How Do We Measure Up?

Dentists spend much of their working hours talking to patients about proper care of their teeth and have studied the ill effects of poor home care.  So how do dentists measure up?  Do they follow their own advice?  The results of a recent study of the oral care habits of pediatric dentists was a big surprise to me.

Turns out that the dentists surveyed do not always follow their own advice.  Although most of the dentists (55%) brush twice a day and 33% brush still more – 7% brush only once a day.  Forty-eight percent of the dentists consume sugar products once or twice a day between meals and 14% consume them more than twice a day.  A large majority (92%) do use fluoride toothpaste.  But 13% floss only occasionally and 21% floss only 2-3 times a week.  A quarter of the dentists do their own check-ups.  (How is that possible and can this be an adequate dental exam?)  Twenty-seven percent last had a dental exam 1 to 2 years ago and 5% had an exam even less frequently.  In their favor, the overwhelming majority of  dentists (90%) have never smoked and another 3% have stopped the habit.

So a significant number of surveyed dentists are remiss in their own oral health care.  And you may ask, where do I stand?  I see too much dental decay and gum disease not to follow recommendations and then some.

In recent years dental and medical credit cards have become a popular option to finance needed medical and dental treatment.  But consumer complaints about aggressive and misleading marketing tactics have lead to an ongoing investigation by the New York State attorney general. The complaints claim that patients feel pressured by medical practitioners to sign up for these cards to pay for procedures they may not need or cannot afford.

So for your protection be sure that you read the fine print and know the terms of any contract you sign.  Any zero percent financing lasts for only a specific period, usually from 6 to 12 months.  After that period of time, you will be charged interest – often a high interest.  Also be sure to be aware of the minimum payment you need to make in order to pay off the loan in the no-interest period.  Paying the minimum that the credit card company requires may not be enough for you to pay off  the loan in the no-interest period.

Yes, we offer CareCredit and CitiHealth Cards.  It sometimes gives people the means to pay for much needed treatment.  But we are careful to explain the fine print.  Rest assured that we never pressure our patients to sign up for a credit card plan. We don’t let people borrow more than they can comfortably pay back.  We behave ethically and treat our patients with respect. We present options and let patients know the full costs before we begin treatment and we present treatment which is within the patient’s budget.  Medical and dental cards can be a convenient way to pay for dental expenses – but they have to be used wisely.
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A successful dentist needs to be sensitive to his/her patient’s fears. I spend a lot of time making my patients comfortable. But sometimes patients are very anxious and feel pain even before we begin a procedure.

I just read about a new approach to deal with this problem. This psysiological/psychological maneuver is credited to Allan S, Berger, MD, Professor of Clinical Psychiatry at Georgetown University. He suggests that the anxious patent hold 3 to 4 cubes of ice (wrapped in toweling) in his hands. The dentist then tells the patient to massage the ice, especially using the thumb. At the same time, he tells the patient to count in his mind backwards from 100 to one. Any dental procedure or injection of anesthesia should be delayed until the palms and the thumbs are numb. The patient should feel less pain.

An interesting approach! – and one that I certainly will implement in my East Setauket dental office and monitor to see if it works as promised.

 

 

The Stony Brook Film Festival opened last night with the comedy “The Answer Man.” Not a film about teeth (except for two ugly veneers on Lauren Graham’s central incisors – wouldn’t I love to replace them for her), but I loved the film for the subplot of the female chiropractor struggling to start a practice. She puts up fliers in the local bookstore, and – in a desperate mood – dresses her receptionist in a vertebral column costume to hand out fliers in front of her storefront office. Hysterical! Sort of like a dentist dressing up as an oversized molar tooth. Not something I can see myself doing! Tonight look out for the vampire comedy “Rosencrantz & Guildenstern are Undead” (see my blog entry, “The Sight of Fangs” about vampire teeth).

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Check out the ads for the new comedy film “The Hangover.” What do you notice?  Right in the center of the ad is a guy who is missing a tooth (the right later incisor, to be exact).   If that photo doesn’t convince everyone to take care of their teeth, then I don’t know what will!  So I checked out the trailer.

