Friday, December 14, 2012

All I Want For Christmas is My 2 Front Teeth?

For dentists, this is one of the busiest times of the year in our offices. We are seeing patients who want to maximize their insurance benefits for the year which is drawing to a close. We are seeing patients who are already stressing out about the once-a-year relatives that will be visiting and grinding their teeth so much that their jaws hurt. There are also people who are enjoying the holiday treats that are so delicious, but can either break a tooth or pull a crown off because they are hard, sticky or both! (The particular sweet I am thinking of is a nougat type of candy.) Last, but not least, there are those holiday-related emergencies, like the time my brother, as a toddler, thought the Christmas tree ornament looked like a shiny golden apple and took a bite out of it! That was a mouth full of cuts and abrasions, and an oral disaster.

Now if you read this blog about two months ago, I suggested that one way to prepare for this Season of Sugar was to visit your dentist early to head off any dental problems or emergencies. Well, too late now for that.  But, I do have some ideas for how you can still prepare yourself to stay dentally safe and sound and maintain your oral health during this time of year.

1.      Prepare yourself a dental emergency kit!  This is simple to do by strolling down the  dental care aisle at your local pharmacy. This kit can include a few Q-tips, temporary filling material, and temporary dental cement. The product  I usually recommend for temporary fillings is called Dent Temp. I have had many patients use this with great success. The Q-tips could be used for pressing the material into a tooth if needed if a filling falls out. Both products have directions on them that are easy to follow.

2.      The best over the counter pain medication for tooth pain is Ibuprofen. If you do encounter a toothache, do not put an aspirin on the gum ( a common misconception). Try taking an appropriate dose of Ibuprofen. Also do not aggravate the sensitive tooth with very hot or very cold foods or drinks.

3.      Even with all the holiday preparations, parties, and busy schedules, be sure to stick to your daily oral hygiene routine. Include toothbrushes ,toothpaste and floss in the stocking stuffers! Many companies put out holiday edition product packaging that is so festive you don’t even have to wrap it. Be sure to include other extra dental things like a  bag of flossers, proxy brushes and toothpaste tube squeezers ( that squeeze all the paste to one end – they are great!)



We can all take a lesson from the children’s holiday movie “Rudolph the Red-Nosed Reindeer”.
Remember the Abominable Snowman? He suffered from a terrible toothache and had to have Hermey the Elf pull his teeth. 

Don’t have an abominable holiday!  Take care of your teeth so that you can smile your way through the season and into the new year!

Happy Holidays everyone! 

Tuesday, October 16, 2012

Halloween and beyond.......

And So the Season of Sugar Begins…………..
In just a few days, children will be ringing my doorbell, yelling out the traditional, “TRICK OR TREAT”, in anticipation of receiving candy. In my neighborhood, it isn’t just one small piece. Oh no. Many of my neighbors hold out a bowl and let the kids take handfuls of candy. One family gives out those king- sized candy bars you buy at the movies. The kids don’t stop until their plastic pumpkin receptacles are full to the top. I know this from experience. I have a son and a daughter, who are really too old to trick or treat, but not too old to celebrate this Halloween in some way. I remember all too well looking at the pile of candy on our kitchen counter at the end of a night of their trick-or-treating. They would sort through the “good candy” (chocolate, Skittles or red Starbursts) and the others they didn’t like so well ( like those little bags of pretzels that they would complain weren’t really treats at all). 
They would have one or two pieces a day, and this would start the season of increased sugar consumption, because after the Halloween candy was gone, then the little chocolate turkeys would show up, then the Christmas candy canes, chocolates, and cookies and before you know it there were Valentine’s chocolates and the finale of this 6 month sugar overload was Easter, with the Easter basket featuring The Chocolate Bunny!

I thought of all this as I stood in the aisle of a store today, trying to decide what kind of treat I would give out to the trick-or-treaters this year.  This is always a personal struggle for me.  Really.  How can I hand out CANDY, when I see the destruction it can cause every day? I once told someone I couldn’t give out candy on Halloween because it was against my religion, which caused great confusion since they saw me at mass on Sunday. One year I gave out packets of microwave popcorn. One year I gave out the infamous little bags of pretzels (that was before I saw how my own children snubbed these treats).  Some years I couldn’t find anything but candy to give out, so if one of my patients came to my door, I had to answer their “Trick or Treat!” with “Be sure to brush your teeth after the candy!” I am surprised my house didn’t get egged that year.

