DentalBuzz: a jolt of current
I wanna be sedated I wanna be sedated I wanna be sedated

I wanna be sedated

Jul. 28th, 2014 | Posted by 0 comments

By Amanda Kaestner


Oh yeah, that’s all we need.

Back in 2006, a research psychiatrist at the National Center for Post-traumatic Stress Disorder, H. Stefan Bracha, M.D., suggested upsetting dental experiences could install PTSD in patients, which might then last their entire lives. Along with another couple of miscreants, Bracha advised that any caption including the word “phobia,” or “anxiety,” wasn’t humorless enough to describe the unfounded fear of our selfless, albeit remarkably remunerative, healing art.

What, then, is it exactly that sends our patients into states comparable with returning warriors who’ve experienced an imminent threat of death on the battlefield?

Thanks Again, Sir Larry

Well, patients who are edging onto the chair for an invasive procedure, obviously enough, are more fearful than those who’re scheduled for a cleaning (though we’ve all seen hygienists who seem determined to even out that particular playing field).

Assuming the dentist is warm and caring, rather than emulating Sir Larry, better known as Laurence Olivier’s character Christian Szell in 1976’s Marathon Man, the single most intimidating factor may well be unconsciousness. When you’re out, you’re unable to inhibit a negative event or experience. It’s not so much that patients expect us to slip ‘em a roofie and wreak havoc with their innocence, it’s just that – in all fairness – being utterly helpless is an intimidating event for most animals. It’s lack of control… it’s…

Sedation and Anesthesia

Choose your poison. Of the several methods of dentistry sedation that ensure reciprocity on the recliner, each has its proponents, but most have problems, too.

Local Anesthesia. The injection of local anesthetic directly into the area where the work’s to be carried out; this blocks nerve impulses, thus moderating or eliminating pain signals. But it’s the jab, man. The. Jab. That needle heading inbound at their head is, for many patients, the very image which sets off their trip-hammering heart. Not nice.

Inhalation Sedation. Nitrous oxide/oxygen is a great deal of fun at frat parties, sure. It has its place in our surgeries, also, after the light-headedness and giggles give way to euphoria and sleepiness. Improperly administered, though, adverse effects can range from vertigo and nausea, through active vomiting to hallucinations and unexpected flash-backs (and couldn’t we expect that to bring on driver lawsuits, were the fact widely known).

Intravenous General Anesthesia. Voila! The Cadillac of the comatose. An intravenous (IV) catheter is inserted into a vein and from there, an infinitely-controllable amount of anesthetic happiness is introduced. Just a few good drips and the patient is in a safe state of unconsciousness, allowing the professionals to get to work without any major side effects after all procedures are said and done. To the patient’s benefit, there’s no sensation of pain at all, and no memory exists afterward of the entire time he or she was “under.” More and more practices are looking to this form of sedation as being their one and only form because it’s just that safe, comforting, and effective. For example, Advance Dentistry, a well-known practice in Cincinnati, has found that IV sedation helps the dentist because it reduces the risk of movement, and it provides maximum comfort (or minimal discomfort, I suppose) to the patient no matter how much work he or she may need done. It’s not uncommon to see IV sedation being their primary option for dental anesthesia. Furthermore, recovery from this form of anesthesia is typically swift and complete, with little or no “hangover” effect as one would see in the other forms listed earlier, so the patient’s free access to their credit card is seldom impacted.

We’ve come a long way since the early 19th century where anesthesia wasn’t even a thing in any surgical practices, much less dentistry. But thanks to Horace Wells first introducing nitrous oxide to his procedures back in 1845, we can honestly say that going to the dentist in today’s world really isn’t that scary of a thing. So look at your options when you go to the dentist and ask about other forms of sedation. It’s a far cry from “pass the liquor and bite down hard on this stick and let’s hope we don’t have to amputate anything from aftermath infection.”

“We heart hygienists. NOT!” says P&G

Mar. 22nd, 2014 | Posted by 13 comments

this is not actually Dr. Smiley McHappypants
Don’t you love it when corporations pretend to listen to criticism, act like they care about the concerns of consumers, make empty promises? Yeah, I didn’t think so.

In light of all the flak that Procter & Gamble has received in response to our previous entry about plastic in Crest toothpaste that has seen a GINORMOUS readership (thank you to all the hygienists who have been alarmed and continue to share the story!) I thought it might be fun to imagine what the company REALLY would like to say to all of us who are creating a nuisance for them.


