Sunday, February 28, 2016

Looking Back Over an Old Email

I am really bad about deleting old emails. In fact, I once had a laptop with 25,000 emails...Crazy I know. I still have old friends and relatives in my phone directory who have died years ago...

Sometimes, we do mine some gold from those old emails and today I found one.

Note from pt.pdf
You might think that Dr. Carlton referred this patient to me a few months ago...Actually it is

I always find it amazing to think that I have cared for someone for a third of a century. I was just 30 when I started taking care of this patient and now we are both 'seniors.'

I am a different person and dentist than I was 35 years ago...Today, I am nationally and internationally recognized for my work...

It is a great feeling.

Thursday, February 25, 2016

Staying on Top of Our Game

Last night I was invited to present a one hour lecture to the members of the Saratoga Dental Implant Study Group. In the upper echelons of dentistry it is expected that you will teach, publish and actually perform in your area of training.  Dr. Bulford asked me to present complex cases that he and I have done for our patients. There are not many dentists who want to do the larger cases because they are challenging to do and one error and a dentist can lose every penny of profit in a case (Remember that overhead in a dental practice is 70-75% and that taxes amount to half of the profit.)

The cases that I presented are usually only seen in dental magazines or at large, national implant meetings but rarely locally. I have 6,000 hours of study in advanced restorative and implant dentistry and this is why patients contact our office or other general dentists refer their patients to us.

I am honored to have been asked to show our cases. Our work speaks for itself.

Sunday, February 21, 2016

Not Your Father's Cavities

People have changed over the last 50 or 60 years and so have their teeth. Back in the day, when a teenager had a cavity, you could literally see a big, black  hole in a tooth  which was obvious to even non dentists. Today, tooth decay is much more "insidious" and appears much less alarming. The reason is due to the ingestion of fluoride and the eating habits of young people today...Kids don't eat 3 good meals, they graze on food through the day providing a constant source of nourishment for the bacteria that causes tooth decay.


Do you see those small  dark  'dots' in the middle of these teeth?
Let's follow them as I enlarge the teeth to reveal deep cavities

Cavity getting bigger

Wow the cavity is huge

Tooth decay right to the nerve of the tooth. See the small round dot in the bottom tooth
Like I said, this is not your Father's tooth decay.
P.S. This patient had a dental check up every six months but her dentist didn't think that those dark spots were tooth decay. Maybe my 40 years of experience is showing.

Mr. Trump and General Eisenhower (Not Political)

Every half a century we tire of our politicians and look for an "outsider" to be our leader. In 1960, both the Democrats and Republicans wanted Dwight Eisenhower to run as their Presidential candidate. We wanted something 'different' but also a known quantity, so to speak. Mr. Eisenhower had been a great General in World War II and that was sufficient for the American people. People called "Ike" a 'care taker' President who would keep the country safe  and stable...But ole "Ike" fooled a lot of people, like when he sent in the military to desegregate Southern State Universities. He was a pretty good leader as well as a military man.

Today, we are again looking outside of the political establishment for 'something different.'  The majority of us are trying to tell establishment politicians that we are not happy...

What will happen? Who knows.

Just something to think about...

The Concept of Passion for What One Does

Wikipedia defines 'passion' in several ways and the one that I like is:

"Passion is an intense emotion a compelling enthusiasm or desire for something."

Last week I asked one of newer patients how she decided to become a patient in our office. She answered that another one of my new patients told her how passionate I was about my work and that is what she wanted.

Also last week, my office manager, Trisha and I had a discussion about how egotistical some physicians and dentists can be. We spoke about ego and she said, "You do not have a big ego, you are just passionate about your work." I responded that the other dentists on one of my forums thing that I am arrogant and egotistical and she said, "They do not know you...they do not understand your passion for dentistry. They are not passionate about dentistry and therefore you come across as arrogant. You are not egotistical."

I truly believe that GOD or nature (whichever you believe) does not give the gene for passion to many. Consequently when we see someone who loves what they do and constantly strives for excellence, we think that they are different, odd or even arrogant.

Think about it...Don't you want the people that take care of you to love what they do and want to be the best at what they do??? And those that are passionate about what we do, rarely care about the money.

Just more to think about.

Thursday, February 18, 2016

Something To Think About

Sometimes I find interesting articles that I think you might find interesting. This appeared on the CNN website.

