Ahh, is there any better time than March Madness season? If there is a better confluence of sports, slacking off, beer and excess, it's gotta be getting out of work at noon and sitting in a sports bar watching four basketball games while drinking Guinness on St Patty's day with a plate of corned beef and cabbage on it's way.
Working in a primarily all-female environment, I find some difficulty relating all this excitement. One of the hygienists, a man (who is SO much cooler than Ben Stiller's Nurse Fokker) keeps me sane. But some women are tricky regardless. I'll come into work all excited about the Olympic figure skating short programs and did anyone watch it? Nope. They were watching American Idol and Dancing with the Stars. Hey, new Pride and Prejudice film out.... who's seen it? No one; they all went to see "Stealth" or "The Hills have Eyes." Sigh.
Currently, however, my pool is being won by our friend Cathryn, who based close decisions on "Do I know anyone there?" Thusly, you have her brilliant predictions of Montana defeating Nevada and Washington squeaking past Illinois to the Sweet 16. With 25 correct picks in the first round, she's 4 up on ESPN's Joe Lunardi and 6 ahead of Sports Illustrated. So hah.
Rachel continues to ride Gonzaga deep into the tournament. I say, "Every year they disappoint you! Why do you keep picking them?" "Well, if I DON'T pick them, then that's the year they'll win it all!" Sheesh. Gonzaga: the abusive ex that you keep hooking up with, even after the relationship is irreversibly flawed.
In other quotes from R: "I think it's good that Kirby goes in the shower, cuz then at least it cleans his butt."
No one likes a cat that's too...er, hefty to reach his own posterior for cleaning.... sigh again.....
Sunday, March 19, 2006
Sunday, March 12, 2006
Wow...she MUST be bored
At the tail end of the conversation on Southern Ohio, a certain first-time poster called "Rachel" wrote, "Wow...I MUST be bored. :) luv you nate..."
Well, I appreciate the love, but.... Seriously, only the painfully bored would POSSibly read what I have to say! YOU are blessed to be exposed to a consistent stream of charmingly whimsical Nate-isms. You should be more symmpathetic to the vast Nate-less populace that has never had the opportunity to bask in Nate-ness all the time, or harsher still, those who have experienced a brief, shining moment of Nate-aity and then had their Nate from their bosom untimely ripp'd.
(The latter is a shameless "rip off" of MacBeth, Act V, scene viii, in case the phrase resoNates with anyone...)
In other news, check out the progress of Ohio State basketball. Go Bucks. Whoot.
Have you ever wanted an Angora rabbit? I haven't. Rachel thinks they're "cute 'n fluffy." blegh!
check outErnie the English Angora. You have to scroll past Oscar the Pug, which is a freakishly odd pet, but only relative to dogs.
Also, theljc blog is charmingly whimsical and I recommend it to everyone.
off to Brunch!
Well, I appreciate the love, but.... Seriously, only the painfully bored would POSSibly read what I have to say! YOU are blessed to be exposed to a consistent stream of charmingly whimsical Nate-isms. You should be more symmpathetic to the vast Nate-less populace that has never had the opportunity to bask in Nate-ness all the time, or harsher still, those who have experienced a brief, shining moment of Nate-aity and then had their Nate from their bosom untimely ripp'd.
(The latter is a shameless "rip off" of MacBeth, Act V, scene viii, in case the phrase resoNates with anyone...)
In other news, check out the progress of Ohio State basketball. Go Bucks. Whoot.
Have you ever wanted an Angora rabbit? I haven't. Rachel thinks they're "cute 'n fluffy." blegh!
check out
Also, the
off to Brunch!
Tuesday, March 07, 2006
Gasp! Mercury!!
So, a couple weeks ago, the award-winning local daily put this article on the front page.
Pretty standard alarmist stuff. I was mad that although they quoted the directors of local dental societies, who ostensibly represent dentists, they didn't bother going to the trouble to find an actual dentist to discuss this issue. Oh, they found Dr. Fischer, "past president of the International Academy of Oral Medicine and Toxicology." His site, which I won't even justify with a hyperlink (google if you like) discusses the imminent danger not only of silver fillings but of fluoridating the water.
Now here's my deal. If someone asks me not to use silver fillings due to concerns about mercury, I'm OK with that. Better safe than sorry, maybe (even tho', as all dentists know, there's no scientific evidence to support the "silver fillings will hurt/kill you theory). Hey, I personally have an unproven superstition that if you hit the "To Cross" button at the crosswalk an even number of times, it will DEactivate the signal. (On...off...on...off) So I always do it 3-5 times.
But when you get to the anti-fluoridationists, I just get mad. I can respect anti-mercury filling people despite their lack of evidence. But the others.... wow, they feel compelled to lobby against the single most cost-effective public health practice on the planet, thereby primarily harming those who can least afford it: Uninsured children, or kids with non-compliant parents.
The other thing seems to be the way the article is structured. They lead off with all these super-scary mercury facts. THEN, at the END of the article, the opponent of mercury fillings states, "We can’t say it will cause harm, but we know there is no benefit."
We can't say it will cause harm, but.... Kinda specious, in my opinion. The SAME poll they use (Zogby) states that of those patients who actually discuss fillings with their dentists, more than HALF feel that they'd be likely or somewhat likely to go ahead and use silver if necessary. Not reported in the article. Thbbt.
Pretty standard alarmist stuff. I was mad that although they quoted the directors of local dental societies, who ostensibly represent dentists, they didn't bother going to the trouble to find an actual dentist to discuss this issue. Oh, they found Dr. Fischer, "past president of the International Academy of Oral Medicine and Toxicology." His site, which I won't even justify with a hyperlink (google if you like) discusses the imminent danger not only of silver fillings but of fluoridating the water.
Now here's my deal. If someone asks me not to use silver fillings due to concerns about mercury, I'm OK with that. Better safe than sorry, maybe (even tho', as all dentists know, there's no scientific evidence to support the "silver fillings will hurt/kill you theory). Hey, I personally have an unproven superstition that if you hit the "To Cross" button at the crosswalk an even number of times, it will DEactivate the signal. (On...off...on...off) So I always do it 3-5 times.
But when you get to the anti-fluoridationists, I just get mad. I can respect anti-mercury filling people despite their lack of evidence. But the others.... wow, they feel compelled to lobby against the single most cost-effective public health practice on the planet, thereby primarily harming those who can least afford it: Uninsured children, or kids with non-compliant parents.
The other thing seems to be the way the article is structured. They lead off with all these super-scary mercury facts. THEN, at the END of the article, the opponent of mercury fillings states, "We can’t say it will cause harm, but we know there is no benefit."
We can't say it will cause harm, but.... Kinda specious, in my opinion. The SAME poll they use (Zogby) states that of those patients who actually discuss fillings with their dentists, more than HALF feel that they'd be likely or somewhat likely to go ahead and use silver if necessary. Not reported in the article. Thbbt.
Saturday, February 25, 2006
Ah, Southern Ohio....
First off: No lurking! If you are reading and enjoying (or even reading and hating) please leave replies! Otherwise I'm forced to assume no one cares and will be forced to sit around wondering why everyone insists dentists have such a high suicide rate. (not actually true; in recent years we've been surpassed by lawyers...)
This post is almost verbatim copied from a recent email exchange with a dental school colleague who now finds herself working in Southern Ohio. (This is, I'm sure, less stressful to her than finding herself, due to vagaries of surnames, sitting next to ME for four years...heh heh...)
Anyway, thanks to Dr. Janice for her inspiration - I wish her the best of luck in joining the small but significant demographic of "NASCAR-watching Orthodontists!"
As you may recall, I spent 3-4 mos working for
[non profit healthcare agency] in [Appalacian Ohio town]; had some good assistants
from [slightly larger town]... I always remember things from that
practice like:
"Bubby don't much take ta sleepin' without his
Mountain Dew, ya see..."
On back of a truck: sticker featuring Osama bin Laden
saying "F--- you A------." That way, when al Qaida's
leader is tooling around Appalachian Ohio, he will see
that, realize he's an a------ and that he can get
f---ed.
On blackboard inside Waverly restaurant/tavern:
"How's a Pike County divorce like a tornado? answer:
Either way, someone's losing a trailer."
Also noted on backs of trucks (it was eerie thinking that my Toyota was the only one for miles around...)
-Keep honking; I'm re-loading.
-(in the style/font of popular milk industry slogan:) gut deer?
- "Terrorism" - just that, w/ an 'anti' ring around it, like the "no smoking" sign or the Ghost Busters logo.
I saw the latter in a parking lot one day and mused, "Ya know, that really makes me stop and think. Cuz ya know, before I got into dentistry, I was totally going to BE a terrorist! But now...I'm just not so sure..."