 From the desk of Dr. Smiley McHappypants, DDS
 VP Global, Professional and Scientific Relations
 Procter & Gamble
 8700 S Mason Montgomery Rd
 Mason, OH 45040

To every primadonna dental hygienist,

Here you go again, making a big deal out of nothing. We’re not ignoring the fact that you exist this time, and apparently in our marketing efforts we should have. As an example, here’s the latest Crest TV ad that you’re complaining about:

What is your F*&#ing problem? The actress says her hygienist is awesome, right? Look, we’re agreeing with so many of you who think your dentist is an idiot because they can’t tell whether or not patients have even had their teeth cleaned yet. What’s so insulting about that? Yet over and over, we get requests to take this off the air. Not gonna happen. We have too much money invested in this product line and these advertising spots to worry about what a bunch of worthless tooth-scrapers think.

Yes, I called you a tooth scraper. That’s what we think of you. Your purpose in life is to nag and torment patients. And you whine and complain when we try to OUT YOU for who you really are! We spent more than your lifetime earnings warning consumers about your evil ways with magazine ads like this one:


So what if we get constant complaints that the ingredients in the Pro-Health products actually contribute to stain and require MORE scraping?


Since we’re big and organized, and you are small and diffuse, you can share photos like this one all you want, but it won’t matter. You don’t have the resources to keep Procter & Gamble from increasing the bottom line for our stakeholders. Maybe it’s just all one sick joke that we’re pulling over on patients and hygienists alike. Naw, that would be over the top. The truth is that we really don’t give a $h!† what you think.

Which brings us to this latest overreaction of yours. Hello? There’s plastic in EVERYTHING! What’s the problem with pretty polyethylene confetti in toothpaste? After all, if your patients swallow it, just tell them to poop. It’ll go away, like fiber. That’s our official line. Plastic is the same as dietary fiber!

When we tested our latest toothpastes, you know, the ones with the new, vibrant names? Be Adventurous? Be Inspired? Be Dynamic? We had many focus groups try the products and they loved them. No one even questioned the plastic. Granted, we didn’t actually tell the users what it was, but since none of them were crunchy granola tree-huggers we didn’t figure they would care. The brown, green, and yellow specks are an important part of the “total product experience.” We want our stakeholders to be happy, and they like the way the unique colors give the toothpaste an exciting aura. It’s all about the feeling, you know.



And those specks getting stuck under the gums? Well, honey, it’s your word against ours. We have study after study that proves that plastic doesn’t harm us. Even though the FDA doesn’t specifically approve plastic in toothpaste, it doesn’t ban it either. So there. Just deal with it until we re-tool the plastic-speck-making machine. We’re planning on replacing the plastic with a suitable alternative, that’s what we’ve told you, but it’s on our own timetable. Bottom line, you can push and push, but there is NO WAY IN THE DEPTHS OF HELL THAT WE WILL BE REMOVING ANY TOOTHPASTE FROM RETAIL SHELVES.

Now back the F*#% off. You have no idea who you are dealing with.

Dr. Smiley McHappypants, DDS

In reality, Procter and Gamble has not yet released an official statement about the plastic, but they have been quietly assuaging fears on an individual basis and have informed Crest representatives to state that their products are safe. As for me? I still can’t find a compelling reason to ignore polyethylene when I am still finding it in patient’s gumlines, and have now seen reports from HUNDREDS of dental hygienists who are just now “connecting the dots.”

And sometimes, well sometimes you just have to connect all the dots by melting them down into masses of brown stuff that smell like scorched Wal-Mart bags:


Poop, indeed.


Only God can explain the ACA to dentists

Jan. 21st, 2014 | Posted by 4 comments


 Why I was chosen for such a task? I didn’t ask for this. Okay, so maybe I did.

Years ago I swore off direct petitioning prayer; you know, the kind where you ask God directly to intervene in the course of human events. Like, please help me to lose weight (that’s just BEGGING for a tapeworm there!) or any other sort of prayer that you ask God to help you in a specific way.

Except this time I forgot to not be so direct.

A few weeks ago I must have quietly asked God if He could help me make sense of Obamacare and how the Affordable Care Act is going to end up affecting dentistry in the next few years. And I had a dream that I would find the answer, only that it was buried and that I would get a signal when it was time to dig.

Dig? As in Joseph Smith, dig? Dude, angels aren’t my thing. Not that I have anything against angels pointing their fingers to the ground and making me do all the hard work.

Fortunately no angel came to me. Instead it was a cricket, chirping in the middle of winter like no cricket should. There’s this closet in a corner of one of my operatories, it’s the hidden closet, it’s where we cram in the Christmas tree every January above the forgotten manual x-ray film developer and all the manila patient files from twenty years ago. All day I was tormented by the shrillness of that annoying survivor. Even after the last patient was gone the cricket continued its unwavering tone. Was that my sign? I began digging in the closet, searching for the little critter.

