Trish Walraven – Page 19

To the patient who wouldn’t get off the phone

February 18, 2011 By Trish Walraven 6 Comments

To my last patient that wouldn’t get off the phone,

Hey, thanks for checking in at the front desk ten minutes late for your appointment. I needed that slowdown in my schedule so that I could stand here at the door and watch your world come dramatically crashing down around your shoulders. Yes, that’s what you made it seem like would happen if you didn’t get to finish that cell phone conversation.

The “I see you” hand signal and nodding of your head told me that your legs were ready to walk my way but that your brain still belonged to that employee yapping in your ear. She couldn’t figure out how to click on some stupid program? Please, I wanted you to fire her right then and for you to get your backside into my chair.

You teased me with an apology. I relaxed, thinking that the time crunch was relieved, draped a napkin over your shirt, put the chair in prone position, but then it was shattered by your obnoxious Justin Bieber ringtone yelling at me BABY BABY BABY NOOOOOOOO! I couldn’t believe that you had the nerve to put that phone right up to your ear and say “What.” You didn’t see me roll my eyes way back into the sockets and into the next operatory as I waited for you to finish moving your mouth so that I could get you to open wide.

Was I gentle to you today? Yes. Did I want to be mean with my dental equipment? I won’t tell you. Did you even see the signs posted all over this office that are written in big bold letters “NO CELL PHONES PLEASE”? Even when I pointed at one of them and glared at you in the nicest way possible, you STILL thought it would be okay to hold your phone up in the air and do a little texting. WHILE I WAS WORKING IN YOUR MOUTH.

Well that’s it. The signs are coming down because it’s always embarrassing when a courteous person will go out of their way to shut down their violating phone. Oxygen explosion? Equipment danger? Whatever. I’m not getting interrupted by the people who read signs. I’m getting interrupted by you, the rude person who probably also doesn’t stop talking on the phone in checkout lines.

So I won’t punish everyone with my threatening signs that just end up making me look intolerant. Next time, it’ll be all on you. If you’re on your phone, instead of wasting our time together, you will be asked to reschedule your appointment because you are just too occupied for the dental care that we are prepared to offer you.

Hello? The world is calling. It wants your attention back.

So why is hearing only one side of a phone conversation so annoying? Here’s what scientists have to say about that. And if you’re clueless, pretend to take this quiz to find out if you are also guilty of abusing your cell phone.

Release the (S.) mutants

February 9, 2011 By Trish Walraven 2 Comments

by Trish Walraven

The Dramatization:

At first it was small. The outbreak began in Florida’s Tampa Bay Area as local hospitals noticed an influx of patients with complaints of turquoise discolorations of their lips and aversion to simple carbohydrates. Once case histories were correlated it was noticed that all those who were affected had either recently received an inoculation of a mutant version of Streptococcus mutans at their dentist’s office or had been in close contact with someone who had.

Initially the culprit was thought to be excessive consumption of blue raspberry slushies, but by the time the CDC discovered that an organism was responsible for these symptoms and that it was bacterial in origin and highly contagious the disease had spread far beyond Florida and had affected millions throughout the US and abroad.

There have been no reports of mortality, save the demise of the soft drink and candy industries. Sugar consumption has plummeted as more of the population becomes infected by this new strain of bacteria which was originally created to cure the problem of dental decay. Because persons who are affected display a noticeable change in their appearance, blue lips have become a strong signal of exclusion due to the fear surrounding this epidemic. However, as more evidence points to the positive outcomes of having been infected, the “blue look” is currently trendy in the larger cities. Blue-lipped patrons that had been banned from public venues such as restaurants and arena events are slowly trickling in, thanks to the assurances from the World Health Organization that this current situation has actually caused more good than harm. The long-term effects will be felt by dentists, who, in the next 30 years, will see an attrition of their necessity as caries becomes extinct, and possibly within the cosmetics industry with a shift in lip color preferences.

The Reality

Um, Yay? It’s been like, since the early 70’s that everyone’s been asking for a caries vaccine. And wouldn’t you know it? A company in the United States is already so ON this. Oragenics first initiated their first Phase 1 Clinical trials in 2005 but were halted by the FDA because of the fear of something happening like the above scenario. Think I’m kidding? Okay, maybe I was being sensational. But there can be genuine risks when you fiddle with a few genes, and the FDA seemed to be mainly concerned with the lack of a plan to eradicate attenuated strains in the test subjects’ children. AHHHHH!

It starts to get interesting when you look at the solution that Oragenics came up with to begin their second Phase 1 testing announced last week: The trial subjects will be inoculated with a strain of S. mutans that cannot survive without the amino acid D-alanine, which is not found in a normal human diet. This means that the subjects will have to feed their germs daily with a mouthwash to keep them from dying.

Are you excited yet? Well, you’d better hold those horses back for a while. A long while. It’s going to take a bunch of time and a lot more money to get this to the market.

The inoculation is designed to be a painless 5-minute treatment with a cotton-tipped swab to deliver the suspension of Oragenics’ patented bacterial strain into a patient’s mouth during routine dental visits. But this one won’t die without feeding. It will live forever.