Needless to say, I was hardly surprised to find John Ashcroft trailing me around for a few days...
Fond memories - I always referred to the area as a place "with more
guns than teeth."
THAT said, I was always impressed that a lot of young
parents with kids were pretty determined to keep their
offspring from losing all the teeth that THEY had; they kept
their appointments, listened carefully to your
instructions and were profoundly grateful for the
services. If Bubby or Sissy weren't brushing enough,
you can belive mom and dad would be letting 'em have
it on the way out the door....
so there you go.
This post is almost verbatim copied from a recent email exchange with a dental school colleague who now finds herself working in Southern Ohio. (This is, I'm sure, less stressful to her than finding herself, due to vagaries of surnames, sitting next to ME for four years...heh heh...)
Anyway, thanks to Dr. Janice for her inspiration - I wish her the best of luck in joining the small but significant demographic of "NASCAR-watching Orthodontists!"
As you may recall, I spent 3-4 mos working for
[non profit healthcare agency] in [Appalacian Ohio town]; had some good assistants
from [slightly larger town]... I always remember things from that
practice like:
"Bubby don't much take ta sleepin' without his
Mountain Dew, ya see..."
On back of a truck: sticker featuring Osama bin Laden
saying "F--- you A------." That way, when al Qaida's
leader is tooling around Appalachian Ohio, he will see
that, realize he's an a------ and that he can get
f---ed.
On blackboard inside Waverly restaurant/tavern:
"How's a Pike County divorce like a tornado? answer:
Either way, someone's losing a trailer."
Also noted on backs of trucks (it was eerie thinking that my Toyota was the only one for miles around...)
-Keep honking; I'm re-loading.
-(in the style/font of popular milk industry slogan:) gut deer?
- "Terrorism" - just that, w/ an 'anti' ring around it, like the "no smoking" sign or the Ghost Busters logo.
I saw the latter in a parking lot one day and mused, "Ya know, that really makes me stop and think. Cuz ya know, before I got into dentistry, I was totally going to BE a terrorist! But now...I'm just not so sure..."
Needless to say, I was hardly surprised to find John Ashcroft trailing me around for a few days...
Fond memories - I always referred to the area as a place "with more
guns than teeth."
THAT said, I was always impressed that a lot of young
parents with kids were pretty determined to keep their
offspring from losing all the teeth that THEY had; they kept
their appointments, listened carefully to your
instructions and were profoundly grateful for the
services. If Bubby or Sissy weren't brushing enough,
you can belive mom and dad would be letting 'em have
it on the way out the door....
so there you go.
Sunday, February 19, 2006
Serious as Cancer
Friday I spent the afternoon "riding shotgun" with a local oral surgeon. Usually it's fun (for me anyway) to watch someone w/ the skills to shuck out four wisdom teeth in the time it takes me to do one. Today was a little different. He was kind enough to see a patient from the non-profit who we were pretty sure had oral cancer.
The slim, middle aged woman is "between homes," as we say, but had recently started a new job and was pleased to be getting health insurance. Unfortunately, even though she'd noticed the sore in her mouth a year ago, and even though there were resources to assist her in seeing someone, she "put it off because I didn't WANT to know for sure...I was scared."
Increasingly, the difficulty swallowing increased, the pain under her tongue and in her jaw became more severe and frequent, and she finally sought help. The ulcerated, bulging lump ventral to her tongue and the nodular involvement appreciable in the submandibular and cervical areas were hardly subtle. Even the greenest dental student would raise an eyebrow with the symptoms and presentation.
While waiting on the oral surgeon, I made small talk with the patient. We both had family in Ohio. Our places of employment are nearby one another. Yep, it sure is windy today.
The oral surgeon confirmed our suspicions without needing biopsy. "T3 or T4," he said, soberly shaking his head out in the hallway. "I'm sending her to Dr. ---- in Boston. She needs a head and neck surgeon - probably radiation, maybe chemo...."
We returned to his exam room to try to gently tell the patient that we would do what we could to facilitate her treatment. "Can I wait 'til my insurance kicks in?" she asked hopefully. "Two months?" my colleague said incredulously. "Ma'am, I don't want you to wait two weeks. We need you down in Boston next week." He wrote out a script for a strong narcotic so she could sleep at night.
Dr. ---- was in surgery, so the oral surgeon dismissed the patient, promising that his office would call her as soon as they reached the Boston doctor. I shook her hand as compassionately as I good, encouraging her to not hesitate if my agency could do anything to facilitate her transportation or other needs. She left smiling unconvincingly, with a hint of tear in her eye.
It's easy to scoff at people for smoking too much or not seeking care. Harder when the person has a face and a family. I wish she'd come in sooner.
The slim, middle aged woman is "between homes," as we say, but had recently started a new job and was pleased to be getting health insurance. Unfortunately, even though she'd noticed the sore in her mouth a year ago, and even though there were resources to assist her in seeing someone, she "put it off because I didn't WANT to know for sure...I was scared."
Increasingly, the difficulty swallowing increased, the pain under her tongue and in her jaw became more severe and frequent, and she finally sought help. The ulcerated, bulging lump ventral to her tongue and the nodular involvement appreciable in the submandibular and cervical areas were hardly subtle. Even the greenest dental student would raise an eyebrow with the symptoms and presentation.
While waiting on the oral surgeon, I made small talk with the patient. We both had family in Ohio. Our places of employment are nearby one another. Yep, it sure is windy today.
The oral surgeon confirmed our suspicions without needing biopsy. "T3 or T4," he said, soberly shaking his head out in the hallway. "I'm sending her to Dr. ---- in Boston. She needs a head and neck surgeon - probably radiation, maybe chemo...."
We returned to his exam room to try to gently tell the patient that we would do what we could to facilitate her treatment. "Can I wait 'til my insurance kicks in?" she asked hopefully. "Two months?" my colleague said incredulously. "Ma'am, I don't want you to wait two weeks. We need you down in Boston next week." He wrote out a script for a strong narcotic so she could sleep at night.
Dr. ---- was in surgery, so the oral surgeon dismissed the patient, promising that his office would call her as soon as they reached the Boston doctor. I shook her hand as compassionately as I good, encouraging her to not hesitate if my agency could do anything to facilitate her transportation or other needs. She left smiling unconvincingly, with a hint of tear in her eye.
It's easy to scoff at people for smoking too much or not seeking care. Harder when the person has a face and a family. I wish she'd come in sooner.
Sunday, February 12, 2006
A Million Little Root Canals....
Much furor has been expended over the "embellishments" of James Frey in his "memoir," "A Million Little Pieces."
For those not tuned in to All Things Oprah, a brief synopsis: Mr. Frey wrote a book detailing a horrific and harrowing experience with drug addiction. It was, fiction or not, moving to many people, including Oprah and her Harpo cronies. They selected it for her Book Club, which is pretty much the writers' equivalency to winning American Idol. Possibly better.
I've heard the author even sold the movie rights to Brad Pitt. (Paging Tyler Durden...)
Eventually, a number of discriminating readers started to question the somewhat incredulous claims made in the book. Several pilots, flight attendants and others in the airline industry said, "Hey...you can't put someone on the plane who is unconscious (and bleeding and covered in bodily fluids) without a doctor...you just can't do that! No one does that..."
People started asking questions. Eventually, Frey admitted the book isn't so much about fact as "impression and feeling."
see his statement from the publisher's website
Now I don't mind a little literary license, but Mr. Frey is doing the dental equivalent of shouting "Fire!" in a crowded theater.
Read this account from a Pennsylvania dentist regarding the absurdity of the story!
While I'd been previously just irritated or amused by this whole brouhaha, I am now of the state of mind of those offended by Denmark's cartoon depictions of The Prophet. He has basically tainted the water for thousands of people who are already paranoid about dentists and now have yet another reason to avoid needed treatment. He has in effect, contributed to others' suffering. Why? Because of an impression.
Look, if you want to say, "Wow, that last exam was brutal - Professor Smith totally f---ed me up the a--!" that's fine, but if you do so in such as way as to imply that you were ACTUALLY sexually abused by your teacher, it's irresponsible.
I have treated dozens, possibly even hundreds of addicts, recovering and otherwise. When I worked with Narcotics Anonymous, I found that they were terrific patients. Right around step 7 or 8, whilst making amends, many of them decided to address long-ignored dental concerns. Transitioning back to the job market, they usually had plenty of time for visits (even a long visit with a student dentist!) and appreciated the reduced fees of being at a teaching institution. They never asked for narcotics, and despite how drug-addled some of their brains might have been, I never encountered an addict so foolish as to think that local anesthetic could get them high or cause a relapse.