When I pulled out the second box of files, there it was, No, not the cricket, but three unassuming sheets of stationery, triple-folded and clinging to each other. The weird part, though, was that there was not actually any writing ON the pages, per se. Instead, the words were like cutout stencils, as if a brood of silverfish had only eaten away the paper where the ink had been. I shouldn’t have been surprised, really, but I figured that Someone had gone through all the trouble to stash the revelation in our dental closet; the least I could do was to transcribe the contents of the document here at DentalBuzz.

This, then, is:

The Fresh Testament for the Everlasting Dentition

Chapter 1

1. In the beginning, there were gingiva, and they were good. 2. As suckling begat the need to chew, the eruption of the primary teeth ensured proper consistency for bodily nourishment. 3. But childish things must be put away, as youth becomes adulthood, the shedding of the smaller allows for the growth of that which is more permanent. 4. The gift of teeth is therefore given to all freely, to last until the final breath of life.

Chapter 2

1. Know your enemies; otherwise they will be your undoing. 2. Beware of acid, and biofilm, and parafunction, for they may cause destruction. 3. Combined, they will hasten the evacuation of teeth from your mouth. 4. Seek refuge in the wisdom of those who are learned about the enemies of the dentition, for they will give you comfort and aid, and you will forever be guided towards pearly dental glory.

Chapter 3

1. The ways of the world take the unaware down the pathways of fear, uncertainty, and doubt. 2. The earlier generations of servants saw their wages frozen so that all would not perish from the earth after the second great war. 3. Thus the idea of a dental benefit was created. 4. The dental benefit is a substitute for actual earnings. 5. The first days of the dental benefit helped many people fight the enemies of their teeth, by sending earnings directly to the physicians of the mouth. 6. The physicians saved teeth with those dental benefits that were given to them instead of directly to those who had served their masters, and all was well. 7. A vast outpouring flooded all the land with a large booming of babies, and as they ripened they began their search for work. 8. No longer were dental benefits under the rein of the masters themselves; instead, they were passed to those who promised to look after the servants’ best interest as an insurance against the loss of teeth. 9. Verily, a seed was planted in the minds of many: if a servant does not have an insurance policy, one cannot attend the services of a dental physician. 10. And God wept when He saw that His children first began to believe they could no longer care for themselves with their own earnings.

Chapter 4

1. Those that promised to look after the servants and insure them against harm wanted to control dental physicians, and for many years the physicians resisted. 2. Three tribes arose in the struggle to attend to the care of the Children of God: the Fee For Service, the Preferred Provider, and the Single Payer. 3. While the lands where the three tribes practiced were not the same, as some were less hospitable than others, all tribes found that they could attend to those who were able to seek their services.

Chapter 5

1. Then in all the lands a clamor of discontent from the servants and their lords created a large cloud that poured out from the District of Columbia. 2. When the dust settled from the cloud it revealed that the tribes were not disbanded, and that those they served would continue to attend to their care to perpetuate the saving of teeth. 3. But with the servants, they felt a fear growing even larger in their hearts that made them feel helpless about affording the ability of themselves and their kin to smile and chew and not feel dental pain, and the care of the dental physician seemed even more unreachable.

Chapter 6

1. A revelation is near: know that the purpose of this Cloud of Obamacare is to assure the Everlasting Dentition for all. 2. But it will not be without struggle, because the Cloud itself is not the answer. 3. More care will be mandated, but the cost to the servants will cause a great frustration. 4. The dutiful will pay excessive amounts for their allotments yet they will not be blessed with their choice of caregivers.  5. Blessed are the children, for they will be adults some day and if every one of them for many years is required to visit a dental physician, then the proof of those efforts will be rewarded. 6. And it will be known that it is the act of visiting the dental care provider that saves teeth, not the insurance itself, and the eyes of all the people of the lands will be opened, and their hearts will be changed. 7. And the people will no longer look to their masters to care for them, for they themselves will know that they are partners in maintaining the gift of teeth that was given to all freely.


Yeah, so see? God doesn’t even know how Obamacare really works, and so He’s staying out of it and instead taking the high road as always. But that doesn’t mean I haven’t tried to figure it out a little bit.  All children are mandated to have dental benefits, however, as a patient if you sign up on the exchange, you can check the box that says “My kids have dental coverage elsewhere” even if it’s not true, and there’s no penalty for doing so. How well is THAT going to assure kids are going to the dentist? Plans for children are required to have no upper limit, but really, if a family has a $3000 deductible and their insurance plan pays for 50% of major restorative, how many crowns does the average kid really need? Wow. That’s a lot of crowns just to meet the deductible. Stand-alone dental plans for children only may be a good bet, but every plan I looked at for adults? In my opinion adults are better off putting their cash under their mattress and doling it out for their dental care as needed. Adult benefits under Obamacare are generally pathetic.

And have you noticed the TV ads for the health exchanges? Even though they show happy young adults, the majority of those who have signed up are over 50? Yeah, the youth aren’t buying in to this idea. Good for you, young-uns. Good for you.