And what is it supposed to do once it goes viral? Err… bacterial? Oragenics calls this treatment SMaRT Replacement Therapy™ and it promises to:

• Offer lifelong protection against tooth decay caused by S. mutans

• Eliminate the creation of lactic acid by oral bacteria

• Dramatically reduce the ability of S. mutans to cause tooth decay

• Be genetically stable

• Grow at a rate similar to non-genetically-altered S. mutans

• Aggressively displace the native, decay-causing strains of S. mutans and preemptive colonization of its niche

• Not cause any acute or chronic adverse side effects

I think it’s a foregone conclusion that this sort of genetic manipulation is probably the only way we’ll and break caries’ hold on humanity and the loss of teeth caused by decay. We can’t just kill all the bugs in our gut – all the Jamie Lee Curtis Activia commercials have given us TMI about probiotics lately – so it makes sense that this same premise is true in our mouths.

And the raspberry slushie is still your best bet for getting blue lips. Sorry, Oragenics will probably not be helping you there.

Light with no shadow, like today’s groundhog

February 2, 2011 By Trish Walraven 10 Comments

by Trish Walraven

Did you really want to see that last pair of centrals in crisp detail? I mean, down to every last craze line and coffee stain?

If not, you’re probably one of those people that like shadows, you’ll want to go back down in your burrow and sleep through the next few months. Nothing uncomfortable or awkward for you, thank you. Please leave now – bye! – because the information below will only lead to spending money on things that you don’t care about.

Are they gone yet? Good. Now we can talk about this shadow business. Do you remember when you first started using loupes, how they made you sit up taller, take notice of things you never saw before, and how it is now that you cannot imagine working without them?

About a month ago I hooked a tiny little light onto my loupes in hopes that it would keep my back straighter. I didn’t really expect any more than that. At first it was nice, the light was whiter and just about the same intensity as the incandescent overhead light. Hmm. Then I realized that I had the power turned all the way down on the battery pack. What happened when I began dialing the light up was nothing short of a knee-trembling-Thank-You-Jesus epiphany moment. THE SHADOWS WERE GONE! I didn’t know that there were shadows in people’s mouths before. I didn’t realize that the shadows were extremely annoying in people’s mouths. I didn’t know that you could visualize the distal of tooth numbers 1 and 16 in full spectrum light and see down into that 4 mm pocket that never gets cleaned and scoop out that little yellow goo like a miner panning ankle-deep in a river of gold.

When you have a light attached to your glasses, it always spotlights your focus point exactly. It goes where you go (ouch! just don’t look your patient in the eye through your loupes). It helps you save time because you’re not always reaching up and adjusting the handle of the overhead light. And patients like it when they don’t feel like they’re in an interrogation session. It’s so free and breezy above the chair without all that equipment hanging over their heads.

Now that I’m using a headlamp it really is like a whole new world opened up to my eyes. It’s like the first time I started using loupes all over again. It’s like. Well it’s like something I should have done forever ago. The only two things that were holding me back until now were comfort and cost. I didn’t want to pay over $600 for what is essentially a flashlight. And I didn’t want it to be inconvenient to wear.

After evaluating just about everything offered at the dental meeting booths, one choice has ultimately claimed its place as my new pet: the LumaDent. Don Ton, DDS is the CEO of LumaDent, Inc. and he packs a great story about how his company got started from a DIY project, so I couldn’t resist supporting his business. Okay, I could have resisted if his product was no good, but in my opinion it is the best dental headlight available, for many reasons:

The Price. It is extremely reasonable for a niche market like dentistry. If you find it’s hard to swallow, geez, build it yourself. You’ll still need a battery pack, which you can purchase a la carte from LumaDent.

The Package. Totally turnkey. You get a rechargeable battery pack, a charger, a hip holster, a mount made especially for your type of existing frame, an orange filter, and all sorts of things to help you control your wires. If you have problems along the way, Dr. Don will make it right until you are happy.

The Promise. You hope that it will be comfortable. At 5 grams and a lens no larger than the size of a dime, the LumaDent weighs almost nothing. The headlight is only noticeable because of the wires. If you’re patient and work with the wires to learn how to wear them, they will be no more difficult to put on and take off than a tie. And as I stated before, the quality of the light is exceptional.

If you’re getting the idea that I was somehow coerced into this endorsement with money or discounted product that’s not the case here. I simply love my loupe light, I love juxtapositioning Punxsutawney Phil with shadowless dentistry and I hope to inspire you to see the way you practice in a whole new….

…way. Ha. You thought I was going to say light.

Patients can keep on smoking?

January 24, 2011 By Trish Walraven 6 Comments

by Trish Walraven

Stanky Moufs, Stanky Moufs, I want to rid the world of Stanky Moufs. When a patient sits down in a chair with a freshly-stanked cigarette mouf, that smell hangs in the operatory longer than their jacket.

Is the American Lung Association with me? NO! Maybe it’s because they’re still getting a part of that $206 billion settlement from Big Tobacco back in 1998. Can’t put their sugar daddy out of bidness.

Well then, is the government with me? Not really. The government wants to tax those stanky moufs for recreational nicotine use, and they want to regulate the patches, gums, and lozenges being sold as medical devices designed for smoking cessation.