I've thought about the concept of triggering our natural fears of dentists in the pursuit of art, and decided that I don't really mind that pursuit in a fictional setting. Marathon Man and Brazil are films where people are tortured by dentists for dramatic effect, while Little Shop of Horrors does so for comedic effect. But no one ACTUALLY believes that this is what will happen at the dentist any more than one fears being eaten by carnivorous plants at the flower shop.
If you need me this weekend, I'll be the one out in Market Square, burning a copy of Frey's book.
For those not tuned in to All Things Oprah, a brief synopsis: Mr. Frey wrote a book detailing a horrific and harrowing experience with drug addiction. It was, fiction or not, moving to many people, including Oprah and her Harpo cronies. They selected it for her Book Club, which is pretty much the writers' equivalency to winning American Idol. Possibly better.
I've heard the author even sold the movie rights to Brad Pitt. (Paging Tyler Durden...)
Eventually, a number of discriminating readers started to question the somewhat incredulous claims made in the book. Several pilots, flight attendants and others in the airline industry said, "Hey...you can't put someone on the plane who is unconscious (and bleeding and covered in bodily fluids) without a doctor...you just can't do that! No one does that..."
People started asking questions. Eventually, Frey admitted the book isn't so much about fact as "impression and feeling."
see his statement from the publisher's website
Now I don't mind a little literary license, but Mr. Frey is doing the dental equivalent of shouting "Fire!" in a crowded theater.
Read this account from a Pennsylvania dentist regarding the absurdity of the story!
While I'd been previously just irritated or amused by this whole brouhaha, I am now of the state of mind of those offended by Denmark's cartoon depictions of The Prophet. He has basically tainted the water for thousands of people who are already paranoid about dentists and now have yet another reason to avoid needed treatment. He has in effect, contributed to others' suffering. Why? Because of an impression.
Look, if you want to say, "Wow, that last exam was brutal - Professor Smith totally f---ed me up the a--!" that's fine, but if you do so in such as way as to imply that you were ACTUALLY sexually abused by your teacher, it's irresponsible.
I have treated dozens, possibly even hundreds of addicts, recovering and otherwise. When I worked with Narcotics Anonymous, I found that they were terrific patients. Right around step 7 or 8, whilst making amends, many of them decided to address long-ignored dental concerns. Transitioning back to the job market, they usually had plenty of time for visits (even a long visit with a student dentist!) and appreciated the reduced fees of being at a teaching institution. They never asked for narcotics, and despite how drug-addled some of their brains might have been, I never encountered an addict so foolish as to think that local anesthetic could get them high or cause a relapse.
I've thought about the concept of triggering our natural fears of dentists in the pursuit of art, and decided that I don't really mind that pursuit in a fictional setting. Marathon Man and Brazil are films where people are tortured by dentists for dramatic effect, while Little Shop of Horrors does so for comedic effect. But no one ACTUALLY believes that this is what will happen at the dentist any more than one fears being eaten by carnivorous plants at the flower shop.
If you need me this weekend, I'll be the one out in Market Square, burning a copy of Frey's book.
Friday, February 10, 2006
Telling it on the Mountain
Hello - as promised, I will (briefly?) discuss my last trip to the cinema to view the critically acclaimed Brokeback Mountain. Although overhyped a bit, it's definitely an excellent film - touching without being overly manipulative. By the end, if you didn't feel the longing and frustration and sorrow experienced by several characters, you probably don't have a heart.
One nice aspect of the film was it's sparse style - the dialogue and pacing often resembled the spare but beautiful scenery. A lot was said by what WASN'T said or even there.
My biggest impression is that you could basically write a book based on audience comments whilst exiting the theater.
From some girls about 10 years younger than me, in regards to a "skinny-diving" scene where the guys jump naked off a cliff into a lake: "Um, hello...I would have been ok but what was the deal with all the flapping genitalia? ohmigod!"
It took a great deal of self-restraint to resist saying, oh, i don't know... "Well, ladies, I don't want you to be TOO surprised on your wedding nights, but let me explain a few things..." or even "Hey, let's try a little experiment. Go take a running jump into a lake (topless) and then we'll talk about who's flapping...." la la la....
and then there was the inevitable: "Ya know, I was pretty much ok w/ the love story but...c'mon, it was two GUYS!"
Um. let's see. That earns a big critical blank stare and head shake from this movie goer. I mean...duh. that's like when I saw some young ladies leaving Saving Pvt. Ryan some years back going, "Oh! I just wanted to see Matt Damon...I didn't realize it would be so VIOLENT!"
All ya had to do was read ANY snippet of any article or see any bit o' TV or hear anyone at all talk about it and the words "most gorily realistic cinematic portral of war EVER" would show up.
Anyway, what I found most interesting was how the two leads were both quite functionally bi-sexual. Most gay men I know are, realistically, as repulsed by the notion of sex with a woman as straight guys are by the possibility of a homosexual encounter. Or at least that what people say - obviously Kinsey & co. feel that everyone is on this continuum....
Anyway, I don't have any more pithy thoughts on the subject, but will welcome comments and discussion!
I'll try to get back to more dentistry next post!
One nice aspect of the film was it's sparse style - the dialogue and pacing often resembled the spare but beautiful scenery. A lot was said by what WASN'T said or even there.
My biggest impression is that you could basically write a book based on audience comments whilst exiting the theater.
From some girls about 10 years younger than me, in regards to a "skinny-diving" scene where the guys jump naked off a cliff into a lake: "Um, hello...I would have been ok but what was the deal with all the flapping genitalia? ohmigod!"
It took a great deal of self-restraint to resist saying, oh, i don't know... "Well, ladies, I don't want you to be TOO surprised on your wedding nights, but let me explain a few things..." or even "Hey, let's try a little experiment. Go take a running jump into a lake (topless) and then we'll talk about who's flapping...." la la la....
and then there was the inevitable: "Ya know, I was pretty much ok w/ the love story but...c'mon, it was two GUYS!"
Um. let's see. That earns a big critical blank stare and head shake from this movie goer. I mean...duh. that's like when I saw some young ladies leaving Saving Pvt. Ryan some years back going, "Oh! I just wanted to see Matt Damon...I didn't realize it would be so VIOLENT!"
All ya had to do was read ANY snippet of any article or see any bit o' TV or hear anyone at all talk about it and the words "most gorily realistic cinematic portral of war EVER" would show up.
Anyway, what I found most interesting was how the two leads were both quite functionally bi-sexual. Most gay men I know are, realistically, as repulsed by the notion of sex with a woman as straight guys are by the possibility of a homosexual encounter. Or at least that what people say - obviously Kinsey & co. feel that everyone is on this continuum....
Anyway, I don't have any more pithy thoughts on the subject, but will welcome comments and discussion!
I'll try to get back to more dentistry next post!
Monday, February 06, 2006
A little bit of chatting...
So at six pm a mom comes in w/ 9 yo daughter; she has a cavity, and we're going out of town.... can you fix it? sure; that was an easy fifteen min. procedure, since we didn't have to anesthetize, and the girl was very cooperative.
Mom had a few questions. Actually, she then had an HOUR worth of questions. Since she was the last patient, and I had no where to be, I was happy to answer - why are silver vs. white fillings sometimes better or worse? What about this crown I had done? why do some dentists try to fill everything and others are "wait and see" and now all my kids have cavities??
So I answered her questions for the better part of the hour ans she was ASTOUNDED that I would take the time. Well, if I had someone else waiting for a filling or something, sure, i couldn't do that. But she was SO happy. She's coming back and bringing her husband and other three kids... I figure I could open up a practice two hours away and she'd happily visit twice a week, now that she's sold on the fact that I will always answer her questions when she (gasp) wants to actually TALK to the dentist.
Kinda always ticks me off when people pay 30-70 bucks for an exam and then just get a 50 second "look-see" and no conversation/explanation from the dentist... Yes, sure, it's busy, and you have to whip through folks to make ends meet and pay the staff, but honestly, most folks only need a couple minutes.... so that was gratifying.
In a completely unrelated story, I saw Brokeback Mountain this weekend. Wow; I could just about write a book on the comments heard whilst exitting the theater. wow. more later perhaps....
Mom had a few questions. Actually, she then had an HOUR worth of questions. Since she was the last patient, and I had no where to be, I was happy to answer - why are silver vs. white fillings sometimes better or worse? What about this crown I had done? why do some dentists try to fill everything and others are "wait and see" and now all my kids have cavities??
