What is cosmetic Dentistry?

I am reflecting on cosmetic dentistry today. We seated a denture last week and as I have mentioned before this was indeed cosmetic dentistry. But above all it was just good solid dental care. The individual needed their remaining teeth removed and we did that and placed a very beautiful full complete denture in place. The patient is very pleased and his smile looks better than it has for years.

This is a point I often make when I can to our team and patients. Cosmetic dentistry is not a specialty of dentistry, it is not a group, or test or a badge, it is an attitude and that attitude is reflected in everything from the shade of a composite filling to the all of the many other items we do in our offices. Whitening, Invisalign, and even dentures are cosmetic procedures.

Many people think of dentistry as a want based purchase in parts of the areas we draw our patients from here in Louisville. Others view it as a need based purchase because they understand that the health of their mouth and surrounding oral soft tissues affects their entire body. Educating patients to these facts is part of our job every day. Our work isn't just in the procedures we do to care for our patients, it is in educating them and passing along our decades of experience to them on a daily basis.

The Whole Body Connection

There is new information every day on how much our bodies speak with our environment and within separate parts with each other. I recently read a study and keeping in mind it was only one study, that showed a connection between depression and the degradation of DNA within the cell.

This particular study normalized for other factors such as alcohol, diabetes or other systemic diseases. This is also only one study, but I believe that many many years from now we will know just how important everything from mental health to diet to sun exposure and family time is directly important to health. In this case the scientists studied the decay rate of a particular protein called a telomere. I have always been interested in DNA and cellular biology, even as a child, In this case telomeres are proteins that actually help hold together our double stranded DNA within our cells.

DNA is the instructional code that tells every cell in our body how to build proteins and eventually organs and then the entire body. In this case it was found that people with depression had a faster decay rate and thus less inability to hold the DNA together.

More study will be necessary but this does not surprise me. We know that Oral Health or lack there of has an effect on diseases such as Heart Disease, Diabetes, and now we now that unhealthy gums are linked to Alzheimer's Disease.

It is basketball season her in the state of Kentucky and things will soon be heating up between the Cardinal and Cats Fans. Our offices gladly support both teams, even though both of our Doctors attended the University of Kentucky, we live here in the land of the cards so we show them the respect they deserve as last years National Champion.

Our patients make us who we are.

The last seven days in our offices have been busy ones. A lot of dentistry has been done and a lot of excitement. Last Friday was very busy at our east end location. We saw a wide range of cases from a large restorative case to a very special pediatric patient. This young man stands out to me because he has a very special place in my heart. He is from China and when he first started seeing me he did not speak the english language. He has been my patient for probably 2-3 years. But I may be exaggerating, as it almost seems like he has always been my patient. When his mother first brought him to me she and I struck up a conversation about a vacation island off the coast of china my brother visited when he was in China. It turns out her parents had a place there or visited often. I've watched him grow as a boy, and sometimes he does not want to behave for me when we treat him. This is what you learn, there are good days to do dental treatment on children and there are not so good days. To me, it is important to recognize the not so good days and just say, hey lets do this another day it was nice seeing you and let them visit the "treasure chest". I know in this "busy" world we live in that seems like a waste of time. And don't get me wrong I am more of an old fashioned guy in many ways including the fact that adults are in charge. I am not one who believes that children should dictate our behavior as a protocol. But I believe in what is best for a child sometimes this coincides with what the child wants, and sometimes it does not. My child rearing beliefs have not been tested beyond my immediate family, as I have no children of my own at this time. I love children and see many in our practices. They amaze me every time I see them. I once read an article that likened having a child was like pulling the arm of a slot machine. You never know what you will get but at the end of the day the possibility of a jackpot keeps us going for another day with our small humans as I call them.

I am currently listening to the new Pearl Jam album, not so sure I am a big fan but as with the last several....it won't keep me from seeing them on tour.

Technology in Louisville

I don't often get the time I want to simply explore business and technology news and my city. I was able to get some time today to just sip coffee and wait for the laundry to dry and just explored. First there was already not news to me about the new venture of the Hammerheads and Game owners over in the Loop area of the Deer Park neighborhood of Louisville. Those that know me are aware that I am a foodie and am a real nosey person when it comes to new places opening and in general all food related news. These guys really appear to have a vision to bring friends along the way with them and when I've seen them interact with Anthony Lamas about food and food shows they all seem to embody a joy of cooking and good food you can't have without being genuine.

I also saw that our Mayor Greg Fisher was speaking at the Code for America Summit in San Francisco. The good old fashioned curmudgeon in me asked exactly what our tax dollars where doing sending this fine man to the west coast....but then I just quieted down and started reading the article about his discussion of transparency in government and just took it al in. After that I read about and jumped to something very interesting.