When I was a kid, people used to give out apples. Real apples, no wrapper. Then some crazy person put a foreign object in the apple , like a needle or a razor or something, and it was all over the news. So then no parent would let their child accept an unwrapped treat.

So back to the aisle in the store, I stood there reading every label, seeing which treat would be the best of the worst choices available. I already had these monster game cards from the ADA which I had been giving out in the office, but somehow I thought they would be received with as much excitement as the pretzels now that I stood amongst the aisle of sugar.  I finally decided on the Halloween packages of Goldfish ( a step up from the pretzels),and mini granola bars.  The granola bar box said in large letters that there was NO HIGH FRUCTOSE CORN SYRUP . This made me feel a little better about making the purchase.

So how does one negotiate their way through this season of sugar?  I have a few suggestions, short of just saying no to any sugar. You have to be one very strong person to turn down all sugar.

1.       Don’t keep eating it throughout the day, keeping a constant level of sugar in your mouth. Decide what pieces you want, eat them at a certain time, and then brush your teeth afterwards.

2.      Don’t keep it accessible – put it away! No candy dish sitting around. Put the stash in a ziplock bag somewhere, and if you don’t trust yourself or those sweet addicts in your house, put the ziplock bag in a closed container. The harder it is to get to, the more you will think about eating it.

3.       As tempting as those after the holiday specials are (I have seen Halloween candy at 90% off on November 1) don’t buy anymore candy to keep in your house. Obviously, if it is not there, you can’t eat it.

4.      Get your teeth cleaned by your dentist or dental hygienist just before this Sugar Season begins, and then again just after it ends in the Spring. This would be about 6 months apart.  This way you can also have your teeth checked and take care of any cavities right away, and not help them get larger from any extra sugar you do take in.

So here’s to a Happy Halloween, Happy Thanksgiving, Merry Christmas, Happy Valentine’s Day and Happy Easter! Try to limit your treats, and remember there are other ways to celebrate the holidays than eating your sugary way through them.


Friday, September 7, 2012

Are you ready for some football?

Are you ready for some football?

Most Americans will soon be once again watching one of our favorite national sports, football. Whether it’s a junior football league, high school, college or the pros, all of us get caught up in the frenzy.  I really didn’t follow football until 1985, when I lived in Chicago and the Bears were on the road to the Super Bowl. I was also in dental school. So when others were watching Jim McMahon throwing the ball in the end zone, or Walter Payton running with the ball, I was looking to see what was that mouthpiece they had in their mouth. We had learned about mouthguards in dental school, how they protect the teeth from trauma during sports, but I had never seen one in use.
Athletic mouthguards have come a long way. For those of you who are not sports fans, here is a simple explanation. A mouthguard is a plastic appliance that is worn by the athlete to protect their teeth from trauma, and may protect an impact on the jaw to cause a concussion. A good one fits like a glove over the upper teeth, and is made from a model of their mouth. 

Mouthguards aren’t just for football players. Anyone who plays a contact sport should be wearing one – ice hockey, field hockey, lacrosse, even baseball and basketball.
There are many types you can buy at sporting goods stores, where you put it in hot water and then put it in your mouth and bite down, but they do not fit as well as a custom made one.
Most of the time these mouthguards fit so poorly, that the players have a hard time wearing them, and this is where they usually are found – not in the player’s mouth!

 I have made many of these guards over the years, and one young man, who now plays college lacross, told me that once he had worn the custom made mouthguard I had made for him, he questioned if what he had been wearing before was even a real mouthguard at all!
I have read various studies that have also shown that athletes perform better when they are wearing an appropriate mouthguard, or that prevents them from clenching their teeth together, which seems be detrimental to their performance.  These studies show that when a person clenches their teeth together with enough force, for a significant time, a neuromuscular response is triggered, which causes a release of hormones that causes stress & fatigue, causing them to be slower and weaker. With the right mouthguard in place, an athlete actually becomes faster, stronger and performs better.

Last year I started making custom-fitted mouthguards for a local high school football team, the Stamford High Knights. They had a great season, their best season since 1978, finishing with a 7-2 record. They had a coach they had been with for just a few seasons, a brand new stadium, and everyone on the varsity team had a professional mouthguard (orange & black, the team’s colors) when they ran out on the field for their first game. They looked great and played great too. Today I met with them to deliver this season’s mouthguards.  Take a look:


Good luck Stamford High Black Knights!  Wear your mouthguards, and here's to a winning season.