So I answered her questions for the better part of the hour ans she was ASTOUNDED that I would take the time. Well, if I had someone else waiting for a filling or something, sure, i couldn't do that. But she was SO happy. She's coming back and bringing her husband and other three kids... I figure I could open up a practice two hours away and she'd happily visit twice a week, now that she's sold on the fact that I will always answer her questions when she (gasp) wants to actually TALK to the dentist.
Kinda always ticks me off when people pay 30-70 bucks for an exam and then just get a 50 second "look-see" and no conversation/explanation from the dentist... Yes, sure, it's busy, and you have to whip through folks to make ends meet and pay the staff, but honestly, most folks only need a couple minutes.... so that was gratifying.
In a completely unrelated story, I saw Brokeback Mountain this weekend. Wow; I could just about write a book on the comments heard whilst exitting the theater. wow. more later perhaps....
Sunday, February 05, 2006
Am I back? perhaps...
Due to popular demand (thank you for nagging Sean, Hank, et al.) I have returned to attempt to be a good blogger again. Geez, it's like working out; you really have to be committed!
So, to update, I have 80% sold out; that's right, I'm now working at a private office in Exeter. Everyone says, Oh, NOW you're making the big money! Well, um. no. not yet. Nevertheless, I remain confident that the "big money" will soon come rolling down the pike, yessir.
I'm still one day a week (and more occaisionally) at the non-profit, so I'm keepin' it real for all da homies, yo.
(to wit: "keepin' it real" means "making dentures" and "da homies" equals toothless or mostly toothless folks w/o insurance.
"Yo" is just added for street cred.)
so i'm going to send this off, eat some breakfast and tell y'all i'm back. more to come, perhaps (ooh!) during the Super Bowl.
So, to update, I have 80% sold out; that's right, I'm now working at a private office in Exeter. Everyone says, Oh, NOW you're making the big money! Well, um. no. not yet. Nevertheless, I remain confident that the "big money" will soon come rolling down the pike, yessir.
I'm still one day a week (and more occaisionally) at the non-profit, so I'm keepin' it real for all da homies, yo.
(to wit: "keepin' it real" means "making dentures" and "da homies" equals toothless or mostly toothless folks w/o insurance.
"Yo" is just added for street cred.)
so i'm going to send this off, eat some breakfast and tell y'all i'm back. more to come, perhaps (ooh!) during the Super Bowl.
Friday, September 23, 2005
Nothing is Happening!
Wow; nondescript week! Oddly, none of the following occurred:
- 90 minute extraction due to extreme decay and divergent roots
- patient consuming truly heroic quantities of narcotics and then have the nerve to ask for more
- uncontrollable screaming child ignoring the fact that we haven't hurt them a bit and bursting into tear for shear effect
- mom blames her cavities on the baby "sucking the calcium out of teeth" presumably in utero
I did have a woman lose her denture swimming (presumably in the ocean) and call in desperately wanting a new one. I fear she's going to ask to get it free, since we only put it in less than a year ago. I always appreciate it when you spill your coffee or drop your burger and the person at the counter says, "Aw...hey, here's another on the house." Tragically, I don't have that luxury.... The overhead is a bit higher. So, I'm going in today to see her. I'm off, but she's pretty upset, so hey. Maybe we can put in a flipper by next week....
I did have a young lady come in w/a lot of decay; we fixed most of it two years ago, but daggumit if she isn't STILL drinking 12 cokes a day... I'm sorry...correct myself; I said, "How many cokes do you drink a day?" "Coke? are you kidding? I don't drink that!" "Oh." "PEPSI is the only way to go." Duh. Anyway, I asked her if she ever did any meth. "What? Drugs?!? Heck no; I've got two kids!"
Ohhhhh. Well, speaking as someone who has lost a patient who OD'd on heroin while pregnant, forgive my not assuming the connection between motherhood and sobriety.
Similarly, I saw a teen girl a few months back. "Hey, Melissa; you didn't check this box on the health history. Are you taking any birth control pills?" "Huh? I'm just 14, silly!" Gosh, I wish is was silly. I wanted to pat her on the head, give her a (sugarfree) lollipop and a hug for being innocent and charmingly naive. At least 'til some 17,18-year-old jerk manages to take advantage of that. Seriously tho', the hormones interact w/ antibiotics (actually vice versa) so we need to know. And of course, a number of young women take them strictly for regulating their period.
One more. Me, jokingly, after extracting a retained baby tooth: "Ok, Jimmy - you a smoker?" "No way! I'm just 13!" Again, how many of my 20 year old smokers started at 12? Yeah.
"House" is back on the air. Both my assistant and I watch religiously and then compare notes, fantasizing about being that openly cynical in front of patients. Mmmmm. He and Dr. Cox on "Scrubs" are just the most lovely alter egos... of my id, at least. Or is that an alter id? Does such a thing exist? Paging Dr. Freud....
- 90 minute extraction due to extreme decay and divergent roots
- patient consuming truly heroic quantities of narcotics and then have the nerve to ask for more
- uncontrollable screaming child ignoring the fact that we haven't hurt them a bit and bursting into tear for shear effect
- mom blames her cavities on the baby "sucking the calcium out of teeth" presumably in utero
I did have a woman lose her denture swimming (presumably in the ocean) and call in desperately wanting a new one. I fear she's going to ask to get it free, since we only put it in less than a year ago. I always appreciate it when you spill your coffee or drop your burger and the person at the counter says, "Aw...hey, here's another on the house." Tragically, I don't have that luxury.... The overhead is a bit higher. So, I'm going in today to see her. I'm off, but she's pretty upset, so hey. Maybe we can put in a flipper by next week....
I did have a young lady come in w/a lot of decay; we fixed most of it two years ago, but daggumit if she isn't STILL drinking 12 cokes a day... I'm sorry...correct myself; I said, "How many cokes do you drink a day?" "Coke? are you kidding? I don't drink that!" "Oh." "PEPSI is the only way to go." Duh. Anyway, I asked her if she ever did any meth. "What? Drugs?!? Heck no; I've got two kids!"
Ohhhhh. Well, speaking as someone who has lost a patient who OD'd on heroin while pregnant, forgive my not assuming the connection between motherhood and sobriety.
Similarly, I saw a teen girl a few months back. "Hey, Melissa; you didn't check this box on the health history. Are you taking any birth control pills?" "Huh? I'm just 14, silly!" Gosh, I wish is was silly. I wanted to pat her on the head, give her a (sugarfree) lollipop and a hug for being innocent and charmingly naive. At least 'til some 17,18-year-old jerk manages to take advantage of that. Seriously tho', the hormones interact w/ antibiotics (actually vice versa) so we need to know. And of course, a number of young women take them strictly for regulating their period.
One more. Me, jokingly, after extracting a retained baby tooth: "Ok, Jimmy - you a smoker?" "No way! I'm just 13!" Again, how many of my 20 year old smokers started at 12? Yeah.
"House" is back on the air. Both my assistant and I watch religiously and then compare notes, fantasizing about being that openly cynical in front of patients. Mmmmm. He and Dr. Cox on "Scrubs" are just the most lovely alter egos... of my id, at least. Or is that an alter id? Does such a thing exist? Paging Dr. Freud....
Tuesday, September 13, 2005
The only thing more fun than a dentist....
...is a GROUP of dentists!
What do we call a group of dentists? I mean, you've got a congregation of pigeons, a parliment of rooks, a murder of crows... So...maybe an extraction of dentists? An amalgam of dentists.... I actually like a gaggle of dentists. I mean, some people gag, and so.... hm.
I'll accept nominations!
In the meantime, I'll report on some activities of my local SOCIETY of dentists (Southeast New Hampshire!).
I'm happy to report that everything worked out fine with my event planning... The plate distribution of salmon vs. chicken proceded evenly, with no one sorely disappointed about missing out on their entree preference. Phew!
We also had a nice presentation by a hygienist from Tom's of Maine on their Community Involvement Program.
I'm a big fan, in that they are socially conscious organiation that makes natural-based products that are effective. There's a lot of "all natural" stuff out there that isn't worth the package it comes in. Tom's products, however, routinely earn the ADA's Seal of Approval.
(i just want you all to know I spent 20 min or more trying to import a .gif of the ADA Seal of approval onto this page. but i can't. Go pick up your toothpaste and look at that one. Thbbt.)
Anyway, along with giving hundreds of thousands of dollars back to the community, Tom's sponsors a program where they give dentists coupons to give their patients to buy Tom's products. The customer saves fifty cents and another fifty cents is taken out of the profit and given to various non-profit dental causes, assisting in access for those who can't afford it. Neat-O.
