Word Of Mouth – A Dental Blog

For several years I’ve been talking to my patients about a comprehensive integrated approach to dental care that evaluates how comfortable it is to chew and how the “chewing machine” is working. This is the “comfort” part in the Health-Comfort-Beauty” triangle. How nice to see that in the JOHN HOPKINS MEDICAL LETTER “HEALTH AFTER 50”, this same topic is covered in the January 2010 issue.
“Putting Jaw Pain to Rest-Without Surgery” describes the prevalence of temporomandibular disorders in the U.S. and discusses some of the signs, symptoms, and treatment modalities available. Here are some of the more important facts from this article:
1. Up to 10 million Americans suffer from TMD (temporomandibular disorder) which can leave chronic sufferers     unable to sleep well and can interfere with normal speaking and eating.
2. TMD is associated with the complex anatomy of the temporomandibular joint which connects the upper jaw to the lower jaw.
3. Dr. Anthony Tufaro at Johns Hopkins talks about musculoskeletal problems relating to the repeated movements of jaw bones and muscles as one of the most common causes of TMD.  And while misaligned teeth can contribute to this type of pain, for some patients, bite problems have nothing to do with the TMD symptoms they are experiencing.
4. Self care for the TMD may consist of:
• Rest
• Heat
• Medication
• Behavioral counseling
• Jaw appliances (orthotic bite plates/night guards)
• Physical therapy
What is left unsaid in this article is that often times we can see the signs of muscle or bite imbalance by observing teeth that are loose, broken, or worn and /or jaw muscles that are tender to touch. A comprehensive evaluation of all the structures inside and outside the mouth is important to determine not only how healthy we are, but what are the correct steps to take to achieve and maintain a healthy bite and jaw.
Further questions? Call us in the office or drop us an e-mail.
Thanks for listening.
RMS

As I’ve said before, in a world that is changing so rapidly in terms of technology, social interaction and economics, we’re trying hard to remain ahead of the curve.  How do we change and stay in touch with our patients?  How have their dental  concerns about health, comfort and beauty changed over the last 18 tumultuous months and how does that affect the way they perceive what we do?  And how do we remain relevant in their lives?  Do they want us to remain relevant in their lives?

We’ve tried hard to ask these questions, both in the office and by surveying our patients on line.  My gut feeling has been that we need to remain supportive of what our patients are experiencing and need to be curious about the best ways to help them stay healthy and achieve their dental goals.  I’ve always believed strongly in relationship based and very personalized patient care. 

In the spring of ’09, I was interviewed by a writer for MY BUSINESS Magazine.  I spoke about my belief in patient centered care and how important it is in the world in which we now live where often the Dr-patient relationship has become depersonalized.  You can find some of my comments at http://www.mybusinessmag.com/fullstory.php3?sid=1970

Who’s listening? We are!

Several years ago my office team and I spent some time attempting to redefine what we do and how we do it.  We had a general idea of what we felt was important to our patients and to us in terms of the care we deliver but felt we needed to better define our core values and become more focused.

 At the time there was a lot of press related to “cosmetic” dentistry and “spa” dentistry (whatever that is).  In an age of “Extreme Makeover” and almost instantaneous gratification, we chose another path.  I never wanted to be just a “cosmetic” dentist.  I felt our patients were entitled to more than just cosmetic care.  I felt comfortable based on my training and experience providing a more comprehensive kind of experience - one that was patient centered, relationship based, and that fully integrated health, comfort and beauty.

Two articles I read in the last week helped confirm that in a world that is rapidly changing my team and I are on the right track.

In New York Magazine, week of June 1, Beth Landman wrote in her article “Nipped & Tucked” about the changing reality of medical and dental practices that were only recently, cosmetically oriented.  She wrote about “lifestyle” medicine losing some of its allure as the result of changing economic times and the trials and tribulations of doctors who now have to provide more health centered treatment.  I apologize if I appear naïve here, but shouldn’t the health aspects of care have been considered all along? 

As I’ve said before, as dentists we’ve been trained to be scientists, biologists, clinicians, and artists.  But concentrating exclusively on the “cosmetic” aspects of care often times neglects the health and comfort of the patient.  Shouldn’t these clinicians have been addressing health issues all along as part of the “cosmetic work” they were doing?  Now they’re getting back to basics because the revenue stream from these cosmetic procedures has slowed to a trickle.

