So it’s 7:45 Saturday morning and I’m awakened from a deep sleep by the sound of my cell phone ringing. “ Expletive!” I forgot to turn off my alarm clock feature, or so I thought. Stumbling out of bed, I reached for the dreaded dream destroying droid only to discover that I had an incoming call. After groggily greeting the caller, I heard a woman respond, “Oh, I wasn’t expecting to get a real person on the line, I broke my tooth and need help before Monday…..I have an important meeting…..leaving for Pennsylvania…” Not knowing who I was talking to, with cobwebs lingering in my head, night-guard still in my mouth, I took the caller’s name and number and told her I’d call her back in 15 minutes. Before hanging up, I realized that this lady was not a regular patient of mine and found out that she learned of me through a Google search!

I jumped into the shower, pondering the predicament: a total stranger calls me out of the blue in the wee hours of a Saturday morning after finding me on the Internet. She’s not in pain, but is clearly distressed. I have no available staff. Do I open the office to see a female stranger alone without supervision? Do I try to locate another dentist with Saturday hours? Is this a true emergency or a terrible inconvenience? Awashed, awake and alert, I finish showering and call “her back. After ascertaining that she does indeed need immediate care, I agree to see her as long she comes in with another adult.

9:30 am: Jackie (not her real name) arrives at the office with her sister, Jamie (also, not her real name). Jackie had broken her four front teeth in a fall. Additionally, two of her other teeth were knocked loose. Having calmed her down, (to say she was nervous is an understatement) we proceeded to the operatory where her sister Jamie sat in my assistant’s chair and held her hand throughout the 2+ hour “appointment”. I don’t know who was squeezing whose hand harder, but before long I had them both smiling and laughing. Jackie was unaware of the injection I was giving her and kept asking Jamie if the needle was in. And both started giggling while the Lidocaine was being administered. The more I bantered with them, the more they laughed. The anxiety and distress of the situation was but a memory. As strange as it may seem, there was a backdrop of levity and humor amidst an otherwise serious situation.

In the end, I bonded and stabilized Jackie’s battered teeth. Her smile was beautifully restored (if I do say so myself). Actually, Jackie thought they looked better than before and Jamie had been regularly updating concerned family members on her iPhone during the procedure proclaiming how wonderful and natural Jackie’s teeth looked. (One might say that she had chair-side seating giving bond-by-bond analysis to her listening audience.)

When we left the office, I was bolstered by the feeling of a job well done and a good deed done for someone deserving and in need. Nothing is more rewarding than being the recipient of a grateful smile. I will be seeing Jackie again soon for follow-up care.

The curious thing is that she did call her regular dentist and spoke to his service. She just never heard back from him.

Though I’m not usually one to be at a loss for words, I often experience a uniquely gratifying feeling that I find difficult to describe while interacting with many of my patients. There is a special bond, born of familiarity, comfort and ease that transcends the typical doctor/patient relationship. Perhaps it’s best portrayed as a unique type of friendship that invites a warm exchange of feelings, stories and ideas. My spirits soar when I think about how practicing dentistry has expanded my world by enabling me to be involved (dare I say be“ intimate”) with so many wonderful people. One person at a time over a course of many appointments spanning many years, being a dentist has led to some amazing relationships.

So, one of the highlights of my week was seeing Jennifer Bahme in my office. Jen has been a patient of mine for more than ten years and what made her visit especially heart-warming is that she now lives in Spain. This wasn’t the first occasion that I’ve seen her since she decided to pull up stakes and move to Madrid. This time she came to New York on a 4-day whirlwind trip to attend to some matters that needed tending to including a dental appointment with me. Now how good do you think that makes me feel? I’ve heard of the guy who would “walk a mile for a Camel” (I know I’m dating myself citing old cigarette ads not seen on TV for at least 20 years), but Jen flew 6,000 miles to see moi. (I choose to downplay the other things she had to do.) We had such a warm reunion prior, during and after her dental visit with the hygienist. “Unfortunately”, Jen had broken a tooth and I had the “pleasure” of seeing her again later in the day to remedy the problem and to commiserate further.