Secondly, we learned of many dentists in the Gulf Coast area who have lost their practices, or at least their patients, who have been dispersed across the region. 400 dental students in the area are going to have to be assimilated into programs elsewhere in the country. This strikes me as being a lot tougher than fitting a couple extra kids into each 4th grade class, since each student needs space to treat patients, etc etc. So, the ADA is contributing $10,000 off the bat, the NHDS is giving $5000, and a few component societies in New Hampshire alone have pledged up to $5000. As the local treasurer, we should be able to kick in a few thousand to the cause.
I can only imagine the total lack of options for people displaced by the storm - They have water but are struggling to just get blood pressure and diabetes meds; good luck if you have a toothache! So hopefully this will help.
In the meantime, I encourage everyone to buy Tom's products. Oh, and in case you care, I DO recommend Trident gum for my patients who chew gum. :)
What do we call a group of dentists? I mean, you've got a congregation of pigeons, a parliment of rooks, a murder of crows... So...maybe an extraction of dentists? An amalgam of dentists.... I actually like a gaggle of dentists. I mean, some people gag, and so.... hm.
I'll accept nominations!
In the meantime, I'll report on some activities of my local SOCIETY of dentists (Southeast New Hampshire!).
I'm happy to report that everything worked out fine with my event planning... The plate distribution of salmon vs. chicken proceded evenly, with no one sorely disappointed about missing out on their entree preference. Phew!
We also had a nice presentation by a hygienist from Tom's of Maine on their Community Involvement Program.
I'm a big fan, in that they are socially conscious organiation that makes natural-based products that are effective. There's a lot of "all natural" stuff out there that isn't worth the package it comes in. Tom's products, however, routinely earn the ADA's Seal of Approval.
(i just want you all to know I spent 20 min or more trying to import a .gif of the ADA Seal of approval onto this page. but i can't. Go pick up your toothpaste and look at that one. Thbbt.)
Anyway, along with giving hundreds of thousands of dollars back to the community, Tom's sponsors a program where they give dentists coupons to give their patients to buy Tom's products. The customer saves fifty cents and another fifty cents is taken out of the profit and given to various non-profit dental causes, assisting in access for those who can't afford it. Neat-O.
Secondly, we learned of many dentists in the Gulf Coast area who have lost their practices, or at least their patients, who have been dispersed across the region. 400 dental students in the area are going to have to be assimilated into programs elsewhere in the country. This strikes me as being a lot tougher than fitting a couple extra kids into each 4th grade class, since each student needs space to treat patients, etc etc. So, the ADA is contributing $10,000 off the bat, the NHDS is giving $5000, and a few component societies in New Hampshire alone have pledged up to $5000. As the local treasurer, we should be able to kick in a few thousand to the cause.
I can only imagine the total lack of options for people displaced by the storm - They have water but are struggling to just get blood pressure and diabetes meds; good luck if you have a toothache! So hopefully this will help.
In the meantime, I encourage everyone to buy Tom's products. Oh, and in case you care, I DO recommend Trident gum for my patients who chew gum. :)
Thursday, September 08, 2005
Kids are...Fun.
So, today I got to yell at a 7 year old. I am a mean, evil dentist. I am like Dr. Mengele, DDS. oh yes.
Nice little girl; we'd done 2 fillings and three crowns on her; just a couple weeks ago, she was reasonably tolerant when we did back-to-back pulpotomy/crowns on teeth A and B. So no worries.
Anyway, we brought her back cuz one of her earlier fillings (mine, I fear) had gone south....it's hard to do a two-surface filling on a first baby molar, cuz the durn thing is like 80% pulp anyway, so good luck not hitting it.... So I did. Shoulda done the pulpotomy on it the first time, but noooo....
So we bring her back, and I'm trying to subtly distract her whilst sneaking up w/ the injection, but she's too smart for that, having been there before. So, she starts whining and crying, "I want my mommy" etc etc ad nauseum. So I use my happy Dr/Mr Rogers voice and explain very very gently how we don't WANT to hurt her, but you see, if we don't get those nasty ol' tooth bugs OUT of the tooth, (which I might add, IS currently sporting a deligtfully pus-filled parulis!) why, you might get sick and have to go to the hospital! Your face would swell up and look REALLY silly and it would really hurt! You don't WANT to go to the hospital, I don't want you to go to the hospital, and you see, that's why Mommy brought you here, cuz SHE doesn't want you to go to the hospital.
"I don't want to be here!!!! waaahh!"
Why? "It's going to hurt!!!"
What's that in your ear, sweetie? "huh?" The hole...in your earlobe. Are your ears pierced? "Uh-huh." Did that hurt? "Just a little..." Well, there you go..... no, just open... "I want my mommy!!!"
At that point she jerks her head dangerously close to appoaching syringe, therein threatening myself, my assistant AND herself w/ acutal serious injury. At that point, you can send her home, or get tough. It's no different that Super Nanny or Dr. Phil. Stop, lower voice, speak a little louder and quite sternly. "Jenny. It is VERY important that you sit still, or someone could get really hurt. Now, I know that you don't act this way at home. I know you are a big girl, but right now, you are acting like a four-year-old. We have four-year-olds that don't even behave like this! This is OUR office and you need to follow our rules."
A much subdued "Jenny" then opens and barely notices the injection. Was that so bad? [sheepishly] "no...." after that, easy procedure. 10 minutes.
So. Nothing new there, I get one or two of those every week. However, THIS time, I'm later pulled aside by a nurse I work with who really felt that I was too loud, too mean, and inconsiderate to the terrified little girl. Why didn't I let Mom back with her? Sometimes that helps them calm down. I should recognize that a lot of people have different anxiety and pain thresholds etc etc. She said that she TELLS her patients when she's injecting so they know what to expect. Also, as a mom, she felt bad for the little girl.
I seriously have the deepest respect for this woman, and I admit that I don't know everything. I further concede that "you're acting like a four year old" may be a little inappropriate. However....
1. Mom is in the waiting room with two other girls, 5 and 2. She can't hold "Jenny's" hand and watch the other girls. Further, I don't want them seeing the sister upset. The odds are, if no one hears horror stories from older siblings, they're just fine no matter what I do.
2. Having Mom in the room, more often than not, induces the child to act out. They "perform," knowing full well if they yell enough, Mom will scoop them up and carry them away. Lovely, but it doesn't help anyone in the long run. Additionally, having a parent there sends the child a message: "I don't trust this doctor, so if they hurt you, I'll take you away." The kid is then more apprehensive. Mom doesnt' stand at the door the whole day at school. Why? Because she trusts Ms. Applebottom, and Jenny can trust her too. She should trust us as well.
3. Nurses have the luxury of being able to inject people and turn them loose. All done! see ya! -I- have to keep them "on my side" for 30 min or more. If it were just about a quick stick, hey, no worries.
4. She didn't hear the entire exchange. Obviously, I didn't start OUT yelling at the little girl! You start out with lovey-dovey, of course....
5. Lastly, I KNOW this patient. This girl LIKES me and had never given us problems. Sometimes you need to step up and be a little intimidating to let them know "Hey, this is my house. You are not going to play that game." Now, if it's a four year old or a brand new patient, sure, you have to play it by ear.
Regardless, I still feel TERRIBLE for raising my voice and scaring a little girl who may just have been having a bad day. And, admittedly, I'm 6'2 and for all I know Jenny doesn't have a father figure, or even she's had one who is nothing but abusive. I don't know. So I feel bad. My assistant said I handled it "perfectly as usual" so that was gratifying..... Can't help feeling bad...Especially because I really like and respect the Nurse.... She knows her stuff, so I'm torn about to what degree I should have used a different approach....
Thoughts?
Nice little girl; we'd done 2 fillings and three crowns on her; just a couple weeks ago, she was reasonably tolerant when we did back-to-back pulpotomy/crowns on teeth A and B. So no worries.
Anyway, we brought her back cuz one of her earlier fillings (mine, I fear) had gone south....it's hard to do a two-surface filling on a first baby molar, cuz the durn thing is like 80% pulp anyway, so good luck not hitting it.... So I did. Shoulda done the pulpotomy on it the first time, but noooo....
So we bring her back, and I'm trying to subtly distract her whilst sneaking up w/ the injection, but she's too smart for that, having been there before. So, she starts whining and crying, "I want my mommy" etc etc ad nauseum. So I use my happy Dr/Mr Rogers voice and explain very very gently how we don't WANT to hurt her, but you see, if we don't get those nasty ol' tooth bugs OUT of the tooth, (which I might add, IS currently sporting a deligtfully pus-filled parulis!) why, you might get sick and have to go to the hospital! Your face would swell up and look REALLY silly and it would really hurt! You don't WANT to go to the hospital, I don't want you to go to the hospital, and you see, that's why Mommy brought you here, cuz SHE doesn't want you to go to the hospital.
