Dining Out, The Indian Giver and the Freakish Gift Card

A hostess greets you with a smile and asks, “Have you dined with us in the past?”

“Yes, but it has been a while; actually quite a while,” you reply with a little twinge of guilt and embarrassment. “But now that I have a good gift card I should be able to come more regularly.”

She smiles again, and takes you to your seat where your waitress is ready to begin your dining experience.

After a few minutes you have perused the menu and decided on what to get.

“I would like the Caesar salad and the New York steak, medium rare. It should all be taken care of by my gift card.”

“Oh, you have a gift card?” the waitress says with a smile, but not as big, nor as friendly as it was before. She seems a little stressed now. “Let me take a look.”

“Oh, you will need the menu that goes with this gift card. I’ll go get that for you.” She takes your menu. The pleasantness is still there, but she still seems agitated and not as happy – all starting from the moment she saw your gift card.

She returns after a while. “I was able to find the menu for your card,” as she hands you the smaller, shorter, plain covered menu.

Opening it, you notice fewer items, many of which you don't really find desirable. “Why the different menu? I thought the gift card was for the menu you always have.”

“Your gift card is one of the less expensive ones we have and comes with a smaller menu of some lower quality items,” she informs you, still trying to stay as happy as possible. “I will also have to move you to our other dining room, the one your card covers. It's just across the courtyard.”

The room is drafty, decorated with 1970’s era furnishings that are so dilapidated they look like they have been used continually since then. The upholstery is cracked and torn, furnishings are covered with years of ground in grease, cobwebs are visible on almost everything, and the floor is dirty and worn severely. While eating note a few bugs scurrying near the walls.

Your food is just as bad and tastes like it was made in the 1970’s then stored away. The meat is tough, beverages bitter, salad completely limp and flavorless, and everything is just absolutely awful.

Then the bill comes. $75! “Waitress, can you apply this to my gift card?”

“Actually, that includes your gift card. Your card has a deductible and meat is not included for the card's first year.”

“I have to have this a year before I get meat paid for? What if I come back before the year is up? Not that I would consider it. This was the worst meal I have ever had.”

“If you come back before your year is up, your meal will be $15 less because you covered your deductible this visit. But if you go over $250 for the year, you'll have to pay your entire bill. Not to worry, you get another $250 for next year. Whether you use it or not, but if you don't, you get no benefits from having the card. You might as well use it.”

Sounds like a nightmare experience. It in reality is just the current scenario for most dental insurances. They call it and even categorize it as "insurance," but it does not resemble any other insurance. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for payment. Dental "insurance" turns out to be what could be described as an expense aid with very little risk with very little risk for the insurance company. You or your employer pays an amount each year to the insurance company and gives in return an amount to aid in paying for dental health care. The amount paid is usually very close to the maximum benefit paid per individual for the year ($1750 in premiums for $2000 in benefits). If you only have a couple of cleanings in the year, which can come with a $50 - $75 deductible, you leave the about $1700 on the table of unused benefits.

At the end of each year every penny of benefit is removed, and a fresh one put in it's place, with the previous unused amount being lost forever. Back when dental insurance first appeared on the scene, they provided $1000 in benefits per year. That was in 1969; at the time a crown was $99 and a filling $15 (and a car was $2700). You could get a whole mouth of crowns in a couple of years, yet somehow the benefits didn't keep up with the rest of inflation. Now you can get 1 or 2 crowns covered with current dental benefits, forget about a full mouth of them.

Why the lesson in dental insurance? Some folks have misconceptions that dental insurance is the same as medical insurance. Not by a long shot. They actually work like opposites. And, dental insurance is nothing like a gift card, unless it is from an Indian-giver, psycho, control freak. 
Well with the new year upon us, a fresh pile of benefits is awaiting you. If you were smart, you used all the benefits you had last year for what you needed. Now is the time to take advantage of this year's benefits. Get in for a visit with the hygienist and for an exam and make sure you maximize those benefits.

Even If You Don't Fit In, You Can Still Live Your Dream

Sometimes Hollywood makes fun of dentists. Actually it seems to happen quite often. I can't think of the last time a year went by where I didn't see a dentist made fun of in a movie; worse than that, I can't think of the last time I saw a dentist featured as the hero of a movie. Somehow I don't ever see it happening; as a profession we make the butt of many really good jokes. At least it is not as bad for us as it is for politicians.