Monday, July 23, 2012

The Evolution of A Dentist: The Carly Chronicles, Chapter 1

            Do you ever wonder why people pick certain professions? Did they always want to be a plumber, a writer, an architect, or a dentist? Over the 25 years of being a dentist, I have been asked many times why did I become a dentist. Now it is quite clear to me why I enjoy being a dentist, but I wonder what I would have said if you would have asked me that before entering dental school. 

            I started this blog in an attempt to change the public’s perception of dentistry and dentists to a more positive light. In an effort to change that persona of the negativity associated with The Dentist, I would like for you to meet someone.  A bright, attractive young lady named Carly, who is about to enter Harvard Dental School in August, 2012. I have known Carly for many years, and I think our recent conversation will help you understand dentists as people.  Our goal is to continue this blog over her dental school experience. Maybe by the end of these chronicles, you will look at dentists in a different way, and may even consider a future in dentistry yourself.

            M: Can you remember the moment or time when you definitely decided you would pursue a career in dentistry? Was there an "Aha" moment for you? If so, please tell me about it.

C: I never had one single “Aha” moment. Deciding to become a dentist was more of a process for me. In high school I volunteered as an EMT, and in college I studied jewelry design and metalsmithing. As an EMT, I loved helping people and was fascinated by medicine and the human body. Being an artist developed my dexterity and attention to detail, and I loved working with my hands. Despite my love of art, I felt qualms about pursuing it as a career. I was doing it to please myself and didn’t feel that my work was beneficial for anyone else or the community. At some point during college, Dr. Lehmann suggested that dentistry would be an excellent career, especially with my metalsmithing skills. Although I didn’t pursue it at the time, her advice percolated in the back of my mind.

After college, I worked as an estate buyer in a jewelry store. I enjoyed it, but I couldn’t help improve peoples’ lives in the way I wanted. I thought of my experiences as an EMT and my conversations with Dr. Lehmann. I knew I wanted an intellectually challenging career that would let me give back to the people I work with and to my community. Dentistry will allow me to combine medicine and my artistic skills to make a positive difference in my patients’ health and give the best care possible.

            M: What is it you are looking the most forward to about being a dentist?

C: I’m attracted to dentistry, because I know I can make a difference in people’s lives. I am looking forward to building relationships with my patients while working to make their lives better. I will also be constantly learning new things and educating myself and my patients.

               M:  What are you looking forward to about dental school?

               C: For the past three years, I’ve been preparing and applying for dental school. I’ve been working so hard towards this, that it seems a little surreal to finally be about to begin. Now I’ll get to work even harder for the next four years! I’m excited about everything I’m going to learn and being able to work with my hands again. I think the human body is fascinating and I’m looking forward to learning about medicine. I’m also looking forward to being surrounded by people with similar interests and goals.

               M: Is there anything that you are anxious about concerning dental school? ( the material, having to dissect a cadaver, having to learn how to give an injection? anything)

C: Because I don’t have a strong science background, I’m a little worried that I’ll have to struggle to keep up with the material. I loved the science classes I have taken, but I haven’t had any advanced courses beyond the basic prerequisites for dental school. Most of the other students in my class are coming straight from undergrad and were biology majors. I have been spending a lot of time this summer studying and reviewing, so I’ll be prepared when classes start in August.

I am also a bit anxious about giving injections, because I don’t want to cause anyone pain. I know that my fellow students and I will practice on each other. By the time I start working with patients, I’ll be a lot more comfortable. Now that I think about it, maybe I should be more anxious about having someone else practice on me.

            M: What kind of reaction are you getting from people when you tell them you are going to dental school?

C: I usually get a positive reaction when people hear I’m going to dental school. Often, people will share stories about their own experiences with dentists. This has been a great way for me to get ideas for how I can better help my own future patients.


            I am very excited for Carly as she begins this experience. I hope she finds as much fulfillment from dentistry as I do. I know she will make lifelong friends while in dental school. Stay tuned for the future installments of The Carly Chronicles.

Tuesday, July 17, 2012

2th brushing – There’s an APP for that!!!

     The single most important thing you can do on your own, to minimize your time in the dental chair, to make your visits easier, is brush your teeth! Now I have heard from many, many people over the years how much they dislike a dental visit, yet, they don’t take care of their teeth,  which leaves the clean-up duty to the dentist and/or dental hygienist and adds to their dental problems. There are additional things you could (and should) do such as flossing, rinsing, water pik usage, rubber tipping, but today I am devoting this writing purely to brushing.