This particular web page(or startup I'm not really sure) let's one input their zip or address to get crime stats and news very hyperlocal. It even told me about a new BBQ place I had heard of in the neighborhood that I wasn't quitte sure where it was located, and it gave me the opportunity to jump to the BBQ place's Yelp. This service seems ready to really make life hyperlocal it is called Louie Watch(beta). Look for it and I think you will at the very least find it interesting.

I always try to give a feel for what I am listening to and today the is a double live Album by the Tedeschi Trucks Band. THese two make great music as well as a beautiful family. I remember hearing stories back in the day of the two performing gigs in Louisville or Lexington and when one was performing the other might be hopping in their Volvo wagon and driving to the other city to perform. I don't know how true that is but I like to imagine these two awesome musicians having a wonderful family at home as well as on the road. Sounds like a movie screenplay to me...but what do I know. I have been a fan of Derek since he was practically a prodigy playing with the Allman Brothers and I saw Suzanne Tedeschi way back in the day in Lexington, what a soulful voice she brings to their sound.

Nick Drake and Social Media

I haven't written in the blog in a while but that's because I've been busy trying to figure out social media. Guess what? I haven't figured out much. But I do have a post a week strategy to at least like things on Facebook and put up something someone might find funny.

We've been active at the offices doing marketing via direct mail and getting to know people in the area. I am still amazed at folks who live down the street but don't know we are there until they get a postcard from us. I just had someone ask us yesterday how long we had been there because they had never seen us. Needless to say that spurns me on to do my best to let everyone know we are at 3707 Chamberlain Lane and 1169 Eastern Parkway in Louisville taking care of people's dental needs.

I have been on a big Nick Drake kick lately. One of these days I will figure out how to post videos again. If you are not familiar with Nick Drake he died about 40 years ago, so that might be why, but he was an amazing singer and songwriter. He performed a song called Pink Moon that you may have heard in a VW commercial 8-10 years ago haha. He was a great singer but his songs have an overwhelming sense of melody that in a way reminds me of a current singer whose band is called Beirut. In this case the singer's voice sort of becomes a melody in the song and they lyrics almost become an instrument. Check him out I don't think you will be disappointed.

IN teeth news this week has been about in my opinion doing the best thing the first time. In dentistry folks will often ask us to "make something work" because its "cheaper" or easier." I can safely say that cheaper or easier is often not the best route. Steven Covey takes about Beginning with The End in Mind. This applies ever so importantly in dentistry. If we know something may cost 40-60 percent more but will last ten times as long there becomes a dollar cost average over the lifespan of the procedure or item. I hope that over the next two decades we can do far more dental implants and increase the longevity of the dentition in our patients.

Nick Drake - Pink Moon

My Kids teeth and other Cookout questions

I was recently at a Holiday cookout when of course the conversation turned to parents asking me questions about their children's teeth. Although I am not a Pediatric Dental Specialist, I do see a lot of children and worked alongside the Pediatric Dental Residents during portions of my elective residencies at the Chandler Hospital at the University of Kentucky.

In this case the questions were about Fluoride and its history and when their children should receive it as well as questions about toothpaste. I really don't mind these questions of course when people start showing me their teeth it is a little less pleasurable cookout conversation.

In this situation I was happpy to give my opinion. Many parents leave their children to brush their own teeth a little too soon. A good rule is that if the child is able to tie their own shoes they are old enough to do most of the brushing themselves.

After this the discussion turned to toothpaste. Specifically "When should my child start using adult toothpaste?" The answer to that as with the answer to many things is "It depends." This isn't an age question but more a behavioral question." The main concern with adult toothpaste when it comes to a child is the amount of Fluoride that would go into the child's system if the were to consume the toothpaste. So if a child is mature enough to expectorate all of the toothpaste(ie. spit out) then this is the age that the child could use adult paste. And this would in my opinion be a priority to be accomplished by the time the child had their first few adult teeth, which is for the majority of children around the age of six.

TRON: LEGACY - Daft Punk's "Derezzed"

Tron Legacy

It often occurs to me differences in how people feel about their teeth. There are many very financially secure and successful people who simply do not care about their teeth. There are also people who come into our offices every day and ask: "Does my insurance cover it?" as if the shareholders of that particular corporation had the best interest of their smile and ability to chew food in mind when they sent out that years list of coverage.

When a patient visits our offices they are paying for a relationship. That relationship is one of trust, understanding, and education. The actual procedures we do are important and they are in essence what our team has been trained and schooled and tested upon. But the most important thing is the type of relationship our patients have with our team.

Its our goal to not just perform procedures and care for our patients but to educate them. I plan to say that very loudly and clearly. We depend on the insurance companies to help us take care of our patients, but at the end of the day Insurance does not cover a relationship.