Jen is a fantastic person simultaneously interesting and interested in our banter. I remember some time ago how she moved to Costa Rica for a year before she returned to the big apple. This time her relocation seems more permanent for reasons I won’t share, except to say that I look forward to visiting her and her Spanish boyfriend when my wife and I go to Madrid. For the record, Jennifer has not been reading my blog but promised to do so if I wrote about her.

So Jen, this one’s for you.

While the expression “It’s all in your head” may refer to one’s mental state, it does not diminish or negate the very real physical symptoms that arise from psychological or emotional distress. Many people are aware of the mind/body connection that was first put forth in Dr. John Sarno’s tome Healing Back Pain: The Mind Body Connection.

Dr. Sarno postulated that many musculoskeletal conditions are more related to psychological and emotional stress than actual physical injury. Sarno’s most notable (and controversial) achievement is the development, diagnosis and treatment of Tension Myositis Syndrome (TMS), which is not recognized by mainstream medical science. According to Sarno, TMS is a psychosomatic illness causing chronic back, neck, and limb pain which is not relieved by standard medical treatments. He includes other ailments, such as GI problems, dermatological disorders and repetitive-strain injuries as TMS related. That said, there is little dispute that stress is detrimental to one’s well being.

I got to thinking about the mind/body connection in a whole different light when I read an interesting blurb in USA Today on April 5^th. (I think USA is the perfect commuter newspaper-written on a 6^th grade level with color pictures and everything you Need To Know from headlines to sports, finance and Hollywood gossip in 25 minutes. And yes, I’m still commuting from my “temporary“ digs in Yonkers because I can’t get the green light from management to remodel my new home on the Upper West Side; but that’s a whole other topic – “Oh, my aching neck!”)

How about that for digressing?

So back to this small article In USA Today reported by Mary Brophy Marcus, Virus that causes cold sores linked to Alzheimer’s.  Basically the article cites a study observing how Herpes Simplex Virus Type 1 (HSV1) grows inside cells. Healing Back Pain: The Mind Body Connection is a common virus that infects mucous membranes and causes cold sores. The researchers also observed how the virus burst out of the cells and enter nerve cells. “In theory, the virus could then travel to the brain and affect dementia plaques.

HSV1 is probably not a cause but a co-factor. Experts advise treating a cold sore quickly to minimize the time the virus is active.” Dentists and physicians can prescribe appropriate anti-viral medication that decreases viral activity and hastens healing. This may just be an example of the “body/mind connection” where a physical malady can affect the health of the mind.

Another example of this is Atherosclerotic Disease (clogging or hardening of the arteries), which can decrease blood flow to the brain and affect neural function.  In more advanced states, this condition can  lead to stroke or heart attack. FYI, periodontal (gum) disease has been implicated in the progression of atherosclerotic disease.

In the final analysis, we are not just what we eat: we are what we think. And to protect our bodies, we must protect our minds and vice versa.

“Radiation Worries Rise with 3-D Dental Imaging”  was an article that appeared this past Tuesday, November 23, on the front page of the New York Times. The article continued  for two more pages describing what could be a serious problem in the practice of clinical dentistry. The article addresses the use (over-use) of cone beam CT scans (“Cat scans”) in some dental offices.

Up until about six years ago, it was common for a dental patient contemplating implant surgery or complicated oral surgical procedures to be referred to a medical radiologist for a CT scan of his upper or lower jaw. Sometimes this represented an inconvenience to the patient both in time and cost and always resulted in more exposure to radiation. With the development of cone beam CT scans designed for private dental offices, patients could have the necessary radiographic imaging with a ten-fold decrease in radiation exposure (compared to the medical scan) and not have to “schlep” elsewhere.

Sounds like a giant leap forward in the delivery of care, right?  Not so fast.

The article goes on to describe how over the last decade this new technology has gained so much popularity in private practices (especially orthodontic and some other specialty practices) that many patients may have been subjected to too many CT scans, unnecessary CT scans and an over-exposure to radiation. In this instance, too much of a good thing is not good at all, in fact it could be out right dangerous. (“Children are 5-10 times more sensitive to radiation than adults.) According to the F.D.A., you double the dose, you double the risk.

With the explosion in implant dentistry, the indication for a CT scan has increased. (“Seeing images in 3D helps to identify vital structures prior to subjecting patients to invasive surgery.”) The advent of the cone beam 3D CT scan, when used appropriately, can be seen as a major advance.

