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

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

Lisa Mandelbaum-Brown, MS,RD,CDN
As a practicing dietitian, I have seen and heard it all when it comes to what people eat, when they eat it, what they thought about before they ate it and how they felt after they ate it.  Something so necessary, so pleasurable can be made into such a complicated experience. 

In a world where we have so much opportunity and so much we all want to accomplish in life, I truly get why so many of us look to our health as the determinant.  Some of us on the way there take a pit stop at vanity and get stuck while others are in hot pursuit of the ultimate elixir.  No matter what the impetus, one thing is for sure, more of a good thing or rather less of a seemingly bad thing doesn’t always add up to making it great.  Less sugar, less white flour, no carbs, low sodium and the list goes on.  We really do not need to ‘treat’ what we don’t have.  Too low of a sodium content can lead to electrolyte imbalances especially for the avid exerciser, too low of blood cholesterol is an indication of poor nutrition, avoidance of carbohydrates leads to a plethora of issues…

This is where I say let’s go back to basics.  Science, which is what we base medicine on, is forever redirecting us. It is exciting and dynamic and at times predictable.  In my experience as a dietitian I have aided and abetted in the chase for the next best thing and then boom, sound the alarms. NO MORE folic acid, NO MORE vitamin E, Trans fatty acids are THE DEVIL…we have all danced that dance.  Not anymore…this is where the KISS acronym has its debut. 

The basics:
Food is a necessity and it is also a source of GREAT pleasure. Let’s maintain that.
Eat real food—food in its or close to its original format.
Eat a wide variety of food—this is your best bet to get all of your nutritional needs met.
Avoid all the additives and processed food as a general rule of thumb.
Eat the real deal — if you want dessert, eat a real dessert.   Eat all throughout the day—don’t skip meals and snacks
Take supplements but K.I.S.S.  If you are a healthy eater all you need is a good multi vitamin, maybe some fish oils for those super Omega 3’s and calcium for us women of age.  Go back to listening to your body. It is the greatest predictor of necessary calorie intake.

AND love the body you are in. Take care of it, exercise it, put wholesome food in it but don’t stress it out with too much exercise, too little food, too much food, too much processed food and too many rules.

We have other complicated matters to attend to, keep this simple and peaceful

 Lisa Mandelbaum-Brown MS, RD, CDN is an associate of Joy Bauer Nutrition, a private nutrition practice in New York City.  She provides counseling to individuals of all ages addressing various nutritionally related concerns. Lisa has worked with some of the leading professionals in her field and has been interviewed and featured in national publications.

She received her M.S. in Clinical Nutrition from Hunter College School of Health Sciences and maintains affiliations with multiple professional organizations.

By Trish Rubin

I’ve hid my smile in plain sight for years.

I had a smile that was big and friendly as a child and I used it with ease, but right from the start I had two major dental demons. 1. Bad “bugs” as a dentist girlfriend of mine called my mouth chemistry and 2. Bad, no make that horrible, dental care.

It’s like the old joke what came first, the chicken or the egg.  Was it my bad bugs which led to cavity after cavity or the awful treatment experiences I endured from childhood to adulthood that led me to be so inconsistent in looking after my dental health?  Whatever the answer, I was in trouble. Almost nobody knew but me. It’s a hard secret to keep.

For me, for you and perhaps others, our behavior is the result of complex emotional issues. As I grew and my feelings about my teeth grew more negative, I learned to live with the smile I wore. I felt I deserved it. Through the years, it degenerated. I stumbled along through spotty, infrequent and sloppy dental care; I endured capping and loss of teeth. I learned to grin and bear it…to shut up and smile. But to smile in a way that hid my flaws. Now, as the years go by it is harder and harder to do. From a cosmetic perspective…it’s challenging…from a health perspective, dangerous…from a comfort perspective, deeply upsetting…

It was in that frame of mind that I met Dr. Bob.

I make my living on my feet in front of others. That’s how I met Dr. Sorin. He watched me speak in a room of over 100 people using my faux smile and getting away with it, barely. I was hiding my smile in plain sight in front of him during our first conversation, knowing my days were numbered when I was going to have to face losing what I had left in my mouth in a most traumatic way. And it felt like a self fulfilling prophecy. I didn’t know how to solve this. But Dr. Sorin and his practice made all the difference. And my path is now clear.

As you will see in this blog…I chose hope, I chose promise and belief…I chose the best care and the most supportive practice in New York City…or even the world… when I stopped hiding in fear about my dental condition and chose…Dr Bob Sorin’s patient centered approach to treatment.

I’ve been with the practice for a year, getting ready to take the big steps toward a brand new smile to use in a room of hundreds, or at dinner with a new date, and not just a cosmetic look. Dr. Sorin’s office has invested in my HEALTH so that I can wear my beauty in a smile I can flash easily again as I did as a child for years and years to come.