On a personal music note I've been listening to a lot of Daft Punk from the Tron Legacy Soundtrack. I've been lucky enough to get out in the weather on my bike and techno has been great music to listen to while doing that. These days its harder to figure out how to get youtube into the Blogger but I'm still going to try to get the DeRezzed video from the film onto the Blog.

Billy Joel - Sings in the piano accompaniment of student

We recently had a situation where we had a patient who had neglected their dental care to the extreme. This young man was really pushing the envelope of ending up in the hospital. We had to do extensive surgery to remove the affected teeth as well as drain the area and see him multiple times. One of the things that my Fellowship in Maxillo-facial surgery has done for me is to let me help people that are in these straights. Luckily this young man knew how much he had risked his health. Many folks don't realize that recently a person in Cincinnati died from a dental infection. Several years ago a young man in Washington, D.C. also died from a dental infection. This person in DC was a child which makes it even more of a tragedy.

The other interesting the the last few days was a patient who came to our office having been given a lot of different information about dental implants. The thing that I find most saddening about the public's perception is that calling and seeing different folks will lead to understanding. In reality there are folks that are fly by night offices offering pie in the sky dreams for people that can't really have them. There is an old country phrase that I am thinking of here, You can't make a silk purse out of a sows ear. The other phrase that comes to mind is champagne taste on a beer budget. We all operate on a budget. Sure Donald Trump's budget is different than say The richest person in Louisville, Kentucky.

I can't get that german sports car I fell in love with at age 7 on the monthly payment of my used SUV I currently drive. That's just reality. Of course, If I wanted to live in a much more meager place, really really scrimp in my clothing and food I'm sure I could get that sports car. But its just not that important to me today. And teeth are the same way. It's important that people be honest with themselves first. I have a patient in her 90's that has all her teeth. It's important to her, when I've gone to tell her about a new dental care product, she usually already knows about it. There is with all things a bit of luck. But it is at the end about priorities.

What are your dental priorities?

We've been listening to a wide range of music at the office. Becky created a new station for the front office on Pandora. We had been combining all the Pandora stations our team and patients had created but good ole Pandora played a few they didn't think were quitte appropriate for the office.

Here is a viral video of the Great Billy Joel at Vanderbilt University being the Kind of Guy(or gal) I think many of us should be. Gracious and kind.

People's Perceptions

I recently had a situation where a person said something negative about our practice. When in fact what they stated on the internet is actually evaluated, they merely don't understand the role of the dental team members or how their particular insurance works. It's hard to not feel that things are unfair when someone takes out their frustration on you for things that they simply don't understand. But in the end it is important to remember that none of us can control the things that people say about us or even do to us. We are in charge of our own behavior and reactions and in fact an eye for an eye just leaves everyone blind.

On another note we just seated a very nice prep-less veneer on a patient's right front tooth and she couldn't be happier. Veneers that require no tooth reduction can only be used in specific situations, but when they can they are a great product that leaves Dr. and patient very pleased as this person was today.

We have been listening to a lot of 1970's music in the office this week. My assistant created a Pandora station based upon the Gerry Rafferty song "Bakerstreet". Many of you may remember Gerry Rafferty from the group Steelers Wheel and more specifically the song from the film The Reservoir Dogs "Stuck in the Middle with you". It is often mis-credited to Bob Dylan but is a very fun upbeat song that seems to allow Pandora to pick some very chill 1070's music.

Father John Misty performing "I'm Writing A Novel" on KCRW

Keeping the Plates spinning

It's been a while since I blogged. I've had a birthday, there have been births(other people's not any children of mine) we've even had the holidays. We at the office continue to focus on all aspects of dentistry done well. The focus for 2013 will be implant dentistry. It is something we've always done well but never enough. Well done and priced appropriately implants are the greatest thing since sliced bread. When I do implants people are some of the happiest I have ever seen. Invisalign and Cosmetic dentistry are the only things that come close. Not many people know that dental implants are over 99.9 percent successful and can not decay. They are not alive so they are not affected by the acids produce by the bacteria that causes decay, S. Mutans.

Of course we are continuing to grow our new location on 1169 Eastern Parkway in the Medical Arts Building. Every day I am amazed at how great a team we have at both of our locations, both patients and the team are very happy we have assembled this group with a common interest of providing great, caring and gentle dentistry with a modern, bio-esthetic approach.

As usual its a bit of a mix of music at the offices. I hear that Dr. Kulb likes her more post modern pop like Neon Trees and maybe even Owl City. She is so skilled and experienced I often forget we are almost a generation apart in music tastes as I grew up in the 70s and of course you know I am going to be at the Yum! Center screaming for Stevie, Lindsey, John and Mic at Fleetwood Mack in April!!

As usual, I couldn't be happier with Louisville's live music scene. I plan on attending father John Misty tonight if I am able. He is the former drummer of the Fleet Foxes and really a talent in his own right.