The problem lies in the misuse/overuse of this technology. Some orthodontists have been using  CT imaging as a routine screening tool. This is wrong.

The American Association of Orthodontists has stated that while cone beam CT scans may be indicated in special circumstances, a conventional panographic x-ray examination is sufficient in most cases. Even endodontists (root canal specialists) have been using modified cone beam CT scans to facilitate diagnosis and treatment of difficult cases. Even though their scanners have much smaller fields and lower radiation output, the American Association of Endodontists released a position paper recommending limited (and certainly not routine) use of cone beam scans.

In my view, there needs to be judicious thought when acquiring and utilizing new technology.  Everyone loves new gadgets-just look at the popularity of the I pad. There’s much to be said about the “wow” factor of new bells and whistles, not to mention the potential for increased revenues. However, a responsible clinician needs to strike a balance between facts and hype. (The latter often provided by the equipment manufacturer.) A practicing doctor must perform a cost/benefit analysis i.e., Does the additional information obtained from a scan justify the risk associated with greater radiation exposure?

For the record, I celebrate new technological advances in dentistry, but I never want to be the first on the block with a new “toy.” I give it time for the bugs to be worked out and for my peers to review it.

I will not “experiment” on my patients.

One last point that was brought up in this valuable article: Most dental practices in the United States use slower D film for their routine x-ray exams versus the faster E or F film. Five years ago, I introduced digital radiography in my office (no film, just specialized sensors and a computer). This has resulted in as much as an 80% reduction in radiation exposure per film. I have also acquired a diagnostic laser, which can help detect tooth decay without radiation, and I have introduced Velscope to my practice to that enhances early diagnoses of oral cancer. None of these  technologies has added to patient cost but has certainly enhanced care. I do not plan on acquiring a cone beam CT scanner.

I want to finish this piece by quoting a colleague of mine who was responding to the obvious profit motive of colleagues who acquired cone beam CT scans predominantly for its potential revenue stream. “If I bought a $150,000 hammer, everyone would look like a nail.”

As your general dentist, I consider myself to be responsible for your dental health and general well being as it relates to your dental care. If you have concerns or questions, do not hesitate to contact me.

It’s not everyday that one gets a chance to see himself in the newspaper let alone to be highlighted in an article in the Daily News, but such was my experience recently.

As I walked into my office to begin the week, I received a text message from a friend who saw my picture in the paper. I immediately scurried down to the corner newsstand and saw in disbelief (make that awe and excitement) a nearly full-page photo of me with an accompanying article on the first page of the Money section. Damn nice picture if I do say so myself.

I bought 20 copies! (because that’s all that were left.)  That was my 15 minutes of fame and helluva way to start the day!

If you haven’t seen it yet, here’s a link.

Hope you all had a wonderful Thanksgiving.

The other day I was asked to explain why I chose to become a dentist, and if it has been a rewarding career. This was for a newspaper article that hasn’t yet been published, but I thought I would share it anyway. It was fun to put into words how I feel. Hope you enjoy it, too!

Why I am a Dentist

Can you think of a better way to spend every day than to work with fun people and have a plethora of interesting people stop by to visit you, too? Can you think of a better way to spend your life than to have the opportunity to develop many meaningful and often intimate relationships that can span decades? Can you think of a better way to spend your career than to be able to help people look and feel better and then to be rewarded by smiles of joy and gratitude?

Well, I can’t.

And that’s why I love being a dentist…even after nearly 30 years of practice.

Dentistry is a perfect blend of art and science encompassing the knowledge of a doctor, the skills of a surgeon and the creativity of an artist. It is as much an avocation as it is a vocation.

I love what I do and do what I love. So, keeping up with new trends, techniques and cutting-edge technology is as much a joy as it is an obligation. (Avid sports fans have a ritual to scour the newspaper for the previous day’s developments. Golf and skiing enthusiasts search for the latest developments in equipment design.) For me, the technological evolution/revolution is exciting to behold…new tools to enhance treatment outcomes-new toys to play with.

Dentistry for me is a wonderfully rewarding profession and each day is a new adventure. For those seeking a career, my advice is to find something that gives you passion; the rest will just fall into place. I couldn’t imagine doing anything else.

