Gas, Guns and Gums

Samuel Colt, famous inventor of the Colt pistol, needed money to promote his new invention.  So he took to the road in the mid 1830's as "the celebrated Dr. Coult of New York, London and Calcutta" and performed nitrous oxide (laughing gas) demonstrations.  He was apparently very convincing and very successful.  Whether he immediately influenced any dentists is not known, but what is known is  after  that laughing gas and dentists became like peanut butter and jelly: a great pairing.  Laughing gas has a very mild anesthetic effect, more noticeably on the gums.  Since Colt used the money he made from his laughing gas demonstrations to promote his gun business, it was left to Horace Wells in 1844  to show how laughing gas could be in dentistry.  From gas to guns, and gas to gums.

ORAL BACTERIA AND PANCREATIC CANCER LINK

As reported in Medical News Today, an article published in the online journal GUT on October 13, 2011 related that certain oral bacteria have been linked to pancreatic cancer; in particular, the bacteria Granulicatella adjacens.  In addition, two lower levels of  bacteria were noted in patients with chronic pancreatic inflammation (which can lead to cancer) compared to a healthy group of patients.  It is unclear if this the relationship between bacteria and pancreatic cancer is direct, or and effect of pancreatic cancer, but is believed, based on previous studies, that bacteria have an impact in the development of pancreatic diseases.  The presence of such bacteria in the oral flora could lead to methods or early detection of pancreatic cancer.  For the compete article as reported in Medical News Today, please visit: http://www.medicalnewstoday.com/articles/235949.php.

Hurricane Irene and Our Office

We were happy to find out there was no damage to our office due to Hurricane Irene.  The only issue was the contaminated water supply in Millburn and surrounding communities.  Fortunately for our patients and us, we had installed ADEC dental units which use self contained bottled water for use in the dental handpieces (drills)---they are not tied into the Millburn water supply. We use bottled water for patients to rinse with, and we have Purell to disinfect our hands after the permitted use of Millburn water for bathing and washing.

The Dose is the Poison

We live in a society which thinks if something is good for you, then more must be better.   Or is something is bad for you, then none of it can be good for you. Science has failed to make people recognize what Paracelsus, the sixteenth century philosopher, recognized, namely, “The dose makes the poison.”  This is perhaps the most valuable and critical point for any person to understand.  Consider some essentials, like water, oxygen and salt.  Clearly these are needed by the human body.  Yet last year a college student died in a stunt by drinking too much water.  It so severely diluted his electrolytes, he could not be revived in time before his heart stopped functioning.  Similarly, we know the tales of shipwrecked sailors who imbibed sea water only to need to drink more and more because the salt concentration prevents the alleviation of thirst, and ultimately causes death.  And Aquanauts like Jacques Cousteau learned long ago you can’t breath pure oxygen for sustained periods.  That is why helium was mixed in so it could dilute the oxygen but not contribute to the bends.

As dentists, we often hear of people refusing a fluoride treatment because it is a poison.  And a certain high doses this is true, just as salt, oxygen, and every other substance can be.  Again, to quote Paracelsus, “all things are poison, and nothing is without poison, the dose permits something not to be poisonous.” We health practioners have to make sure people understand the dose they receive is a safe dose for a given treatment.  People must evaluate the risk/reward ration with Paracelsus in mind before succumbing to knee jerk reactions to buzz words and hyperbole.  We as dentists must help people understand this important concept so they can accept treatment or face the consequences which could result from the lack of such treatment.  

Snoring- A Sign of Obstructive Sleep Apnea?

Snoring: A sign of Obstructive Sleep Apnea?

Not all snorers have sleep apnea, but snoring can be an indicator of obstructive sleep apnea (OSA), the condition in which there is  insufficient oxygen flow to the lungs when sleeping. Many times this can be cause by an obstruction of the air flow into the lungs, frequently caused by enlarged tonsils or a tongue that blocks the air passage in the throat.  This can lead to the sounds we regard as snoring.  But more importantly, the snoring can indicate the obstruction is causing a lack of oxygen flow to the lungs. 

Many patients are unaware of snoring.  But if you have any of the following signs, you may indeed have OSA.  Do you have puffy, tired eyes? Do you wake up with a sore throat?  Do you feel sleepy during the day?  Have you ever been told you gasp for breath, or pause and stop breathing during the night?  Do you fall asleep while sitting, reading, watching TV or worse, driving?  These are all indicators of OSA and warrant an evaluation to determine the severity of your apnea. Typically, this is done through a sleep study at a hospital or clinic.

Treatments include surgery, CPAP-continuous positive air pressure via a mask tethered to an oxygen tank, or oral appliances.  Some of the more severe cases may preclude oral appliances, but for many, oral appliances are a comfortable way to breath easier.  Spouses agree!

Humorous video on MidLevel Providers

For a clever look at the Midlevel Provider issue visit:
http://www.xtranormal.com/watch/11804404/midlevel-dental-providers

Hi tech- hi touch?

A few years back practice management people would lecture on the value of keeping current on technology and maintaining good relationships with patients as the model for success in dentistry.  They even promoted abundant contact with the patient in those safety zones of the body (shoulder and hands).  A gentle tap on the shoulder or hand was a way to connect with a patient in a safe, non-aggresive, and nonthreatening way.

Yet in today's workplace there is no leniency for personal violation.  Besides shaking hands on greeting or leaving, there is tolerance for bodily contact. I read on a forum on the internet where one person actually considered it assault. The hi-tech may be true, but the hi-touch may be a thing of the past...or is it?

We have many patients who value the gentle holding of their hands by the assistant when they are afraid and nervous.  We have patients who appreciate a gentle pat on the back to signal everything is all right.  While it may be inappropriate to tap a total stranger on the back, our patients are not total strangers.  Yes, they are entitled to their personal space, but dentistry is more intimate than the corporate world which evoked these changes.  Just because the corporate world needed such distance, do our patients really want this?  I invite your comments.

New Technology

Dr. Lavine presented a wonderful and encompassing lecture on technologies of interest to the dental profession.  From intra-oral imaging to extra-oral data backup, there is so much change going on.  I would highly recommend Dr. Lavine's lecture to anyone interested keeping current and keeping up with the changing face of technology.

I have planned some future blogs with timely information for dental professionals and patients alike.  I hope they will prove to be of interest and/or useful.

Dr. Schonberg