We were about to take xrays on a patient today when she asked if we had heard about the recent Dr. Oz show in which he spoke about the increase in thyroid cancer among women.  No, we hadn’t heard about it.   Apparently Dr. Oz linked thyroid cancer to dental xrays and mammograms.  I haven’t been able to find any serious studies linking dental xrays to thyroid cancer, but that is beside the point.  The patient understood the importance of the dental xrays we were about to take, but she wanted to know if we used a thyroid guard (thyroid collar).  Yes, we assured her that we do use a thyroid guard (collar).  We placed the guard, just as we always do to assure maximum protection for our patients.  The American Dental Association recommends that a thyroid guard be placed for all dental xrays.

My son Aaron has just written a book called “Users Not Customers: Who really determines the success of your business.”  http://aaronshapiro.com/usersnotcustomers/.  He is the CEO of Huge, Inc, a digital marketing agency that helps companies re-imagine how they interact with their customers online.  Of course I am a proud mother - but the book is a fascinating account of the online business model.

I understand that my website is my online persona and I update it regularly so it is informative and easy to navigate.  I launched my website, drterryshapiro.com, in 2006 when there were few dental websites, but I recognized at the time that people would search the web for a dentist, even as they increasingly search there for everything else. (Surprisingly, Aaron was skeptical about the need for a dentist’s website.)  Nevertheless, people very often find me from my website.

Readers learn about my dental practice and my approach to dental treatment, they ask questions, get answers, look at our photos, read and listen to our testimonials, and become great patients.  I am amazed that even today most dentists do not have a website.  It is how we present ourselves to the public.  So enjoy clicking around and drop me an email with your suggestions or questions!

Several communities in the United States have stopped adding fluoride to their water systems.  Recently Pinellas County in Florida elected to stop adding fluoride to its public water supply although they just started the program 7 years ago.  Two hundred other communities have also stopped fluoridating in the past four years.  They are motivated by the economic downturn and by concern about the benefits of fluoride.

The US Public Health Service and the Centers for Disease Control and Prevention maintain that it is a mistake to end public water fluoridation.  The Federal government recommends water fluoridation, a practice which began in the 1940’s.  About 72% of the American population drinks fluoridated water.

Although fluoride has been demonstrated to decrease tooth decay, large amounts can lead to dental fluorosis, or brown spots on the teeth.  In 2011 The federal Department of Health and Human Services recommended reducing the amount of fluoride added to the water supply to 0.7 milligrams per liter of water.  The old standard ranged from 0.7 to 1.2 milligrams per liter.

It is finally here!  The newest version of our work horse dental management system, Dentrix.  We have been Dentrix users for many years and have watched it evolve into a powerhouse management system.  Recently our computer technician installed the newest version, G4, level 8. It has all of the appointment scheduling, reminder scheduling, insurance tracking and billing that we are accustomed to.  But the charting capability is more sophisticated with better integration of xrays and photographs and Guru, our patient education videos.  We can better chart alternative treatment plans.  We can access records off-site and better utilize text messaging and input documents into patient records.  We have been more or less paperless for awhile now
and now are more so.

So come in for a demonstration and view your treatment recommendations on our office ipad!

Smoking and gum disease go together like (love and marriage?).  Oral cancer is also linked to smoking.  I often speak with my patients about their smoking habits and their efforts to quit the habit.  Some patients have used the nicotine gum and nicotine patches but with uneven success.

The annual market for nicotine replacement products was over $800 million in 2007, compared to $129 million in 1991.  But now a long-term study of nicotine replacement therapy shows that the approach has no lasting benefit and may backfire.  The study was published this week in the Journal Tobacco Control at http://tobaccocontrol.bmj.com/content/current.  According to the study, nicotine replacement may help people quit but it does not prevent relapse in the longer run.  Motivation, social environment, support from friends and family and workplace rules also play a role.  New smoking laws, media campaigns and tobacco taxes also have an effect.

A lovely young lady came into the office last week with a complaint of brown spots on her teeth.  She needed to know that these brown spots were decayed spots (cavities).  The spots were not merely cosmetic but needed to be restored immediately before further damage occurred to her teeth.  The spots (really pitted areas in the enamel) were caused by plaque accumulation around her orthodontic brackets.  As a teenager her oral care was not as thorough as it could have been.  The acids from the bacteria resting on the plaque destroyed the enamel.  She did not visit the dentist the entire time of her orthodontic treatment.  Luckily I will be able to restore her teeth and she is determined to take better care of her teeth from now on.

People ask me how I came to have such nice teeth (lots of brushing, flossing, good food and regular dental visits.  I also get asked who does my dental work (That’s a closely guarded secret.) But wouldn’t you know it - I recently developed a cavity - not supposed to happen to a dentist - Right?  Wrong! It happened and so badly that I required a root canal, post and core and crown.  I didn’t miss my regular dental visit but I delayed taking cavity-detecting xrays.  So do as I say - not as I do!  And I won’t let this happen to me again.

There are lots of ways that tooth enamel can become worn.  Abrasion and erosion are two ways.  But I just learned two new terms: “fruit mulling” and “soda Swishing.”

Fruit mulling refers to excessive chewing of fruit.  That is, keeping the fruit in your mouth for minutes at a time.  The acid in the fruit eats away at the dental enamel.  Soda swishing refers to excessive swishing of soda - keeping soda in the mouth for minutes at a time.  One victim of soda swishing was apparently trying to cut down on his habit of drinking 9 bottles of Coke a day, so he hoped that by swishing, he would reduce his consumption of the drink.  It may have reduced his consumption, but he was keeping his teeth bathed in the sweet liquid and it destroyed his enamel.

Hasn’t everyone done the experiment of placing a baby tooth in a glass of coke to watch it dissolve?   I guess he didn’t learn this lesson.  So avoid swishing and mulling.

What do you think John Lennon’s molar tooth sold for at auction this past November?  Would you believe $31,000!  The decayed tooth was bought by Michael Zuk, a dentist from Alberta, Canada.  He is a collector of animal teeth and celebrity memorabilia.  The dentist plans to have the tooth mounted and placed on display in his office.  He said he would also lend the tooth to dentists or dental schools or anyone who would like to display it.

John Lennon gave the tooth to his housekeeper who lived in England at the time the tooth was extracted in the mid 1960’s.  She then moved to Canada and has kept the tooth ever since.  She provided an affidavit confirming that the tooth was authentic.  Even so, I doubt I would want to display it!

Last week I wrote here about the questionable practice of bite analysis in criminal convictions.  This is true, but dental forensics still has a very important function in body identification.  Dental records can help identify an otherwise unidentifiable body.

Many years ago I helped confirm the identity of a young boy who tragically perished in a house fire.  I had a set of dental xrays and records of his dentition and restorations.  The medical examiner’s office called me and requested the boy’s  records.  The boy’s identity was confirmed on the basis of these records.  It was very sad for the family and community but I was glad that I could help put the family at ease that the remains were their son’s and he could have a proper burial.