival in our first major airport, I was cheerily greeted by a pair of unlikely, but obviously very close women. "Hi, my name's Nell, and this is my doctor, Dr. Benjamin." I introduced myself in response to their welcome, and asked where they were from. I believe that they were traveling from somewhere down South. We joined with the remaining 16 or so people and completed the final leg of our flight into Tegucigalpa, Honduras.



We drove on to Flores, a small mountain village with one church and a boys' and girls' school and orphanage run by a Christian non-profit organization. The tiny cement block "clinic" building would be our office for the next two weeks. We unloaded all of our supplies, arranged our dental and medical treatment areas, and prepared medications for the first day of service.


Nell and her doctor, Dr. Regina Benjamin spent alot of time working together organizing the pharmacy, packaging gauze, labeling drug envelopes, and sorting through numerous bottles and jugs of donated pills to be ready for the next day's onslaught of patients. Wherever I would see Regina or Nell, I would see them together - hardworking, cheerful, and getting the job done.


The next few days were a blur, as patients lined up at the clinic at 5:00 a.m., through the gates of the school and down the highway. We took a short break in the heat of the afternoon, and then continued on into the evening, ending sometimes at 9:00 at night. We had a trickle of water in our faucet, and limited unreliable electricity, but we were able to take care of alot of people. I didn't see Nell and Regina often during the day, as they worked the other side of the clinic. I spent most of my time extracting unrestorable and abscessed teeth in a small room on the right side of the clinic.


It was in the evening hours that I got a better chance to visit with Nell and Regina. After dinner, we would sit outside in the cooler evening air on ramshackle folding lawn chairs and talk about the day's experiences and speak of home. Sitting with Nell was one of my most memorable experiences. Nell was pleasant, outgoing, and spoke in a matter-of-fact way. Her humility was overwhelming to me, as she constantly referred to how wonderful "her doctor" - Dr. Benjamin was. Nell had worked with Regina for three years in a small rural health clinic. Nell related to me about how Dr. Benjamin worked tirelessly for her poor patients. She told me stories of her doctor's generosity and compassion. She had a sparkle in her eye every time she relayed another story of how she and Dr. Benjamin had helped the needy people from their area. I knew Dr. Benjamin must be special, but I was also convinced that Dr. Benjamin's success was at least in part due to the passion and dedication of her nurse Nell.


I found myself that Dr. Regina Benjamin was an incredible human being. Nell was right. She did work tirelessly for her Honduran patients. With Nell at her side, they accomplished great things for those needy people. They took care of each person like they were the most important people on earth. Always smiling, always waiting anxiously for the next patient, always caring about the people around them, they worked on together.


It's been many years since I have heard from or of my nurse and doctor friends from the Honduras medical - dental mission trip. As I read the news a couple of days ago, I did notice a familiar name and face: Regina Benjamin, M.D. The news also talked about her nurse, Nell. The still white-haired 79 year old Nell Stoddard, LPN predicted that someday "her doctor" who had worked so hard for her patients and endured so many hardships would become very important someday. Nell continues at the side of Dr. Benjamin in the Bayou La Batre Rural Health Clinic in Bayou La Batre, Alabama. They've been together for about 19 years now.


Nell's prediction is at hand. Recently, President Obama announced his selection of Dr. Regina Benjamin for the position of Surgeon General of the United States. This is a most fitting position for a person (team) that has served so selflessly. I am proud to have served with Nell and Regina. Congratulations to you both, for we know that noone can reach the summit alone.


Sherpa Nell - I liken the journey of Dr. Regina Benjamin and her Sherpa Nell to that of Sir Edmund Hillary and his Sherpa guide. They could only reach the summit together, relying on each other. In some stories of Everest, the unknown sherpa guide would not only carry much of the provisions on their back, but would on occasion carry their explorer as well. I'm sure that Nell and Regina have carried each other through much that life has brought their way.