With that in mind, I revert back to my childhood days when network TV had America by the eyes and every channel had a Christmas Special that you absolutely couldn't miss. While there were many specials geared toward adults (Bing Crosby, Bob Hope, Perry Como, Andy Williams, et. al.) some were directly targeted at a "little kid" audience. As a kid of 4 or so, they were point directly at me! I can recall the first time I saw "Rudolph The Red Nosed Reindeer," which debuted in 1964. It was a fascinating animated story that completely captivated me. The story gets you cheering for the underdog, which in this case, is a reindeer who befriends a rejected elf, who wants to be a dentist, and a miner who looks for precious metals at the North Pole. These societal outcasts band up to face their life challenges, then end up separating to face them alone, all along the way they meet others who, likewise, just don't fit in.


While I didn't realize it at the time, or maybe it was a brain washing, the seeds of my career were being subliminally planted, and while I have never taken teeth out of an abominable snowman, I somehow related to the character Hermey, and still somewhat relate to him today. Even though he is 1/10 my size, towheaded, pointy eared, mostly nasal-ish, seems to like the very cold,  Santa elf I still like him; he has a heart of gold, he has a dream, and he sticks with it.


So, at this time of the year I give you my salute to Hermey. Thanks for not fitting in, and being a little bit of an inspiration to all us dentists.

A "Retired" Dentist Sounds Off.

Now, I don’t really hate anyone, at least I try not to; it is just not good for your overall health and well-being. I can’t remember the last time I did really hate someone.

Back to the subject at hand. I came across this blog written by a former dentist; she is young and decided it was time to change careers. It seems she had a few things she had to get off her chest after her vocational alteration. I laughed pretty hard, and keep it in mind that this is done light heartedly and is just meant to have a good giggle.

So here it is, not quite in David Letterman format;

10 Reasons Your Dentist Probably Hates You Too

Posted on November 28, 2011

     Now that I’ve left my career and cut some dead weight out of my life, I feel ready to look back and have a laugh– or just finally be able openly bitch about it.  So here’s my confession: I am a dentist who really didn’t love the dentist either being a dentist.  A few months ago I came across a funny post titled, “10 Reasons I Hate The Dentist.“  It appeared right when I was in the thick of my career transition.  It inspired me to write this, so, RedHead Chronicles, thank you for the inspiration.

10 Reasons Your Dentist Probably Hates You Too

1.  The first thing you say when you sit down in my chair is, “I hate the dentist.”  Really?!?  Did your parents teach you any manners?  Did they ever teach you that it is impolite to tell someone you hate them the moment you greet them?  What I really want to say back is, “aww, I hate you too.”

2.  You come to your appointment, and it’s obvious you haven’t brushed your teeth in days.  I’ve had some people with great hygiene come in and apologize because they’ve just eaten lunch and couldn’t brush.  This is not what I’m talking about.  I mean food and thick plaque everywhere.  After 10 years of seeing blood and rotten teeth and some really nasty things, this is still the 1 thing that makes me dry heave.  You know when you come to us that we have to be in your mouth.  Would you clean your home before having company?  Additionally, I have spent hours literally bending over backwards repairing your teeth.  Could you at least pretend that you are caring for the work that I have struggled to complete for you?

3.  After we have spent hours of meticulously repairing your teeth, you complain about the bill.  Would you walk out of the grocery store with a bag full of groceries and expect not to pay?  I’ve just helped you to continue to smile and eat comfortably, two pretty valuable things that help your quality of life.

4.  I tell you that you have a cavity and you need a filling, and you wait months or even years to get the necessary work done.  Eventually the tooth starts hurting.  Two weeks of pain go by, and you call me on a Saturday night while I am at dinner with friends because your tooth that needed a filling a year ago and that started hurting 2 weeks ago is suddenly an emergency.

5.  You come to me so I can help you, but you make it hard for me to do a good job.  You wince and make faces when it’s not hurting.  The idea that I’m hurting you makes me just as uncomfortable and stressed as you are.  If it hurts, please tell me, and I can help you with that.  But if it’s because you don’t like the whole experience, you are only causing me to work in undesirable conditions, making it harder to do my best.  And when you push your tongue in the way, or you don’t open wide enough, it makes it physically impossible to get my work done.  Don’t you want it to be easy for me to do the best job for you?