Do you think that you know the best way to brush your teeth? From what I see coming through my hygienist’s chair, the answer for most people would be “no”. There are 3 simple points about brushing I am going to go over: 1) Amount of time you should spend brushing; 2) Different types of toothbrushes; 3) Toothpastes. Easy, right? I have even added some extras at the end to make this whole topic a little more interesting.

I surveyed about 25 people at random. Some were patients, some were not. I asked them to time themselves brushing their teeth. Now you have to figure that just because they were being timed, maybe these people took a little longer than usual. Maybe they were a little more careful than usual. Well, the first thing you should know, before I tell you the answers I got, is in order to do a great job cleaning a full adult mouth of teeth, it should take you about TWO MINUTES. Just two minutes, twice a day. Two minutes is about as long as 4 television commercials. That’s shorter than your favorite song. That’s only 28 minutes a week. Come on! You can at least do 4 minutes a day.  Well, the answers I got ranged from 20 seconds (yikes!!) to 4 minutes or more. Incredible!  There was a trend.  The faster brushers were using manual, regular toothbrushes. The longer brushers were using electric powered toothbrushes, most of which come with a built in timer, that keeps the brush going for 2 minutes.  You just keep brushing until it stops. Dental studies have shown that most people brush for about 30 seconds.

So here are a few tips to get you to improve your brushing. Maybe you want to try a brush with a timer in it. The longer you brush, the more likely you are to do a better job. Even if you use a manual brush, be prepared to have to stop and spit a few times.  I think most people think that when they have to stop and spit, they are done.  Also be prepared to brush, rinse and repeat! Repasting your brushing is totally acceptable, and may be necessary. Make sure you do the inside surfaces as well as the outside surfaces of the teeth; the most commonly forgotten place is the inside of the lower front teeth. Gentle, circular motion is the best, with the bristles of the brush angled towards the gumline.

ALWAYS use a soft bristled brush. Hard bristles can damage your gums, and cause recession. If you use an electric brush, the sonic action ones seem to get the best results.  An electric powered brush just has more bristle action that you cannot provide manually. Personally, I use a manual brush in the morning, and a powered brush at night.

Paste. There are so many to choose from, how do you pick the right one?  Well, no matter your age, you want a paste with fluoride.  Everyone can benefit from fluoride, from the developing child’s teeth to the adults with edges around fillings or receeding gums, there are many benefits to fluoride. If you have sensitive teeth, the sensitive formula pastes work well, if they are used consistently.  It takes about 2 weeks for them to take effect.  Conversely, if you have sensitive teeth, you shouldn’t be using a tartar control toothpaste.  The ingredient that prevents the tartar can actually make your teeth more sensitive. One ingredient that is helpful in keeping teeth their cleanest is baking soda.  Contrary to popular opinion, it is not abrasive in the amounts found in over the counter toothpastes. Some of my patients who exhibit the cleanest teeth tell me that they put the regular toothpaste on their brush and then dip it in straight baking soda.  This isn’t the best taste, but it sure works.  One man just told me that he brushes with paste and baking soda, and then holds hydrogen peroxide in his mouth for up to 10 full minutes to keep his teeth white.

               With all this being said, some of you may still not spend those 2  minutes twice a day brushing, so here is something that can help you – an APP! Yes, someone out there came up with a Toothbrush Timer App, and it wasn’t even me. 

I have over 60 apps on my iPhone, and my favorite one is the Toothbrush Timer. It has many features, but the thing it helps the user do is actually time how long you brush, which we now know should be a full 2 minutes.  It has a cartoon type picture of an open mouth, and it shows you where you should be brushing at what time and when to change areas.

There are extras like entering when your last dental visit was, when you are due for one, and when to think about changing your toothbrush (which is when the bristles start to bend or fray). Definitely check out this APP. It is free, and fun!

               One final note: for all of you who participated in my survey about toothbrushing, I promised I would give away to one of you a powered toothbrush.  The winner is Michael, of Greenwich, CT!  He actually also had the shortest reported brushing time, so this should help him spend some more time brushing!

               So grab your brush, paste up, and get to it! Remember to brush, rinse, repeat, and 2 minutes “2th brushing” can make your next dental visit a whole lot easier!