In the New York Times Business Section, June 7, 2009, Julie Weed wrote an article entitled “If All Doctors Had Time To Listen”.  She talks about changing models of health care delivery; new methodologies that allow physicians to spend more time with their patients, emphasize prevention, and decrease the number of referrals to specialists.   Ms. Weed  states that these “patient centered” practices are popular and growing.  That shouldn’t be a surprise.  Patients are looking to re-establish a more relationship based personalized kind of care where they feel cared about and cared for.

All in all, a good week that made my team and I feel comfortable that we are on the right track, trying to remain relevant in the lives of our patients.

As always, thanks for listening.

RMS

By Trish Rubin

On the personal journey to Health, Comfort, and Beauty there are many impressionable stops to be made.  Sharing positive first impressions of the people who are part of my care is important for me .The people who make up Dr. Sorin’s family have a vital role in keeping me connected to my goal, in keeping me believing in the work of developing my dental health for a shining result, in helping me keep appointments, and helping me to follow through with my actions.

My dental condition has been managed for the last year by an amazingly caring dental hygienist…she’s my smile architect…the woman who is part construction worker and part artist, since she knows exactly how to create and support a smile that has been neglected for years. Elvie is welcoming and understanding, No judgment, only support. From her experience as a runner, she knows about working to a goal. Talk about a first impression. Meeting Elvie further connected me to care on a personal level that I needed.

With first impressions in mind, imagine me sitting in the treatment chair and I am
anxious.   The impression that was made in Dr. Sorin’s office this week was mine…the impression of my teeth…my crowded, crooked, chipped teeth that have been hiding in plain sight for years. It’s a first step along the way. Straightening out the teeth that time has pressed unattractively together over years. Some overlap, some receding. And lots of angst for me.

But along with Dr. Sorin, I am in good hands… Meet Ro, a patient care specialist in whose hands I have been placed…literally. Rose has the patience of an angel as she assists in my care, and she has the soothing demeanor necessary to take on the dental phobic, leaving her boss, Dr. Sorin free to work his magic.

My first impression is that she is confident. She is clear in explaining the procedure I will undergo as she knows it from coaching other patients through. She is empathetic I feel absolutely supported by her, and I feel that she can carry my burden of anxiety  during treatment on her delicate but strong shoulders.  Just seeing her at my side feels comforting. Her patient eye contact, voice tone, a caring pat to the arm, a needed paper towel pressed gently against the corner of your mouth. “I’m with you,” she said, not once, but many times to me in the course of the appointment. As I rested back against the chair at her suggestion, eyes on the tropical beach scene projected on the plasma TV, she kept me feeling relaxed. I felt she was with me, and …we could have passed tropical drinks to each other in an imaginary mini-break! I felt calm and cared for.  Despite my vulnerable situation, it seemed to me, I was so protected in a dental office! In my history, the words soothing, protected, safe were never part of the experience.

For those who seek the best in care, it is a gift to bestow on yourself. And I was fortunate to be in that safe place. I even was able to weather the breaking of the seal of the impressions….the hardest part for the patient since you have the feeling that you might lose filings and caps along the way! That fear summons up a lot of negative dental baggage! But no, Ro was there to coach me through that part too. She gave me confidence and held my hand. It was her job  to get me through. The results were perfect. The seals were broken on my impressions, and the bonds were made closer to my caregivers.

Recently a popular New York weekly magazine featured several articles on the popularity of cosmetic procedures, including cosmetic dentistry. One of the authors interviewed several “cosmetic” dentists to discover what treatment would be most appropriate for him. I found the article surprising and disappointing.

The author consulted five Manhattan dentists, reporting on their “styles of care”, their bedside manner and their treatment proposals. What I found most surprising and disappointing was that in none of the offices being evaluated, did the author (patient) receive a comprehensive evaluation of his dental health. No mention of an oral cancer exam, no mention of a check for gum problems, no mention of an examination to determine if the muscles and the tempromandibular joint were working harmoniously -only an emphasis on what to do to improve the “the look”.

Now I must apologize if I am missing the boat, but as one who provides cosmetic services I have always thought, and still believe that patients can and should have it all. Good dental care should be based on health, function and beauty. A desire to achieve improved dental aesthetics does not have to neglect either oral health or masticatory function! After all, an outstanding cosmetic result can only be created on a well functioning and healthy foundation.

While it is certainly true that more and more patients are seeking cosmetic dental care to help them look and feel better about themselves, aesthetic care must also consider the health of the underlying structures and how these structures work as an integrated unit. Anything less and the patient is simply not getting the best.