6.  You call and say, “my tooth didn’t hurt before you worked on it.”  You came to me with a cavity.  I did not put it there.  You did.  I am simply fixing a rotten hole that was in your tooth.  To do so, I must use a tiny drill to cut the rot out of your tooth.  If I took a drill, cut a hole in your femur bone, and then filled it in with a foreign material, don’t you think it might be sore for a while?  Same concept.

7.  When we try to take an x-ray, you won’t bite down on it.  We have to do this to see what is going on with your tooth.  Without knowing the problem, we can’t properly treat you.  I know, in some cases some people really can’t do it; but some people could and won’t just suck it up for 15 seconds.  I’ve had x-rays too, and they hurt and dig into my gums, but I just do it.

8.  You tell me that you bought my car for me after having a crown done.  Contrary to how it seems, you actually didn’t buy me a car.  You bought yourself a crown.  I have spent hundreds of thousands of dollars on an education, and have spent hours making this crown fit precisely in your mouth, so maybe you helped me make a portion of a student loan payment.  But you certainly didn’t buy my car.

9.  You no-show an appointment or cancel last-minute.  Some things are unavoidable, but when it’s because your hairdresser got a last-minute cancellation and you had to take that appointment instead, this is just rude.  Not only am I unable to fill the 2 hours of my schedule that I reserved specifically for you, but someone else who wanted to get in had to wait 2 weeks for his/her appointment.  And on that note, when you have the first appointment of the day, and you show up late for your appointment, I am late for every other patient the rest of the day.

10.  When I tell you that you grind your teeth, you deny it, as if I am accusing you of having a horrible disease or being a baby murderer.  It’s not that bad to be a tooth grinder.  I’m just pointing something out and maybe offering a way to prevent more problems in the future.  This observation is concluded from signs or symptoms that are based on real science, not myth.

And along those lines… bonus #11. You tell me a diagnosis I make is simply wrong without listening to me.  If you know so much, why are you coming to me?  You do the filling or root canal yourself.  You obviously don’t need me.

Aaahhh… I feel much better now.

If this isn’t you, I am sure your dentist loves you.  You are probably the bright spot of his/her day.  But it makes you wonder, how do you behave when you go to the dentist?  And most importantly, are you making it easy for your dentist to give you the kind of care you want and deserve?

OK. Just a light hearted view from the other side of the chair. Hope you laughed.

Actually, we don’t have too many folks like the ones in the descriptions above. I have great patients and my staff seems to not invite the bad ones back. : )

Who is the enemy?

People are shocked when they find out that bacteria don't decay teeth.

Yes, that is correct. The bacteria don't aim at your tooth and start eating away. They don’t have a way to penetrate into your enamel or dentin and make it weak. They don't even do anything with the tooth material -- calcium, phosphorus, and fluoride -- that is lost when decay occurs.

Why do dentists and hygienists get all bent out of shape when you don’t brush your teeth if the brushing is only to remove the bacteria? So what causes decay?

Well those bacteria actually are involved in the process, but indirectly. They release, as a by-product of their metabolism of the sugars you eat, strong and weak acids around the little colony where they are living. Within seconds of you consuming simple sugars they start pumping out large quantities of acid, which have the ability to dissolve the enamel and dentin of your teeth. The attack of the acid on your tooth chemically dissolves tooth structure. This makes more room for the bacteria to grow into and get protection from things that can clean them off the surface, and the process accelerates.

Preventing decay involves doing a few things. First, stop the high sugar diet and reduce high acid foods also. Not only is sugar making you gain weight, it is providing food for the bacteria that release acid to dissolve your teeth. And the acid in foods and especially drinks (citrus is the worst, way above acid in sodas) keeps the environment in your mouth at a low pH, setting the stage for a quick dissolution of your enamel and dentin. Second, remove the bacteria that are associated with chemical cavitation of tooth structure, the faster the better. One study found that within 3 minutes of consumption, 85%+ of the damage was done to tooth structure. Brushing and flossing often and soon after meals will reduce the chance of decay developing. Third, strengthen the tooth structure by having fluoride in your toothpaste and, if necessary, having supplemental fluoride when you have your dental visits.

So now you know. And we will still get bent out of shape if you don’t brush, so do it often. : )

Bad Advice: Mehmet Oz is not a dentist!