Sunday, June 17, 2012

Don Draper's Dental Disaster: When a Toothache Won't Go Away

               Have you ever had a tooth pain that comes and goes, and you debate whether you should call the dentist or not? Then one day the tooth pain comes again, but this time it doesn’t go away. It rages on and on until it gets your full attention. Such was the case in the recent season finale of Mad Men, when Don Draper had the return of a toothache that this time would not go away. He had been avoiding the call. The call he needed to make with the dentist. He said a few times that he thought it would get better, that it always did, but not this time. The pain went away only after he visited the dentist.

               Although Mad Men is a fictitious television show, the story of this toothache could have been very real. No one wants a dental emergency or a toothache. So how can you avoid an incident like Don Draper’s? How can you know the signs of a real dental problem that needs the immediate attention of a dentist?

               The best way to prevent a toothache is to handle dental problems early on when they are treatable. The two major reasons that a tooth needs attention are either decay  or periodontal (gum) problems. Many times these dental problems don’t bother you, don’t exhibit any symptoms, which can be misleading. Many times you can not see the problems either, which is why routine dental x-rays are valuable. A thorough exam can detect these problems and they can be treated before they turn into something larger.

               Decay at its start can be easily removed and treated with a filling or restoration. Sometimes sensitivity isn’t decay, but an exposed root surface, which can be treated with a brush-on desensitizing varnish that gives immediate relief.  

               But let’s say you are experiencing some discomfort now. Try to pay attention to the pain and see if you can answer the following questions: 1) the duration of the pain – when it hurts is it for a few seconds, a few minutes or longer,; 2) whether the pain starts on its own, or only when stimulated, and does it wake you while you are sleeping:; 3) what makes the tooth hurt – hot, cold, or biting; and 4) can you identify exactly which tooth it is? 5) Does anything make it feel better? Over the counter pain medications like Advil, or Tylenol, or does cold actually make it feel better?

               The signs that a tooth pain will not go away on its own, and you need the help of a dentist, are:       

1)      The pain lasts more than just a few minutes, or is even constant.

2)      The pain starts spontaneously, on its own

3)      The pain wakes you at night

4)      You can identify the tooth the is the culprit

5)      Cold things like ice make it feels better

               If you have an episode of pain like this, even for days, and you leave it untreated, it probably will subside, but it will return with a vengeance. Don’t ignore the symptoms. Get the treatment you need. I don’t like seeing patients in pain as much as you as a patient don’t like seeing The Dentist, so let’s help each other out. The more regularly you go for a routine dental check-up , the less likely you are to have a Don Draper incident.

               Don Draper ended up losing a tooth because he had constant pain, that was occurring unprovoked, and he did get some relief from applying cold ice to the area, but the tooth in his case was beyond the treatment of a filling or root canal treatment, had probably infected the bone surrounding it, and it’s only hope was extraction.  Let’s hope that this information helps you to avoid this!

Monday, June 11, 2012

Sweet 16

Sweet 16

The number 16 is a special number for many reasons. It is the age at which most teens in America can legally get a driver’s license. It is also the magic number of basketball teams in the NCAA that make that elite status of being the Sweet Sixteen during March Madness. Then there is the Sweet Sixteen birthday party for many girls. Now, the number 16 is of special significance to the people of New York City, because Mayor Bloomberg announced recently that he is planning on banning the sale of sugary drinks larger than 16 ounces.

I don’t want to turn this writing into a political commentary, but when it comes to a tooth-related issue, I have an opinion. Hearing a few minutes on the radio about this plan of the mayor’s sent me looking at his website, and the entire report on this pending legislation that was prepared by The Mayor’s Task Force On Obesity. ( The report is very straightforward. It states that, “Americans consume 200-300 more calories daily than 30 years ago, with the largest single increase due to sugary drinks.”  It went on to stress that “High consumption of sugary drinks is linked to an increased risk of heart disease and diabetes.” The report immediately had me question what was their definition of “sugary drinks”? How did they come up with this size of 16 oz limit? And really, we are a free country, and as adults do we not have the right to drink whatever we want and as much of it as we like? (Although I wish people would drink less of this type of thing, I didn’t think a law should restrict it.)