(BBC News:) 1953: Hillary and Tenzing conquer Everest

The New Zealander Edmund Hillary, and the Nepalese Sherpa Tenzing Norgay, have become the first to reach the summit of Mount Everest on the Nepal-Tibet border.

They reached the top of the world at 1130 local time after a grueling climb up the southern face.

The two men hugged each other with relief and joy but only stayed on the summit for 15 minutes because they werre low on oxygen.
Mr. Hillary took several photographs of the scenery and of Sherpa Tenzing waving flags representing Britain, Nepal, the United Nations and India.
[On the return,] Col Hunt saw the two men looking so exhausted that he assumed they had failed to reach the summit and started planning another attempt.
But then the two climbers pointed to the mountain and signalled they had reached the top, and there were celebrations all around.

Thursday, July 9, 2009

Lip Repositioning - A Reason to Smile

Jean was in today for her final "glamour shots" after her lip repositioning surgery. In both photos, she is forcing a large smile. The "after" photo shows a beautiful result, and she's most pleased with it.




Jean says that she's smiling all the time! It's hard to believe that she wasn't smiling all the time before.


Wednesday, July 8, 2009

A Picture is Worth . . . Sending You to Prison

Usually a picture is worth a thousand words, but this time a picture is worth a few more visits to the Liberty Hotel in Boston.


Paula and I just returned from Boston visiting our son Bryan for the 4th of July. We chose to stay at the Liberty Hotel which seemed aptly named for a visit during the Independence Day Holiday. When Paula made the reservations, she was asked what the occasion was for our visit. She mentioned that we were visiting our son who was attending the Harvard School of Dental Medicine.


On arrival in our hotel room, we were pleased to find a personal, hand-written note welcoming us to the Liberty Hotel and wishing us a nice time visiting with our son. Wow! That's customer service. About 15 minutes later, we realized this was only the beginning of our special experience in the Liberty. I looked over to the night stand, and saw a framed photo of the Harvard School of Dental Medicine propped in a prominent position. Now that was impressive. That is a quality of customer service that demands to be recognized.


The Liberty Hotel was a great place to stay. The staff was accommodating. The restaurant was fabulous, and they had a unique motif. Did I mention that the "Liberty" Hotel had at one time been a prison? Yes, if you're ever in the Boston area, I'd recommend you spend your weekend in this prison.


Kudos to the people at the Liberty Hotel in Boston. I guess a picture is worth . . . well, alot.

Tuesday, June 30, 2009

Overcoming 1980's Dentistry


Hey, the 80's called. They want their teeth back!

When I first started practicing dentistry in the 1980's, the most common, least expensive thing we could do for someone who had a large space between their front teeth was to fill the space with two large crowns.

Quickly, we realized that running around flashing two humonstrous chiclets wasn't exactly sexy.

Our next generation solution for this problem was to crown the front four teeth instead to divide out the extra space between more teeth. This worked better, but the teeth generally owned two faults: They looked wider than they were tall, and there was a funny shape to the gum tissue beteween the two front teeth due to missing tissue.

Enter the 2000's . . . Contouring the gingival tissue to make the teeth look larger, and to create a natural "emergence profile" combined with fabrication of murano veneers and crowns really produces a smile that shines on. The gum tissue is contoured with a laser to simulate natural gum contours and "points" between the teeth. Murano veneers and crowns are computer designed to capture natural size and shape relationships between all the smiling teeth.

The photos above illustrate a recent success at the Jacobs Smile Center. The before photo shows the 80's style dentistry, while the after photo highlights what can be accomplished with the technologically superior murano veneers and crowns and laser recontouring - gum lift - of the tissues. The photos have been taken about 3 weeks apart.

Oh, yeah, I also did some ZOOM! whitening to round out the brilliance of her smile.

This lady is very active publicly, and tells me that many people have commented on her beautiful new smile. "I can't believe I waited so long," she tells me. I'm glad it was worth the wait.