Word Of Mouth – A Dental Blog

I presented a lecture to the Oral Surgery and General Practice Residents last week at New York-Presbyterian Hospital on “Implant Aesthetics”.  As part of the presentation I talked a little bit about the “Psychology of Beauty” so residents get a better understanding of why the esthetics are so important to the patients they are treating.  I addressed issues concerning the evolution of plastic surgery since the first reported plastic surgical procedures in 600 BC.

In Beauty Junkies,  by Alex Kuczynski, the author talks about the historical change in the emphasis and goals of plastic surgeons from creating an appearance that allowed an individual to  “fit in” to one that allowed patients to stand out by enhancing their physical appearance.

In the NY Times Magazine section this past weekend I read an article entitled What are You Really Worth?  Speaking of appearance related issues, here are some interesting findings:
·    Above average looking man over his working life earns $250,000 more than least attractive men.
·    Attractive men are paid 5% more than less comely counterparts.
·    Prettiest women earn about 4% more.

Who would have thought?  Maybe beauty IS more than skin deep!!

As always, just my thoughts.
Thanks for listening.

RMS

Who would have ever thought that business would condone “sleeping on the job”?  It’s true.   According to a recent article in the Harvard Health Letter (Vol 35, Nov 2009), companies like Google are encouraging naps at work.  How can this be?

Recent sleep studies have shown sleep improves learning, memory and creative thinking.  According to the HHL, several studies have shown that when people are asked to memorize things, and then they nap, they will remember more than they would if they had not napped.  Short duration naps of 5-6 minutes have even been show to improve information retention.

We all have a form of a biologic clock in the part of our brain called the hypothalamus.  The cells located here help to set up a certain circadian rhythm controlling among other things, body temperature, blood pressure, sleeping and wakefulness.  Normally we are awake during the day and sleep at night. But it’s common to have a little “hump” of mid- afternoon sleepiness programmed into the body’s rhythm.  The afternoon nap can get us through this afternoon period where we may get tired.

Robert Strickland, a Harvard sleep researcher, says “napping makes people more effective problem solvers”.  And he goes on to say that recent findings make a case for employer policies that encourage napping.  This has led some companies to set up nap rooms or “nap pods” that block out sight and sound.

Of course, some fear abuse of mid day napping at work, and understandably so.  But in fact, there may be a case made for strategic napping.  Next time someone says they are just “resting their eyes” there may be a biologic reason behind it and a benefit to themselves and their employers.  Who would have thought? Maybe someday not only will we get a lunch break, but nap time too!

As always, thanks for listening.  Hope you got through this without falling asleep!

RMS

As I’ve said before, as dentists we wear many different hats; we’re clinicians, biologists, artists and scientists.  As scientists and clinicians we should be basing our treatment decisions and recommendations on scientific facts and evidence, not hearsay.  That’s the basis of evidence based science.
Two articles in this past Sunday’s newspaper caught my attention.
The first article, on the front page of the href=”http://www.nytimes.com/”>New York Times, addressed the relatively new technique of robotic surgery.  The pros and cons of robotic assisted surgery vs. the old fashioned way of using human hands were evaluated.  The author, Gina Kolata, discussed the lack of scientific studies proving that robotic assisted prostate surgery resulted in better results for patients.  Only one long term study has been done that included robotic surgery, but that study didn’t really differentiate between robotic results vs. non-robotic results. 

In the absence of definitive conclusions, the author goes on to discuss the role of marketing in the patient decision making process; newer being interpreted in many instances as being better.  She also discusses how popular robotic surgery is becoming even in the absence of studies citing its clinical superiority!  And finally, she points out the pressure placed on medical institutions to provide these services because of the huge initial investment in the robotic technology.  All with no evidence that robotic surgery gives better results.

The 2nd article, also in the New York Times (Style section),  dealt with stress and tooth grinding.  Michael Winerip, the author, relates several discussions he had with various dentists and dental professionals in an effort to support his premise that these stressful economic times are causing more tooth grinding; a plausible hypothesis indeed.  But once again, show me the evidence!  Where is the science behind the conclusion that increased stress in causing increased grinding?  Indeed, Mr. Winerip states in his article that “there are no studies about grinding and its relation to the recession.”

 There is no reason to dispute that one dentist in the article made 65% more night guards in 2009 than the year before.  But just because we are living in extremely challenging economic times may not be the only reason the number of night guards made increased.  Nor is polling 3 or 4 dentists a sufficient scientific pool on which to conclude that increased stress is causing more grinding.  The entire subject of tooth wear is extremely complicated; indeed the vast majority of teeth wear occurring not during the night, but during the day.
Our goal as health care providers should be to evaluate our patients concerns, evaluate conditions that exist, and come up with treatment solutions that can address the problems based on scientific evidence, not just the solution “du jour”.  That’s what scientists do.
Just my thoughts, thanks as always, for listening.

RMS

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!