I went on to read that the proposed plan defines sugary drinks as soda, sports drinks, energy drinks, sweetened teas and coffees, sweetened fruit drinks, vitamin water , and any other drink that had more than 25 calories per 8 oz serving. It also excludes diet beverages, unsweetened teas and coffees, alcohol, dairy drinks and any beverage that was over 70% fruit juice without added sweetener. Who would be restricted in selling these drinks in larger than 16 oz portions? Restaurants, movie theaters, street carts and sports arenas in New York City. What I learned from the study is that the serving size that is being offered to the public is the problem here. When drinks such as Coca-Cola first came out, the suggested serving size was 6 ounces.  Now bottles or cups of 16 oz are routinely sold as the medium or small size, and when offered, people will buy the 16 oz or larger and consume the entire portion.

I did a lot of thinking about this issue. I didn’t appear to be the only one, either. Most major news shows on television covered the story ( ABC, NBC, CBS, CNN) and The New York Times ran an Op-Ed by Daniel Lieberman on June 6, “Evolution’s Sweet Tooth”.

I encourage you to read this, along with the Mayor’s plan, and make some decisions for yourself. I can tell you what I have concluded from all of this. Government has its own reasons for limiting our sugar intake, and it seems those reasons stem from the fact that an overweight, unhealthy population costs them more than a healthy population. I am disappointed in the task force that was set up to tackle this agenda, in that they repeatedly take issue with fighting obesity and its consequences of diabetes and heart disease, but make no mention of sugar and tooth decay, which should be a most obvious correlation. So what if you don’t live in New York City and your sugar consumption will not be limited? What if that bottle of soda is less expensive than a bottle of milk or filtered water? What if you choose to continue to drink these type of drinks?

Think about this. On average, 16 oz serving of one of these sugary drinks has about  49 grams of sugar.   That comes to about 12 teaspoons of sugar or about 12 packets of sugar.  

 So you might say you gave up soda long ago. Soda is not the only culprit. Sweetened iced teas, sports drinks and flavored iced coffees are in the running in this group too.

The sugar content isn’t the only problem. Try looking at the pH, or acidic level of these drinks. That is something that is not listed on the label, but should be. (For the record, the pH of water is about 7, milk is about 6.8, saliva is 7.4 and battery acid is about 2) The pH of soda, diet or regular, is below 3. Sports drinks come in around 4, and sweetened teas about the same.  This combination of sugar and acid is deadly for tooth enamel.

Now in the survey I referenced in my previous writing, in which people told me quite a bit about what they did not like about The Dentist**, one thing that was very clear was that they do not like to be lectured to about brushing, flossing  or their dietary habits. So, if you want to curb your sugar consumption that would be great, and if not, here are some suggestions to help your teeth combat the effects of what you are drinking. (Not a lecture!  Just suggestions)

  1. Drink the sweetened beverages while you eating. The combination of food and beverage in your mouth will neutralize the pH, and the solid food being chewed and contacting your tooth surface will help to not have it settle and remain on the enamel. Constant sipping throughout the day, constant exposure of the tooth to sugar and low pH is very harmful. Really, the best thing to drink by itself is water.
  2. If you feel you must drink a sugary drink alone, follow it up with water or chew a piece of gum that will neutralize your mouth, like Trident Xtra Care, or any other gum with Recaldent in it. This ingredient is absorbed by the tooth and strengthens the enamel.
  3. When you brush your teeth, use a toothpaste like Sensodyne Pronamel, which you can buy over the counter, or you can get a prescription from your dentist for a higher fluoridated toothpaste. These pastes promote re-hardening of enamel that has been softened by acid erosion.

I hope this information is helpful to you. Think about what you are drinking, whether you live in NYC or not. Make smart decisions on your own as to portion size and read the labels. Less sugar means fewer cavities, healthier mouths and more smiles.

**The Dentist is a reference to a prior posting in which in response to a survey I conducted for this blog, many people reported they didn’t like The Dentist, who I referred to as that entity that causes them pain, discomfort and expense. Certainly not me! I may be a dentist, but I am not The Dentist.

Thursday, June 7, 2012

When I say DENTIST, you say..........???

When you hear the word DENTIST, what is the first word that comes to mind?

I asked this question to 50 people. Although I myself am a dentist, I tried to get honest answers. I didn’t  ask patients who were sitting in my chair while I loomed over them in my white coat. I sent e-mails to people from my address book, most of whom are not my patients. The answers I received were more than I asked for.