The film is about some friends who get together for a raucous bachelor party.  The next morning they all have headaches but remember nothing of the night before. “ I lost a tooth,” says our hero, as he looks at himself in the mirror.  You’d think it would have hurt!  Well if you need a tooth extracted, it’s better to come to our Long Island dental office for the procedure, and don’t be afraid – I promise it won’t hurt and we won’t let you go home without a replacement tooth!

 

Cover of "The Hangover (Unrated Edition) ...

The Hangover

 

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When I read about Supreme Court nominee Judge Sonia Sotomayor’s finances, I noticed that she owed money to her dentist. I haven’t had a good look at her teeth, but as she does have diabetes and there is a strong link between diabetes and gum disease, there is a strong possibility that she suffers from the latter. Gum disease needs to be controlled with frequent visits to the dentist for periodontal scalings. If neglected, surgery and/or tooth loss can result. This can be costly. If you suffer from diabetes, be sure to visit the dentist regularly for a periodontal examination. Healthy gums should have a firm, stippled consistency, should not be swollen or bleed or have an odor.

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Last week I participated in Career Day at the Nassequegue Elementary School, near my East Setauket Dental Office. I spoke to third to sixth graders about Dentistry as a career. I explained how to become a dentist and what my work is like. I talked about the technological advances in dentistry and about the uses of computing and photography.

They were very attentive and asked excellent questions. I was impressed by their knowledge; they knew about palatal expanders and athletic guards! I told them that they didn’t have to go to dental school, that they sounded like they were already dentists! I asked them how to keep their teeth healthy and they quickly responded: brush after meals, eat healthy foods, and visit the dentist twice a year.fish called wanda a download

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At last! A fearless dentist hero! Check out the March 30, 2009 New Yorker Magazine article “Tails of Manhattan” by Woody Allen. In this comedy, Abe Moscowitz, a “decent citizen, a dentist, a mensch,” dies of a heart attack and is reincarnated as a lobster. Not a very dignified beginning for the dentist, and I read on, expecting the usual “dentist as schlemiel” story. But what a surprise! Turns out that Moscowitz lost his life savings in the Bernard Madoff swindle and has a myocardial infarction when he finds out.  The reincarnated Moscowitz spends his time swimming around in a restaurant lobster tank.  One day Bernie Madoff turns up at the restaurant and Moscowity gets his chance at revenge.  Moscowitz and a companion manage to turn over the tank and attack Madoff.  Moscowitz grabs Madoff’s nose with his giant pincers and the swindler is severely injured.  Moscowitz escapes to live out his lobster life in the waters of Sheepshead Bay. What a hero!

 

 

 

I wrote an entry this week about sibling teeth on the Sibling Blog.  Check it out!  Sibling teeth are inherited, and the form and eruption patterns of sibling teeth can be remarkably similar.  For example, if one of your children has over retained primary teeth, it is likely that her siblings may also have a delayed eruption pattern.  If one child is missing one or more permanent teeth, his siblings may also be missing the same – or mirror – tooth.

But habits also affect the teeth.  Thumb sucking, tongue thrusts, blanket sucking can all affect the development of the jaw bones.  My patient Melissa had a habit of sucking her middle three fingers but her parents sent her for early orthodontic intervention. She is now a young woman with a lovely smile. Her older brother did not have a finger sucking habit but he was older when he had orthodontic treatment and his smile is not quite so beautiful. The siblingstuff blog has lots of good stuff on siblings. Sibling teeth is one topic.

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A patient came to our Long Island dental office today to report that Good Morning America had a segment on a possible link between denture cream and imbalance. The source was a June 4, 2008 article in the journal Neurology which concluded that chronic, excess zinc intake can result in copper deficiency and profound neurologic disease. The authors identified four patients with various neurologic abnormalities. Each of these patients wore dentures and used more than two tubes of denture cream a week.

This is excessive!! If you must use denture cream, use just three to four dime-size dots in key places on the denture. You are using too much denture cream if the cream oozes out of the side of the denture when you put it in place.

But the real question here is why are these patients using denture cream? A denture that needs cream is a failing denture. My denture patients never use adhesives. I make the best dentures, and you don’t have to add glue!

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