Word Of Mouth – A Dental Blog

Like all of us, I like to get positive feedback; it’s always nice to feel appreciated.  Two nice things happened today that made us feel we are on the right track and people understand our value system.

A patient called this morning to say she was no longer physically able to make the trip from Westchester to NYC.  She was sad that a relationship that had started in 1979 had to end because traveling to our office was now too difficult.  She thanked us for many years of service, and special attention, and was appreciative that we took the time to listen to her concerns and act in ways that addressed her needs.  I volunteered to send any appropriate records to her new dentist and told her our door would always be open should she have questions or feel well enough to again make the trip to NYC.  We understand that circumstances change and our patients have to act in ways that work best for them.

A 2nd patient came in to see our hygienist later in the day.  This was a patient who had previously left our practice for another dentist on her “plan”.  The other dentist’s fees were obviously less then ours but after a visit or two she returned to our office.  When I asked her why, she said the quality of care in our office was much better; we spent more time, cared more about her and she was now willing to spend the extra money to be treated here.  It was gratifying to me and to my hygienist to hear this.  She also told us the other office gave her a difficult time when they were asked to send recent x-rays to our office; tried to make her feel guilty about leaving.  She felt they weren’t concerned about what was best for her.

Similar circumstances for two patients; dissimilar reactions by two different offices.  We believe that our words and our actions should support our patients.  As I’ve said before, patients come to see us to express their concerns, learn what conditions exist, and decide on a protocol that best helps them meet their goals.  Our responsibility is to act in responsible and professional ways that support the best interests of our patients.  Simply said, it’s not about us, it’s all about them.

So nice to see that people appreciate this.

Just my thoughts, thanks for listening.

RMS

I examined a patient yesterday after a routine visit with our hygienist.  This was a patient who was seen on a regular basis every 3-4 months.  I was startled to see the amount of change in the enamel surface of her teeth.  The signs of acid erosion were unmistakable; cupped out biting surfaces, existing fillings that now protruded beyond tooth surfaces, darkening of normal tooth enamel. When questioned, the patient said she had started drinking warm water with lemon as a breakfast drink and was frequently sucking on lemons.

The amount of tooth destruction was severe enough to share this incident in an effort to educate others and prevent this from occurring wherever possible.  I’ve found information through the Academy of General Dentistry that I share with you below.

Many people consume carbonated beverages, fruit juice, and highly acidic foods every day but probably don’t realize that they might be harming their teeth. The acid in the foods we eat and drink can cause tooth enamel to wear away, making teeth sensitive, cracked, and discolored.

What is tooth erosion?
Tooth erosion refers to the loss of tooth structure; the wearing away of the hard part of your teeth (enamel).

What causes tooth erosion?
Tooth erosion occurs when the enamel on your teeth is worn away by acid. Usually the calcium contained in saliva will help remineralize (or strengthen) your teeth after you consume small amounts of acid, but the presence of a lot of acid in your mouth does not allow for remineralization.

Acid can come from many sources, including:
• Carbonated drinks. All “fizzy” drinks, including soda (even diet varieties), contain a lot of acid and can dissolve enamel on your teeth very quickly. More damage is done when you drink large amounts and or you hold the drink in your mouth for a long time.
• Pure fruit juice. Sucking on limes or lemons can result in significant tooth erosion over short periods of time. Juice can have similar effects on your teeth because it contains a lot of acid.
• Bulimia and acid reflux. Bulimia, a disease in which a person vomits to avoid gaining weight and acid reflux(GRD) also can cause tooth damage due to stomach acids. Medical and dental help should be sought immediately if you or anyone you know suffers from a condition such as this.

What are some signs of tooth erosion?
• Sensitivity. Since protective enamel is wearing away, you may feel a twinge of pain when you consume hot, cold, or sweet foods and drinks.
• Discoloration. Teeth can become slightly yellow or brown because the dentin (underlying tooth structure below the enamel) is exposed.
• Rounded Teeth. Your teeth may have a rounded or “sand-blasted” look.
• Transparency. Your front teeth may appear slightly transparent near the biting edges.
• Advanced Discoloration. Teeth may become more yellow as more dentin is exposed because of the loss of tooth enamel.
• Cracks. Small cracks and roughness may appear at the edges of teeth.
• Severe Sensitivity. As more enamel is worn away, teeth become increasingly sensitive.
• Cupping. Small dents may appear on the chewing surface of the teeth. Fillings also might appear to be rising up out of the tooth.

What can I do to prevent tooth erosion?
Because there are different reasons why you may experience tooth erosion (e.g., swishing carbonated drinks, drinking a lot of juice or wine, eating disorders), talk to your dentist about your habits so that a plan for preventive action can be determined. Here are some general things you can do to protect your teeth:
• Reduce or eliminate drinking carbonated drinks. Instead, drink water, milk, tea, or coffee—but skip the sugar!
• Drink acidic drinks quickly and use a straw so that the liquid is pushed to the back of the mouth. Don’t swish them around or hold them in your mouth for long periods.  Stay away from sucking on lemons or limes.
• After consuming high-acid food or drinks, rinse with water to neutralize the acids, and wait an hour before brushing your teeth.
• Chew sugar-free gum to produce more saliva so your teeth can remineralize.
• Brush with a soft toothbrush and be sure your toothpaste contains a high amount of fluoride.

You can find more information on dentally related topics at  www.agd.org.

I was listening to Brad Paisley sing “Welcome to the Future” the other day on satellite radio.  He remembers as a child wishing he had a Pac-Man game in his basement and having to get a ride to the arcade- and now having it on his phone.  I’ve spoken before about our need to embrace changing technology and staying relevant in the lives of our patients.  So come 2010 we’re going to use some of the latest technology to help us and our patients stay connected.

For those of you who have been in our office, you know that outstanding patient care is of the utmost importance to us.  It’s a basic building block of our practice foundation.  And while in the past we’ve used the phone and mail to reach out and stay in touch with you, we’re going to be trying something new.  Early in 2010 we will have the ability to communicate and respond more effectively by introducing an advanced, patient-friendly system that allows communication through e-mail and text messages. 

We have noticed that for many of you, texting and e-mail is the primary way you now communicate.  How many of you are still texting and reading e-mails even while sitting in the dental chair?  Lots!  We are hoping our new system will make it easier to alert you of upcoming appointments, find out how you’re feeling after appointments and give you an opportunity to reach us besides using the telephone.  Of course, for those of you who still prefer using the telephone and US mail, we will note your individual preferences and reach out to you in the ways that work best for you.

As we transition into 2010, I’d like to take this opportunity to express my gratitude to all of my patients for the opportunity to help them get healthier and achieve their dental goals.  And to my outstanding team of caring professionals, I thank you for your help in making this happen.

A Happy and Healthy future to all!

As always, 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