I have been a dentist for 25 years, and I honestly love what I do. Many people ask me why I became a dentist, and I have come to realize it is because it provides the perfect combination of science and art, and being able to deal with people personally every day.  I also have come to realize that most people hate “The Dentist”. Not me personally, but that entity that is a source of anxiety, pain and expense to them. I understand that their favorite part of a dental visit is the moment they are getting up from the chair and walking out the door. I thought I would start this blog to try to change the public’s perception of   The Dentist by telling them about dentistry from my side of the dental chair. My thought was that information could minimize that fear, that knowledge would help people make dental decisions, but after getting feedback to my initial question of the word association with DENTIST, this goal no longer seems that easy.

About the responses, first I have to say that the replies were quickly made (some within minutes) and the number of replies was better than if I was looking for RSVP’s to a party invitation (I don’t know where Miss Manners has gone, but we need her back to teach people the lost art of common courtesy and manners to such things as RSVP, but that is another subject all together).  These responders were indeed honest – their answers ranged from “pain”, “ouch!”, and “smelly”, to expletives I cannot repeat here. There were a total of 3 responses that I considered neutral, which were all “clean”. These people associated clean teeth or getting their teeth cleaned with DENTIST.  There were hardly any positive responses to DENTIST, except those people that made a personal reference to me. (Thank you!)

What amazed me the most was that the majority of the responders also felt the need to explain their answer, at great length. I read horrific stories of people who are now in the 40’s and 50’s, being held down in the dental chair as a child, had cavities filled without local anesthetic (novocaine), and when they cried out in pain they were yelled at, punished, and even hit by the dentist! One person even told me they jumped out of the chair, climbed through a window, fled from the dentist and rode his bike all the way home alone. Another person told me that due to a dental experience he had when he was 9 years old,  to this day, he starts every dental appointment by saying his personal mantra, to the dentist,  which is, “ If you hurt me, I will hurt you.” This may seem harsh, but at least this person goes to the dentist, on his own terms, and sets up boundaries.  These people were abused – physically and psychologically, and it has scarred them for life.  

As a dental professional, I would like to apologize for those dentists before me that caused all this horror. I am sorry for your pain.  I am sure those dentists were never told anything about a chairside manner or patient comfort.

So my mission of trying to create a positive association with dentistry now appears to be an arduous task! How can I expect you to smile and look forward to something that was torture? I am willing to give it a try, if you are willing to hear me out.   I want to know how I can break down this barrier between the dentist and the patient, how can we get a positive association with The Dentist. 

For those of you who have these terrible associations with The Dentist, here are some thoughts for you.

1.      First, before you even set foot in a dental office, think of what specifically bothers you the most about the experience. It could be the smell, the sound of the equipment, the pain of the injection, the fear you won’t get enough anesthetic, or the anxiety of not knowing how long it will take.

2.      Some of this you can try to control yourself, such as if it is the smell of the office or the materials while you are being treated, try putting on your favorite perfume or cologne just before you enter the office.  If that isn’t strong enough, you can put some type of mentholatum rub or lip balm on your upper lip or under your nose, to mask the other smells of the dental office.

3.      If the sound or noises bother you, bring headphones with your playlist ready with your favorite tunes.

4.      As for the other issues, tell your dentist or hygienist before they start that  there are a few things you just want to talk about to make the appointment easier for everyone.  I try to initiate this type of conversation especially before the first time I treat a patient and I appreciate if they can tell me what bothers them the most. 

5.      If the injection bothers you, there is a topical gel that can be rubbed on the area prior to the injection to make it more comfortable. There are also different types of anesthetic, or novocaine – some is stronger than another, and some last longer than others.  If a patient is afraid they won’t be numb enough, I joking tell them we will use the “high test” novocaine, which technically speaking is Articaine, and is stronger and lasts longer.  Other people don’t like to feel numb after they leave the office, so I have to be sure to use the shorter acting anesthetic for them.

6.         If it would make you feel better knowing how long it will take (approximately), kindly ask first if the dentist or hygienist could guess how long it will take.  Then you can look forward to that time when you get to take the bib off and walk out the door!

7.      Finally, and to me most importantly, you as the patient need to know that there is a way for you to have some control during the procedure and have a way of communicating with the dentist. I usually tell the patient that if for any reason they feel the need to stop and take a break, for them just to wave their hand at me.  You can ask the dentist if this would be OK with them, in case they haven’t suggested this to you already.  

I hope these ideas are helpful to you, whether you are a patient, a person who hasn’t been a patient in a long while, or even a dentist.   I hope we can all try together to make the dental office a place we can smile about.