Why doctors choose to die differently

Story highlights

  • Jacquelyn Corley: One problem with medicine today, is that it is too good; people live longer than ever before
  • Painful truth that doctors are often asked to use intensive measures they would never wish for themselves, says Corley
Jacquelyn Corley, M.D., is a neurological surgery resident at Duke University Medical Center, a member of the Duke Division of Global Neurosurgery and Neuroscience, and a human rights journalist focusing on health care-related topics. The opinions expressed in this commentary are hers.
(CNN)Snow was falling. He sat wrapped in a blanket on the edge of the couch, watching intently out the window. Large flurries lazily made their way down from gray skies. In North Carolina, this was a rare sight. 
I stood next to his husband. His body had a musty, sick smell of unwashed hair and urine. His bloated and pale body was littered with tape and tubing. Half his head was shaved, and he had a drain protruding from his scalp. It sunk into the depths of his skull, pulling out the fluid in his brain, drop-by-drop. Large round pupils stared blankly back at me when I pulled back his eyelids, stubbornly refusing to constrict when I shined a light. His arms and legs were covered in green and blue bruises from when we pinched him every hour in vain to see if he would move a muscle. He didn't. He was a corpse with a beating heart. 
    Jacquelyn Corley, M.D.
    "It's beautiful, isn't?" I called over to the patient's husband. He was still watching snowflakes. 
    "Mhhmmm," he nodded absentmindedly, never tearing his eyes away from the snow-globe scene outside. 
    Pharmaceutical CEO speaks about $1 cancer drug
    Pharmaceutical CEO speaks about $1 cancer drug 03:32
    This was Day 20. As far as we could tell, the patient was gone at Day One. He had suffered a massive hypertensive hemorrhage. Blood had filled every free space in his brain, and the swelling encroached oppressively on gray and white matter alike. 
    We lost brain stem reflexes by Day Two, but the patient's husband insisted we push on. Three weeks. Three weeks of neuro checks on-the-hour, an intrusive routine in which we gag, pinch, and prod the patient to induce a reaction. Liters upon liters of fluid had been pumped through a nonresponsive body and countless needles had been used to violate veins for samples to send to the lab. He had endured at least half-a-dozen CT or MRI scans in addition to daily X-rays. There had been three weeks of brutal suffering. I felt guilty. I was an accomplice to this poor man's torture. 
    I could not blame his husband for keeping him alive. He was in love and devastated. He was only doing what he thought his partner would have wanted. Even after multiple family discussions and meetings, we could not convince them that he would not wake up. We were instructed to keep up this level of care until his body failed completely. 
    One problem with medicine today, is that it is too good.People live longer than ever before, and many patients are able to recover from deadly illnesses the world knew nothing about when my grandparents were children. Doctors can keep people alive in ways once thought impossible. 
    We can sustain a pumping heart and fill lungs with air indefinitely. Kidney function can now be replaced by humming dialysis carts and stomachs fed through surgically implanted tubes. In the intensive care unit, this process is carried on with extreme monotony, indifferent to whether the patient is actually able to think, feel, or protest. There comes a time for every person when his or her identity is gone, and the quality of life should be valued more than the mere presence of it. 
    This is a common viewpoint for many in the health care community, but it seems to be in opposition to the beliefs held by the general public. Families are suddenly forced to make weighty decisions for loved ones, often erring on the side of caution. "Do everything you can for him, Doc" is a phrase with far-reaching implications. Doctors, nurses and others who devote their lives to taking care of very sick patients see it happen all the time: A patient's time has come, but the family just can't let go. 
    Studies show there is a dichotomy between how health care workers view end-of-life care and how the rest of the world does. To illustrate this, a recent report published in the Journal of the American Medical Association (JAMA) describes data that was obtained from death records from Massachusetts, Michigan, Utah and Vermont from 2004 to 2011. 
    It revealed that compared with the general population, doctors were less likely to die in a hospital, less likely to undergo surgery at the end of their lives, and less likely to be admitted to an intensive care unit. Similarly, a study published in Plos One by doctors at Stanford University in 2014 found 88.3% of 1,081 physicians surveyed for the study designated "do not resuscitate" as their advanced directive.
    It is a painful truth that doctors are often asked to continue the kind of intensive measures they would never wish for themselves or a loved one. For those in the health care community, death is not an abstraction, but a daily reality. We know how precious life is, and we understand how difficult it is to watch family members lose people they love. But we also know in modern medicine, dying with dignity is a luxury more people should enjoy. 
    Note: Some of the details of the condition of the patients described in this story have been changed to protect their privacy.

    Sunday, February 14, 2016

    Hanging Out with the Big Boys

    On February 4-6, I attended the Dental XP Global meeting in Fort Laurderdale, Florida. Yes it was 75 degrees but I was only outside for 10 or 15 minutes during the entire time that I was in Florida... I went to study and that is what I did. Dental XP is a dental group composed of dentists from all around the world and the majority of dentists attending the meeting would surpass the average American dentist...Sad, I know.

    The speakers at the meeting were among the best in the world in the field of surgical and restorative implant dentistry. Listening to the speakers, one gets an appreciation for what the most talented people in the field are capable of doing and this explains why I post my clinical cases on the XP dental forum. These are the dentists with an appreciation of excellence and offer praise and valid criticism of the work shown.

    There are only a relatively small group of dentists who are capable of performing at a high level, take great photographs of their work and have a healthy enough ego to withstand critiquing of their  work. I was most fortunate to finally meet some of the other dentists who post their work on a regular basis; it was like old friends meeting.

    What you need to know is that it is my hope to continue to improve my level of care when I do your dentistry. It should give you great comfort to know that I am continuing to learn from the best in the world. I have no intention of slacking off like many older Professionals...I am not working so that my pension will increase. I work because I love doing dentistry and it is my goal to excel.

    You would be proud to know how many dentists from around the world appreciate the dentistry that you have in your mouth.

    Wednesday, February 3, 2016

    Don't Fly Jet Blue

    I am not a fan of 'discount' anything...There is a reason that the business is going to sell you something of little value.

    I have dental course in Fort Lauderdale tomorrow and was scheduled to leave in 3 hours.. Jet Blue called to say that they had downsized their plane from 180 seats to 100 seats...This was NEITHER a weather related decision or a mechanically related decision. This was:


    Airlines have a contract with the public. The agree to fly us to our destination at a fee that we are willing to pay... Like any other contract...

    Eric T. Schneiderman, the Attorney General of the State of New York is every citizens greatest defender and I immediately filed my complaint with his office...

    I called the headquarters of Jet Blue...The phone rang literally 100 times before someone answered and then I was referred to place so that someone would call me backthe next day.. REALLY????

    What they are telling us is that they really don't care about their customers and that they will do what they want and that whatever is in the best interest of the airline....

    I understand that the airlines are at the mercy of the weather...We all hate the weather related delays as does the airline...That is understandable... What is not understandable is to violate a contract because it is inconvenient or unprofitable (at the last minute.)

    There are many days that I go to work and make NO money...That is not YOUR problem and I would never think of either asking you to pay an additional fee for that day or create unnecessary treatment to allow me to make money..