"I don't want to be here!!!! waaahh!"
Why? "It's going to hurt!!!"
What's that in your ear, sweetie? "huh?" The hole...in your earlobe. Are your ears pierced? "Uh-huh." Did that hurt? "Just a little..." Well, there you go..... no, just open... "I want my mommy!!!"
At that point she jerks her head dangerously close to appoaching syringe, therein threatening myself, my assistant AND herself w/ acutal serious injury. At that point, you can send her home, or get tough. It's no different that Super Nanny or Dr. Phil. Stop, lower voice, speak a little louder and quite sternly. "Jenny. It is VERY important that you sit still, or someone could get really hurt. Now, I know that you don't act this way at home. I know you are a big girl, but right now, you are acting like a four-year-old. We have four-year-olds that don't even behave like this! This is OUR office and you need to follow our rules."
A much subdued "Jenny" then opens and barely notices the injection. Was that so bad? [sheepishly] "no...." after that, easy procedure. 10 minutes.
So. Nothing new there, I get one or two of those every week. However, THIS time, I'm later pulled aside by a nurse I work with who really felt that I was too loud, too mean, and inconsiderate to the terrified little girl. Why didn't I let Mom back with her? Sometimes that helps them calm down. I should recognize that a lot of people have different anxiety and pain thresholds etc etc. She said that she TELLS her patients when she's injecting so they know what to expect. Also, as a mom, she felt bad for the little girl.
I seriously have the deepest respect for this woman, and I admit that I don't know everything. I further concede that "you're acting like a four year old" may be a little inappropriate. However....
1. Mom is in the waiting room with two other girls, 5 and 2. She can't hold "Jenny's" hand and watch the other girls. Further, I don't want them seeing the sister upset. The odds are, if no one hears horror stories from older siblings, they're just fine no matter what I do.
2. Having Mom in the room, more often than not, induces the child to act out. They "perform," knowing full well if they yell enough, Mom will scoop them up and carry them away. Lovely, but it doesn't help anyone in the long run. Additionally, having a parent there sends the child a message: "I don't trust this doctor, so if they hurt you, I'll take you away." The kid is then more apprehensive. Mom doesnt' stand at the door the whole day at school. Why? Because she trusts Ms. Applebottom, and Jenny can trust her too. She should trust us as well.
3. Nurses have the luxury of being able to inject people and turn them loose. All done! see ya! -I- have to keep them "on my side" for 30 min or more. If it were just about a quick stick, hey, no worries.
4. She didn't hear the entire exchange. Obviously, I didn't start OUT yelling at the little girl! You start out with lovey-dovey, of course....
5. Lastly, I KNOW this patient. This girl LIKES me and had never given us problems. Sometimes you need to step up and be a little intimidating to let them know "Hey, this is my house. You are not going to play that game." Now, if it's a four year old or a brand new patient, sure, you have to play it by ear.
Regardless, I still feel TERRIBLE for raising my voice and scaring a little girl who may just have been having a bad day. And, admittedly, I'm 6'2 and for all I know Jenny doesn't have a father figure, or even she's had one who is nothing but abusive. I don't know. So I feel bad. My assistant said I handled it "perfectly as usual" so that was gratifying..... Can't help feeling bad...Especially because I really like and respect the Nurse.... She knows her stuff, so I'm torn about to what degree I should have used a different approach....
Thoughts?
Friday, September 02, 2005
It's Darts Season!
Yes, it's that time again, when I actually dabble in a meaningful activity that may even pass as a hobby. Yes, along with fish 'n chips, pubs and representative democracy, darts is one of our best British imports. There is nothing I enjoy more than standing in the company of a group of darters, consuming ethanol whilst hurling sharp objects. Brilliant!
I play on The Cockney Rejects, based at the Coat of Arms Pub in Portsmouth. We are the Boston Red Sox of our league - Always good enough for 2nd place! Even last year, the Sox threw off their curse, but we remained 2nd in the standings and 2nd in the playoffs. On the positive side, we consumed a lot of beer.
This season, we hope to recover from the loss of longtime team captain, Eden Moe, who, for some crazy reason that had to do with marrying a beautiful British physician, emmigrated to the UK. Eden and his clutch bullseyes will be sorely missed. Also, I'll have no one to shoot me dirty looks when I follow unconventional strategies in my singles matches....
Native Brit Nigel Smith is stepping into the captaincy. Mr. Smith is a master of throwing darts while drawing puffs of his cigarette, which is a clever trick, when you think about how easy it would be to hurl the butt and stab a dart in one's mouth... On the rare occaisions that he misses his mark, one can hear Nigel's characteristic explosion: "WANK-er!"
In the past, the British-ness of the team was bolstered by Roger and Simon; Roger plays on as an alternate, and also runs the pub in his spare time. We have no Callums, Olivers or Liams, however.
Ironically, Andy English is a Yank. Andy and I used to hang out at the same Irish Pub in Columbus, Ohio (Byrne's) but didn't know each other until moving to New Hampshire in '02. Andy plans on missing several weeks of the season this fall, for some crazy reason that has to do with marrying a beautiful American architect, and..... hmmm.... anyone else see a trend here? Anyway, he'll be back; Best Wishes to Andy and Cathryn, however!
Hailing from Dover, Dennis Wiggin and Chuck Schlicter will have to travel to Portsmouth for every game this season. Someone should offer to help with gas... Dennis finished on the leaderboards after coming on strong last season, and we're happy to have Chuck back full time from his educational hiatus of last season.
Joining the Rejects this season, Sean Lyons brings his mad phat Irish dart skills to the team. He was smart enough to get married last year (beautiful/American/therapist, for those keeping track of non-darts stats here...) so he shouldn't miss many matches this season!
We opened with a win this week at the Coat; our opponents threw valiantly, despite being down two players. They thusly forfeited three matches. I thusly only played one of the three matches I was scheduled for. Disappointing, but I won by default. "De, Fault! the two sweetest words in the English language!" according to Homer Simpson. Most notable was the tour de force of a throw by Mr. Wiggin, who had a round of five corks. This means that he hit the "red-eye" twice and also a regular bullseye just for giggles. I've never actually seen that done in competition. I did it once while practicing, with no one around to see.... *sigh*. No sour grapes; congrats to the Big Fella! Roger subbed for Nigel this week, as the latter remains in England on "Holiday," I believe. Although simply out-matched in his singles, rookie Sean acquitted himself very well, contributing to his trio's win in 601 and teaming up with Chuck to win a hard-fought doubles Cricket match.
In other news, the Coat's Soft Taco Special is delightfully spicy, but could use some more shells to help mop up the plethora of tasty goodness served w/ the soft steak. Yum.
Back to dentistry later.....
I play on The Cockney Rejects, based at the Coat of Arms Pub in Portsmouth. We are the Boston Red Sox of our league - Always good enough for 2nd place! Even last year, the Sox threw off their curse, but we remained 2nd in the standings and 2nd in the playoffs. On the positive side, we consumed a lot of beer.
This season, we hope to recover from the loss of longtime team captain, Eden Moe, who, for some crazy reason that had to do with marrying a beautiful British physician, emmigrated to the UK. Eden and his clutch bullseyes will be sorely missed. Also, I'll have no one to shoot me dirty looks when I follow unconventional strategies in my singles matches....
Native Brit Nigel Smith is stepping into the captaincy. Mr. Smith is a master of throwing darts while drawing puffs of his cigarette, which is a clever trick, when you think about how easy it would be to hurl the butt and stab a dart in one's mouth... On the rare occaisions that he misses his mark, one can hear Nigel's characteristic explosion: "WANK-er!"
In the past, the British-ness of the team was bolstered by Roger and Simon; Roger plays on as an alternate, and also runs the pub in his spare time. We have no Callums, Olivers or Liams, however.
Ironically, Andy English is a Yank. Andy and I used to hang out at the same Irish Pub in Columbus, Ohio (Byrne's) but didn't know each other until moving to New Hampshire in '02. Andy plans on missing several weeks of the season this fall, for some crazy reason that has to do with marrying a beautiful American architect, and..... hmmm.... anyone else see a trend here? Anyway, he'll be back; Best Wishes to Andy and Cathryn, however!
Hailing from Dover, Dennis Wiggin and Chuck Schlicter will have to travel to Portsmouth for every game this season. Someone should offer to help with gas... Dennis finished on the leaderboards after coming on strong last season, and we're happy to have Chuck back full time from his educational hiatus of last season.
Joining the Rejects this season, Sean Lyons brings his mad phat Irish dart skills to the team. He was smart enough to get married last year (beautiful/American/therapist, for those keeping track of non-darts stats here...) so he shouldn't miss many matches this season!
