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

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

GUMS GINGIVITIS GENES

What’s the connection?  Researchers at the University of North Carolina- Chapel Hill along with Procter & Gamble Oral Care published a report in the December 2009 Journal of Periodontology documenting a connection between swollen gums and the genetic code.

Traditionally when your dentist discussed with you that you had “swollen gums” he usually suggested you improve your oral hygiene habits; brush more, brush more effectively, floss more, remove plaque more effectively.  It now appears that our ability to prevent and fight gum inflammation (gingivitis) may involve factors other than diligent brushing and flossing.

According to Dr. Steven Offenbacher, a lead researcher in the above study, over 9,000 genes (30% of the total genes in the body) are expressed differently during the onset and healing process of gingivitis.  “Details of this discovery indicate that the same biological pathways that are associated with activation of the immune system are the major pathways activated during the body’s reaction to the buildup of plaque on the teeth” according to the AGD Impact news magazine(Feb, 2010) discussing the research.  Furthermore “the gene expression pathways associated with thwarting plaque overgrowth are the same as those involved in wound healing and skin repair.” The genetics associated with gum inflammation and healing may therefore apply to other areas throughout the body.

Researchers are hoping that their understanding of gum inflammation on the molecular level will not only help clinicians eventually improve our understanding of prevention and treatment of gingivitis but will help others better understand and explain what is occurring in a person’s body at the onset of disease and how it relates to their overall health.

This study is just another that shows the increasing connection between dentistry and medicine and how clinicians and researchers are attempting to better understand the dental-medical connection.

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