How many smoking patients do you have that don’t want to quit? They’re not supposed to admit to you that they really love smoking, now. Especially not to you. But more and more of them are coming into my practice, breaths a-bloomin’, tissues pinkin’, and when I ask them if they quit smoking, they don’t say yes. They say that they’ve switched to e-cigarettes.

RRRrrrRRT ( that record scratch stop noise that’s used too much in media but I can’t help myself). WHAT THE? WHAT IS AN E-CIGARETTE?

I Gurgled it. Gurgling is kind of like Googling except that you ask your patient an open-ended question while they’ve got a little spit in the back of their throat that they really don’t have but they think they do and they want you to suck it out before they answer the question.

Best answer I got: “Well, everyone in our office either got a supply of E-Cigarettes if they would quit using regular cigarettes, or $200 to use on themselves if they weren’t smokers.” An employer has gone out of their way to get tobacco out of the bodies of their workforce. This sounded BIG.

That’s when the internet got much more handy than Gurgling. Here’s a great description of an E-Cigarette from AlterNet:

The e-cigarette was invented in China in 2004. It’s a cigarette-shaped tube that contains a rechargeable battery, a mini-vaporizer, a small reservoir, sensors and, in most cases, a light on the tip. The sensor notes when you take a drag on the tube and turns on the vaporizer, which more-or-less instantaneously turns the substances in the reservoir into a stream of visible water vapor that mimics the taste and feel of tobacco smoke. The tip glows like the end of a lit cigarette with each drag. It’s infused with the taste of tobacco – or tobacco combined with other flavors for those who are into that sort of thing – and nicotine, in various doses (including none at all). The refill cartridges – which look like the butt of the cigarette–give you about the same number of drags as a pack of cigarettes, but cost around $3 each – a bit more than half the national average and a third of what a pack of smokes go for in places like New York City.

The next question everyone asks is “Is it safer?” (I must stop with the Marathon Man references…this is only my second offense, sorry!). But really. Are e-cigs safer than tobacco? I for one am totally convinced that they will kill you much, much slower than tobacco, and far slower than water (if you’re drowning in it, of course). It’s the combustion that creates the majority of carcinogens found in cigarettes, which is why no real smoke is safe. The vapor ingredients in an e-cigarette – propylene glycol or glycerin – are Generally Recognized As Safe (GRAS) by the Food and Drug Administration. The problem arises when you don’t know what else is being added to the cartridges. Like Cialis. No joke. You can get some Cialis to smoke in an e-cigarette here. What about a dangerous, banned weight loss drug? They’ve got that too.

These extreme additives are all the excuse that e-cigarette opponents need to try to get them banned in the United States. That’s why no one will touch this issue, especially with the FDA coming down hard on new tobacco products in March. The federal courts are leaving it alone for now, but arising is a vast current of e-cigarette fanboys. They call themselves Vapers, and their recreation? Vaping.

What do you prefer? Stank Mouf or vape mouth? If your patients are committed to their cigarettes, it might not be such a bad idea to turn them on to something that may do less harm than their current habit.

I don’t know about you, but my ops are smelling better already.

UPDATED 2/21/19: The CDC has an infographic with a few surprising current statistics about e-cig usage. You can view it here:

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/pdfs/Electronic-Cigarettes-Infographic-p.pdf

New year at DentalBuzz

January 1, 2011 By Trish Walraven Leave a Comment

By Trish Walraven

2011 is the year for inspirations to move us towards actions, so it only seemed right today to share a few things with the DentalBuzz audience.

My subscriptions to various RSS feeds is getting rather long, especially the dental blogs, and it’s just not fair for me to keep them all to myself! You’ll notice that there’s a new Bloglist to help you get all of the news and insights that concern you as a dental professional. Some other resources that I use are DentalTown and Dr. Bicuspid, but if you also enjoy following individual voices then you simply must browse through all of the great blogs that I’ve evaluated here at DentalBuzz. Also, please me know if there are some that you read that I haven’t listed.

You may have already noticed the other change. It’s the voice here. The impersonal nature of third person sometimes causes me to feel disengaged from the audience, and as much as humor is less risky from that perspective (especially when bravery is involved because it can be DIFFICULT to pull off!) it also makes it harder to stay inspired. So hi, audience. One of my favorite kinds of humor is that which is Andy Kaufman-esque so it’s okay if you laugh uncomfortably at my poor comedic attempts.

In the meantime, this controversial article was recently written about a product that I was hoping to bring to the table at our next office meeting. The product in question is Perio Protect®, an anti-biofilm regimen that shows great promise for non-surgical perio resolution. Is it a scam? Can a periodontist’s opinion be trusted, especially when the argument is against a product that is being touted to specifically keep patients out of a periodontist’s practice? In this case, power to the blogger perio dude. Even though it is in his best financial interest to scorn a system that relies on patient compliance at home to be effective, he gets huge points for diligent research. Ultimately, it comes down to me and the irritation that he has caused me personally. Because I’ll now have to find some other implementable product or service to present in our practice for the new year.

Also Dr. Todd, thanks for the inspiration.

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