We opened with a win this week at the Coat; our opponents threw valiantly, despite being down two players. They thusly forfeited three matches. I thusly only played one of the three matches I was scheduled for. Disappointing, but I won by default. "De, Fault! the two sweetest words in the English language!" according to Homer Simpson. Most notable was the tour de force of a throw by Mr. Wiggin, who had a round of five corks. This means that he hit the "red-eye" twice and also a regular bullseye just for giggles. I've never actually seen that done in competition. I did it once while practicing, with no one around to see.... *sigh*. No sour grapes; congrats to the Big Fella! Roger subbed for Nigel this week, as the latter remains in England on "Holiday," I believe. Although simply out-matched in his singles, rookie Sean acquitted himself very well, contributing to his trio's win in 601 and teaming up with Chuck to win a hard-fought doubles Cricket match.
In other news, the Coat's Soft Taco Special is delightfully spicy, but could use some more shells to help mop up the plethora of tasty goodness served w/ the soft steak. Yum.
Back to dentistry later.....
Wednesday, August 31, 2005
How to Extract Teeth
This is in response to a comment yesterday from Dave L, a first year dental student at UMB in Baltimore. You can check out Dave's site from my sidebar. Dave asks: "we haven't gotten to oral surgery yet I was wondering what is it about extracting teeth that makes it so difficult. I haven't seen a tooth extraction yet, but evidently there's a lot more to know than 'take a pliers and pull'."
Non Dental Types and the Squeamish might want to take a pass here....
Hey, thanks for the comment, Dave. To answer your question: Extractions are not hard, per se. Certain TEETH are hard. Go open your dental anatomy text and compare, say, #3 to #24. The molars, especially uppers, have three roots. If your text is like mine, it should show molars with a variety of roots, from convergent to highly divergent. if there's just one root, no problem, 2 minute extraction. 2 roots is harder. 3 is harder still. NOW pretend that the tooth is super decayed, so there's a minimal of cornal structure to grab on to! THAT was my patient yesterday. And there were two of those.
No, you don't just pull. You "luxate." Think of pulling up a fencepost. "Yanking" won't get you anywhere; you have to wiggle wiggle wiggle. bone is more flexible and less dense than tooth. So you can expand the socket. Then the tooth is ready to come out. If your roots are particulary divergent, you section into 2-3 pieces to remove in parts. If you don't have the access, you have to lay a perio flap (which is the gingival equivalent to peeling a banana) and then drill away the bone holding the tooth in. This is called a surgical extraction. To quote Dr. Hank, "If you're gonna take away bone...take away bone!"
A lot of dentists don't do surgical extractions, or extractions at all. They realize this is unpredicatble. The amount of time spent doing a surgical extraction (especially if you're not super good at it!) would be more economically spent doing a few crowns. So maybe you don't even have the equipment. This is what oral surgeons are for. This is why OSs can get up to $350 per tooth, as well.
Hank and I work in Community Health clinics and our uninsured patients are not super popular with the oral surgeons. So we end up doing a lot of it. We also end up getting pretty good at it; even a bit cocky. Some patient comes in, "Oh, Dr. Smith said I had to see an oral surgeon for that." Five minutes later, you're casually tossing that #16 onto a tray, making a flip remark like, "Congrats; it's a boy!" The patient is stunned. "Why did Dr. Smith think I needed an oral surgeon?" The temptation is to say, "Well, my friend; Dr. Smith is a p....er, conservative practitioner." But we all know sometimes the tooth that looks easy isn't. So be careful of that.
Oh, and Dave - Please call them "forceps" from now on! If you even whisper "pliers" up in the clinic, the 4th years will peg you as the guy to send off in search of an "amalgam shade guide" when you start assisting.... word to the wise - Good luck!
Non Dental Types and the Squeamish might want to take a pass here....
Hey, thanks for the comment, Dave. To answer your question: Extractions are not hard, per se. Certain TEETH are hard. Go open your dental anatomy text and compare, say, #3 to #24. The molars, especially uppers, have three roots. If your text is like mine, it should show molars with a variety of roots, from convergent to highly divergent. if there's just one root, no problem, 2 minute extraction. 2 roots is harder. 3 is harder still. NOW pretend that the tooth is super decayed, so there's a minimal of cornal structure to grab on to! THAT was my patient yesterday. And there were two of those.
No, you don't just pull. You "luxate." Think of pulling up a fencepost. "Yanking" won't get you anywhere; you have to wiggle wiggle wiggle. bone is more flexible and less dense than tooth. So you can expand the socket. Then the tooth is ready to come out. If your roots are particulary divergent, you section into 2-3 pieces to remove in parts. If you don't have the access, you have to lay a perio flap (which is the gingival equivalent to peeling a banana) and then drill away the bone holding the tooth in. This is called a surgical extraction. To quote Dr. Hank, "If you're gonna take away bone...take away bone!"
A lot of dentists don't do surgical extractions, or extractions at all. They realize this is unpredicatble. The amount of time spent doing a surgical extraction (especially if you're not super good at it!) would be more economically spent doing a few crowns. So maybe you don't even have the equipment. This is what oral surgeons are for. This is why OSs can get up to $350 per tooth, as well.
Hank and I work in Community Health clinics and our uninsured patients are not super popular with the oral surgeons. So we end up doing a lot of it. We also end up getting pretty good at it; even a bit cocky. Some patient comes in, "Oh, Dr. Smith said I had to see an oral surgeon for that." Five minutes later, you're casually tossing that #16 onto a tray, making a flip remark like, "Congrats; it's a boy!" The patient is stunned. "Why did Dr. Smith think I needed an oral surgeon?" The temptation is to say, "Well, my friend; Dr. Smith is a p....er, conservative practitioner." But we all know sometimes the tooth that looks easy isn't. So be careful of that.
Oh, and Dave - Please call them "forceps" from now on! If you even whisper "pliers" up in the clinic, the 4th years will peg you as the guy to send off in search of an "amalgam shade guide" when you start assisting.... word to the wise - Good luck!
Tuesday, August 30, 2005
Some mornings it just isnt' worth...
...gnawing through the straps...
-Emo Phillips
Good Heavens - a pair of extractions today took me nearly 90 minutes, as much due to difficulty of teeth (14,15) as to the patient whining about how much vicodin she had coming to her afterwards....
The two root canals I had today BOTH branched into accessory canals and other anatomic weirdness... (Hank; when was the last time you got a 13 w/ two??) and that took me forever. Now we're trying to change our computer system so the records are more accurate and so forth.
That's all well and good, but I'm FAST on the "slow" system I've been using for the last 2.5 years....! Well, such is progress. I keep telling the powers that be that the "new" system is going to make some peoples' jobs easier (data entry and collection) and other peoples' jobs harder (the dental department) so as long as they're prepared for decreased efficiency (at least in the short run), I'm ok with it.
Gotta go eat; hey, thanks for all the comments you guys! It really picked me up after a tough day. Also, see my comment to those comments... :) laters.
-Emo Phillips
Good Heavens - a pair of extractions today took me nearly 90 minutes, as much due to difficulty of teeth (14,15) as to the patient whining about how much vicodin she had coming to her afterwards....
The two root canals I had today BOTH branched into accessory canals and other anatomic weirdness... (Hank; when was the last time you got a 13 w/ two??) and that took me forever. Now we're trying to change our computer system so the records are more accurate and so forth.
That's all well and good, but I'm FAST on the "slow" system I've been using for the last 2.5 years....! Well, such is progress. I keep telling the powers that be that the "new" system is going to make some peoples' jobs easier (data entry and collection) and other peoples' jobs harder (the dental department) so as long as they're prepared for decreased efficiency (at least in the short run), I'm ok with it.
Gotta go eat; hey, thanks for all the comments you guys! It really picked me up after a tough day. Also, see my comment to those comments... :) laters.
Monday, August 29, 2005
The Highest Praise....
So I cemented a crown on today, which is a bit unique. Here in Non-Profit Dental World, crowns (bridges, implants, etc) are a bit of a luxury. If someone comes to us and has a boat load of "bombed out" teeth, we can't just go and do root canals and crowns and all that jazz that most of you who are middle aged or older are familiar with, dentally.
It's more cost-effective (and the best use of OUR resources) to fill and save teeth we can, extract teeth we can't and then fabricate a partial denture (usually with a metal frame) to restore function and esthetics to some degree.
Of course, taking a denture out of your mouth to clean at night isn't the best thing with which you can saddle someone. But I can do one for about $340 for folks on the sliding-fee scale. Compared to $2500 or so for a bridge that replaces just ONE tooth, that's a great deal.
