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Alabama education’s new low

March 14, 2011 By Trish Walraven Leave a Comment

Alabama’s reputation in dentistry has recently been elevated to EPIC FAIL status.

According to today’s news at DrBicuspid.com, dental students at the University of Alabama at Birmingham (UAB) are deficient in their education. They’re playing video games at the retirement homes instead of doing dentistry, unless you count “brushing someone’s teeth” as doing dentistry. A whole lot of other allegations are being raised as well, but I thought this one especially was worth a hoot and a holler.

SPANK!

Take that, Alabama! This little slap will teach you not to hand out licenses to dental professionals without requiring students to take a national board exam first. Or even go to college first. Hey, does this mean that a dentist from Alabama will only be able to get work as a dental assistant in all the other states, like licensed dentists from other countries, until they pass the OTHER states’ board exams? The good news is that now that there’s a bunch of eyes on the situation brewing at this dental college, maybe there will be a tasty intervention coming. Remember, the first step in recovery is admitting that you have a problem.

Get the whole story here at Dr. Bicuspid (you may need to subscribe first). And if you’re from Alabama, sorry for the smack. Does it help you forgive me a little if I say I loved Alabama in Forrest Gump?

To the patient who wouldn’t get off the phone

February 18, 2011 By Trish Walraven 6 Comments

by Trish Walraven

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.

Worst Tasting Top Ten

August 30, 2010 By Trish Walraven 8 Comments

The next time your patient makes a yuck face at you with the accusation that the stuff that just hit their tongue has the most awful flavor EVER, you need to be sure and come back to this blog to share your experience so that your offending dental material can be rated accordingly.

For now, you’ll have to settle for this Top Ten, which was created by someone who is so meticulous about isolation that they never (!) get complaints about the taste of the following products:

The Top Ten Worst-Tasting Dental Materials

10. Air polishing powder

Some people like the taste of baking soda, which is why this is at the high end of the list. Others, you’d think that you’d hit them with the entire Pacific Ocean with the way they wretch from the spray. Young Dental has one of the better products in this category. And most patients actually do prefer it to the grit of pumice prophy paste if an operator is good at managing an air polisher.

9. Impregum Penta impression material

Fortunately the second generation flavor is much better than the first. But what is with the aftertaste? It’s not like you can use a rubber dam when taking a full mouth impression.

8. Vizilite rinse

Sour flavors seem to go over worse than salty ones. And because this cancer-screening pre-rinse is essentially vinegar, you may get a dirty look right before you start checking for the dirty bombs that are cancer cells.

7. Jeltrate Plus

Yum. Unflavored alginate with a splash of antimicrobial quaternary ammonium compounds to give it a little bit of awkward je ne sais quoi.

6. Compounded tricaine topicals

This is like benzocaine on steroids. Because it is not available in a commercial formulation, you’ll have to have a pharmacy compound the gel for you. John Hollis Pharmacy whips up a pretty mean cocktail of lidocaine, prilocaine and tetracaine at a decent price. It tastes pretty bad, but when patients rave about your painless injections afterwards, you’ll want a tube of it in every operatory.

5. Parkell Mucohard relining material

Not only does it taste foul, it gets bonus points for heating up while it’s curing in your patient’s mouth. This PDF from Parkell even cautions against leaving the patient alone for fear of spontaneous combustion.

4. Septocaine

Even a few drops of the local anesthetic inadvertently dripped onto the back of the tongue will make your patient want to chew through the stainless steel of your syringe. Be careful or else you will be switching back to lidocaine.

3. Viscostat hemostasis gel

Great for getting a lot of bleeding under control. Unless that bleeding is on the tongue. Then, not so great. Ultradent has addressed this notoriety by bathing their latest Viscostat with mint flavor ribbons. But I’m sure you can still taste the caustic astringency that would make bleeding to death not seem so bad.

2. The goo under a loose crown that you just removed

Can we all gross out at this one for a moment? And hahahahaha, they can’t blame this flavor on you. Which brings us to:

1. RelyX Unicem cement

Stag-nasty payback for that loose crown you just had to smell. RelyX gives you the ultimate in sourness and bitterness that lasts and lasts (but so does the bond).

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Why more dental product manufacturers don’t try to mask the noxious flavors inherent in their materials is a question that can’t be easily answered with chemistry or economics. If you’re not one to wait on this development, let your patients choose the flavor of their next crown seat or impression tray instead by carefully slipping them a few drops of one of these flavoring agents that are especially created for that purpose.

Pearson Dental Supply Flavorings