Dr Oz has lots of advice to give people concerning their health. However, when he tries to discuss dentistry he usually completely mucks things up. This is one example of what he flippantly says about bleaching your teeth at home with an "oh so wrong" recipe:


http://www.doctoroz.com/videos/naturally-whiten-teeth-pt-2


There are so many things that are incorrect about what he says about bleaching. Let me list them:

1. Baking soda crystals (yes it looks like a powder, but they are micro-crystals) are very abrasive and will scratch the enamel of your teeth
2. Lemon juice is very acidic, citric acid and phosphoric acid are both present, and will erode your teeth
3. The mixture doesn't actually bleach your teeth chemically like what a dentist would give you. The mixture actually erodes your teeth and in doing so gives them a chalky surface which appears whiter.
4. The acids in the lemon juice have been linked in commercial sodas and waters to be the most erosive and decay causing ingredients in beverages, 4 - 5 as erosive as the acids in Coke or Pepsi
5. The recipe given has no ingredient amounts; toss in a blob of baking soda and put it on your teeth. If it is mixed with too much baking soda, it will be very abrasive, too much juice, it will be very acidic. While there is no optimal ratio, if it actually did work it would be a vital detail for success
6. The length of time that the mixture would have to sit on the teeth is also of importance. The strength of the recipe would make a big difference in time needed on the teeth to make a discernible effect.

So, for bleaching, come see us and get the right ingredients on your teeth which will actually react with the colored stains in the teeth while leaving the structure of the teeth safe and unharmed.


More of what Dr. Oz has to say about dentistry will be the subject of future blogs.

Gum Disease and Pregnancy

New studies are more closely linking pre-pregnancy and pregnancy with oral infections and it is not good news.


A study from Obstetrics and Gynecology compared women who were trying to get pregnant, both with and without gum disease. What they found is the women who had no gum disease were able to get pregnant on an average of 60 days earlier than those who had oral infections. In having periodontal disease, an inflammatory process occurs because of the infection present anywhere in the body, it was felt by the researchers that the inflammatory process triggered the body's natural defenses to protect the yet to be conceived fetus by a prevention or delay of pregnancy. The women who had no periodontal infection conceived, on average, at five months and the one's with conceived in 7.


Also significant in the area of women's reproductive health link to oral health is the woman who had a stillbirth and insisted that the baby had a full autopsy and pathology report done to determine the cause. After extensive testing it was determined that the fetus died because of an infection from bacteria that was genetically traced to a species of oral bacteria in the mother. The mother had periodontal disease. For a preventable disease like gum disease to cause this type of tragedy just makes it all more of a personally devastating.


These new studies and the ones from five plus years ago which showed pre-term births associated with mothers who had periodontal disease show that gum disease and womens reproductive health are very intimately related and overall health should be looked at when deciding to have children.


Make an appointment and get your oral health checked off long before you start picking names or repainting a room to become a nursery.

Invisalign® No one will know!

In todays very busy and aesthetically aware professional world, little forgiveness is allowed for the way we look; looking good is a must.  Somewhat verboten are the signs of treating or problems that are usually associated with adolescence, such as acne, or our subject today, metal “railroad-track” braces.

Now for adults, who may have never had the chance to get braces as a child, there is a virtually invisible solution to crooked teeth; Invisalign. Almost everyone prefers Invisalign’s® clear and removable orthodontic solution to traditional brackets and wires. And though it is high technology, it is tried and true; Invisalign® has the experience of over 1,000,000 patients worldwide, and has a 96% of patient satisfaction rate.  In fact, Invisalign® is so comfortable and so aesthetic that surveys indicate that 9 out of 10 patients would recommend Invisalign® to their friends and family. It is also for teens now too.

Invisalign® treatment consists of a series of aligners that you change approximately every two weeks. Each aligner is individually manufactured with exact specifications to gradually shift your teeth to where they belong. And since your Invisalign® system is custom-made for your teeth and your teeth only, with a plan devised by you and Dr. Colleran, you know you'll end up with a smile that truly fits. It is nice to know what you will look like before you start treatment.

Invisalign® is a patented proprietary system that uses 3D modeling software and cutting-edge manufacturing technology to provide a clear, removable solution for straightening teeth. Invisalign® able to treat a wide variety of orthodontic issues including:  Crowding, rotation, spacing, over bite, under bite, deep bite, open bite and mid-line shifts.

Call and ask for a free consultation with Dr. Colleran for your Invisalign® treatment.