However, if someone comes in who ISN'T missing teeth, and, for some reason, has ONE bombed out tooth... Well, you can't say, Oh, sorry, let's extract and put in a partial for one tooth; that's crazy. So we do some root canals and so forth there.
Anyway, I finally finished an upper molar (#3 for dr hank and the rest of you) and cemented it. Everything worked well. No adjustment (insert plug for Captek here!) needed. The young man who is the patient went out to his mom (who paid for it!) and I asked her, Hey, what do you think?
She said, "Well... huh... I'm not even sure what I'm looking at; it looks normal."
I said, "That's RIGHT!" It's not what it looks like; it's what it doesn't look like, which is FAKE. So that's gratifying.
Thanks to Don, Hank and anyone else who's reading - if you're out there, leave a note!
It's more cost-effective (and the best use of OUR resources) to fill and save teeth we can, extract teeth we can't and then fabricate a partial denture (usually with a metal frame) to restore function and esthetics to some degree.
Of course, taking a denture out of your mouth to clean at night isn't the best thing with which you can saddle someone. But I can do one for about $340 for folks on the sliding-fee scale. Compared to $2500 or so for a bridge that replaces just ONE tooth, that's a great deal.
However, if someone comes in who ISN'T missing teeth, and, for some reason, has ONE bombed out tooth... Well, you can't say, Oh, sorry, let's extract and put in a partial for one tooth; that's crazy. So we do some root canals and so forth there.
Anyway, I finally finished an upper molar (#3 for dr hank and the rest of you) and cemented it. Everything worked well. No adjustment (insert plug for Captek here!) needed. The young man who is the patient went out to his mom (who paid for it!) and I asked her, Hey, what do you think?
She said, "Well... huh... I'm not even sure what I'm looking at; it looks normal."
I said, "That's RIGHT!" It's not what it looks like; it's what it doesn't look like, which is FAKE. So that's gratifying.
Thanks to Don, Hank and anyone else who's reading - if you're out there, leave a note!
Sunday, August 28, 2005
Almost Famous
The Daily Flos
Last night, at an upscale restaurant in town, we sat next to a pair of sharply dressed, professional-looking women. After a few sips of wine, I glanced at one of them.
With a flash of recognition, she exclaimed, "I know you! You're that fabulous dentist! We heard you speak at J_____'s party."
The party in question was a fundraiser/auction to benefit the non-profit for which I work. I remember working hard to prepare my remarks to be insightful, persuasive and witty.
I don't recall being fabulous, but I'll take what I can get! "That's DR. Fabulous to you, dahling...."
Last night, at an upscale restaurant in town, we sat next to a pair of sharply dressed, professional-looking women. After a few sips of wine, I glanced at one of them.
With a flash of recognition, she exclaimed, "I know you! You're that fabulous dentist! We heard you speak at J_____'s party."
The party in question was a fundraiser/auction to benefit the non-profit for which I work. I remember working hard to prepare my remarks to be insightful, persuasive and witty.
I don't recall being fabulous, but I'll take what I can get! "That's DR. Fabulous to you, dahling...."
Rejected Dentist Blog Names
John Wayne was born Marion Robert Morrison.
U2 started out as The Virgin Prunes, while REM was originally Buckets of P#$%.
If a certain father who shall remain un-named had had faster X gametes, I believe I would have been Elizabeth.
So in the spirit of whismy (and since it's the weekend) I now present "Rejected Dentist Blog Names."
The Secret Lives of Dentists (already a film as well as a
book by the appropriately named Jane Smiley)
Dentisty Bites
Dentisry Bytes
Chew on This
On the Cusp(id) of Fame
Tooth Wisdom (one of Rachel's favorites of my ideas...)
Brace Yourself!
Mental Floss
The Root of All Evil
Open Wide (disturbingly, but not surprisingly, this is already a...um, film. I will not hyperlink to it, but if you are an "adult" who is into "film databases" there is a "dotcom" where you can....bleah. i feel so dirty already....)
and the other two finalists:
This is Not a Drill
and The Awful Tooth
So, hopefully it's readily apparent that my chosen title is a play on The Daily Kos, which is, however technically pronounced "ose" as in "close," not "oss" as in "floss." But it's too well-known a blog to not play with the name.
Adios, amigos.
U2 started out as The Virgin Prunes, while REM was originally Buckets of P#$%.
If a certain father who shall remain un-named had had faster X gametes, I believe I would have been Elizabeth.
So in the spirit of whismy (and since it's the weekend) I now present "Rejected Dentist Blog Names."
The Secret Lives of Dentists (already a film as well as a
book by the appropriately named Jane Smiley)
Dentisty Bites
Dentisry Bytes
Chew on This
On the Cusp(id) of Fame
Tooth Wisdom (one of Rachel's favorites of my ideas...)
Brace Yourself!
Mental Floss
The Root of All Evil
Open Wide (disturbingly, but not surprisingly, this is already a...um, film. I will not hyperlink to it, but if you are an "adult" who is into "film databases" there is a "dotcom" where you can....bleah. i feel so dirty already....)
and the other two finalists:
This is Not a Drill
and The Awful Tooth
So, hopefully it's readily apparent that my chosen title is a play on The Daily Kos, which is, however technically pronounced "ose" as in "close," not "oss" as in "floss." But it's too well-known a blog to not play with the name.
Adios, amigos.
Saturday, August 27, 2005
A day at work.....
This is from 8/22....
ok. So, my First Day of blogging after work.
It's 6pm, and it was a pretty well-balanced day.
Just 2 fillings, but 4 exams (2 kids), an extraction (easy!) a root canal (not bad) a denture impression and 3 emergency exams.
Emergency exams are interesting, as people aren't sure what to expect. They usually don't expect me, I've noticed. :) Anyway, the most annoying emergencies are folks who no-show appointments. They make an appt., stand us up, and then, sometimes months later, they call back, "Ooh, I have a toothache, I need to be seen immediately!"
It's hard not to adopt an attitude of "Well well well. Look who's come crawling back!"
or, "I told you so. I SOOOO totally told you so. You said, 'ooh, the antibiotic fixed the problem' and we said, 'um, no, you see...' [CLICK!] [boooooooop] and then you hung up. Not so bright, eh?"
But it does rankle one, let me tell you. Hey, general public: If it's a nice day, and you're gonna blow your dentist off....at least have the courtesy to call and cancel, 'k?
Today's moment of Zen is brought to us by 10 year old Cody:
"OK buddy," I say, "It looks pretty good in there."
"No needles?"
"Dude, you're obsessed with needles. No, not today."
"oh."
"Well, if you're disappointed, I suppose I could...."
"No! nonononono!"
"OK, well, we'll just bring you back down the road for a cleaning and some sealants."
"Down the Road? I'm going down the road?"
"er...in a manner of speaking, yes."
"Are you coming?"
pause. "Tell you what - I'll meet you there, ok?"
I think he was being a smarta---, but hey, it's charming in 10 year olds.
That's all for today as it have to buy some salad materials on the way home and the cats need feeding. la!
dentist blog
ok. So, my First Day of blogging after work.
It's 6pm, and it was a pretty well-balanced day.
Just 2 fillings, but 4 exams (2 kids), an extraction (easy!) a root canal (not bad) a denture impression and 3 emergency exams.
Emergency exams are interesting, as people aren't sure what to expect. They usually don't expect me, I've noticed. :) Anyway, the most annoying emergencies are folks who no-show appointments. They make an appt., stand us up, and then, sometimes months later, they call back, "Ooh, I have a toothache, I need to be seen immediately!"
It's hard not to adopt an attitude of "Well well well. Look who's come crawling back!"
or, "I told you so. I SOOOO totally told you so. You said, 'ooh, the antibiotic fixed the problem' and we said, 'um, no, you see...' [CLICK!] [boooooooop] and then you hung up. Not so bright, eh?"
But it does rankle one, let me tell you. Hey, general public: If it's a nice day, and you're gonna blow your dentist off....at least have the courtesy to call and cancel, 'k?
Today's moment of Zen is brought to us by 10 year old Cody:
"OK buddy," I say, "It looks pretty good in there."
"No needles?"
"Dude, you're obsessed with needles. No, not today."
"oh."
"Well, if you're disappointed, I suppose I could...."
"No! nonononono!"
"OK, well, we'll just bring you back down the road for a cleaning and some sealants."
"Down the Road? I'm going down the road?"
"er...in a manner of speaking, yes."
"Are you coming?"
pause. "Tell you what - I'll meet you there, ok?"
I think he was being a smarta---, but hey, it's charming in 10 year olds.
That's all for today as it have to buy some salad materials on the way home and the cats need feeding. la!
dentist blog
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