Next Halloween, stop by the office and you’ll see the entire staff in costume…just for fun.

As I reflect on my more than 28 years of private practice, what enthralls me most about being  a dentist is that I’ve be  given the opportunity to improve the quality of someone’s life and the  gratification of the relationship that is born of  that experience.

There is no melodrama intended in that statement.

Relieving someone’s pain; recognizing and compassionately addressing a person’s crippling fear and anxiety; restoring a person’s ability to enjoy life’s simple pleasures like eating in comfort or spontaneously smiling without embarrassment or inhibition. These can be life-changing encounters and the most intriguing, if not amazing thing about such personally and professionally powerful interactions is that they can happen on any given day of any given week.

These seemingly spontaneous experiences are not planned, unlike the actual treatment which most certainly is and meticulously so. They begin like so many human relationships: with a phone call and a first meeting.

There is a scene in the movie, Jerry McGuire, when Rene Zellweger says to Tom Cruise, “You had me at “Hello”. Well, such is the philosophy and ambience of my office: we want you at the first “Hello”. You feel the smile through the phone and see it when walk in the door.

No one comes to his or her first visit to a new dental office with euphoric enthusiasm. Quite the contrary. There’s often an underlying feeling of uneasiness or trepidation. In order to lighten the mood (break the ice, so to speak) a quick and comfortable rapport needs to be established. People are like musical instruments and the proper melody, which resounds within them, must be sought. One must find the proper chords to play.

It is human nature to establish physical comfort zones that can be measured. The more familiar you are with a person, the closer you allow them into your personal proximity. Whereas arm’s length might be a comfortable distance for an acquaintance, for a stranger is probably too close for comfort. As a dentist, meeting a patient for the first time, I’m not just brushing up against their comfort zone, I’m in their personal space, literally and figuratively.

And it is with this awareness and sensitivity that I approach each patient, find their melody, and await “the invitation” to enter their space. It is only then, that the “magic” of trust can occur and what may be the beginning of a beautiful relationship.

Not too long ago, I wrote (or more fashionably stated: blogged) about blogging. Virtual word of mouth is how I described it.

Well it seems that my musings have gone a bit viral, thanks to a little help from Betsy Kent of Be Visible and Lisa Skriloff  at Multicultural Marketing Resources. Betsy helps me with my website, Twitter, and Facebook. Lisa is a publicist by profession.

Anyway, I seem to be attracting some attention from the media!

Today, I was featured in an article on the Wall Street Journal’s Small Business site. Yesterday, I was interviewed by the Daily News. And I’ve already appeared in articles on MSNBC.COM.

But not to worry my beloved patients! I’m not quitting my day job-I love it to much. Though, I have to admit, I’m getting a thrill from the attention.

Click here to read the Wall St. Journal Article: On a Tight Budget? How to Land a Client

Click here to read the MSNBC.com article: Stress of daily grind takes toll on teeth

Click here to read the MBNBC.com article: Her baby teeth are finally gone — at age 28?

Related: A Blog about Blogging

A year ago, I wasn’t even sure what a blog was.

Six months ago, I thought blogging was the exclusive domain of the cyber elitists and by default, nothing that I had any interest in.

I’ve been a dentist for nearly 30 years and my profession has given me the opportunity to visit with different people every day. Because of this opportunity, I have developed meaningful relationships with a wide diversity of unique and fascinating people.

My “office window” offers a view of life in the Big Apple from many different perspectives. It’s as though my fingers were on the pulse of New York. Be it good times or challenging times, I sense prevailing emotions without having to leave my inner sanctum.

And now I choose to write about my experiences and the people who make my life so rich and interesting: my patients. Their observations and reflections have enriched my life.

Today I am a blogger!

I find myself drawn to blogging as a vehicle of self-expression, gratitude, and the chance to engage with an audience of kindred spirits who might find some value in my musings (be it humor, insight, or pause for thought).

I thank you all for the opportunity to listen, learn and share. It is in this spirit that I offer up my thoughts of the dental and incidental.

‘No man is an island, entire of itself; every man is a piece of the continent, a part of the main’ (John Donne, Meditations XVII)