Our office will be closed Thursday, June 6th and Friday June 7th because we will be participating in the Michigan Dental Association’s “Mission of Mercy.” This amazing project will be held at Saginaw Valley State University on Friday and Saturday of this week. The goal of the Mission of Mercy is to provide dental treatment to 2000 people in two days…for free! Dentists, dental hygienists and assistants from all over the state will converge on Saginaw to volunteer their time and abilities to provide dental treatment at no cost! This is Michigan’s first Mission of Mercy and the MDA has been planning it for more than a year!
Please spread the word! If you are interested in being a patient you can read more information at the Michigan Dental Association’s FAQ page. Registration for volunteering at the Mission of Mercy has closed, but you can be put on a waiting list by emailing the coordinator here. Include your name, volunteer type (dentist, hygienist, general volunteer, etc.), email address and a phone number so the MDA can contact you at if any cancellations occur.
We’ll be back to normal on Monday, June 10th! Thanks for your understanding!
It’s basketball season. So we’re seeing a lot of fans. MSU fans, U of M fans, Pistons fans and a whole lot of different high school basketball team fans. Those fans LOVE rebounds! Those aren’t the rebounds that I’m talking about.
Quite a few of our patients 50 and older are taking some kind of anticoagulant medication. Aspirin, Coumadin, Plavix or even the newest ones like Exanta are used to prevent the buildup of plaques in the arteries of the heart. And they work. They cause the blood to be less “sticky,” which can help reduce the risk of heart attack, stroke and embolism in those with artery blockage. The side effects are that they can cause bruising and extended bleeding from wounds. Some dental treatments, particularly surgeries like tooth removal, can cause mild to moderate bleeding. Since bleeding is the first step in wound healing, this is O.K.
In the past, those taking anticoagulant medications were sometimes told to stop taking them 2-3 days prior to a tooth extraction. It was a gray area. Some docs said 2 weeks, some docs said a couple days and some docs said “don’t worry about it.” A lot of patients have been taking these medications for awhile and what they remember is that they stopped taking them for an extraction.
More recent research has described the “Plavix rebound.” It happens when someone discontinues anticoagulant therapy suddenly. Like 2 days before an extraction. This rebound effect puts the patient at significantly higher risk of stroke, heart attack and embolism for the NEXT 90 DAYS! Although most of the current research is with Plavix, the same effect has been known for quite some time with older anticoagulants.
So let’s say you’re on an anticoagulant and you need a tooth removed. My experience has been that in most cases we can remove the tooth and control any bleeding in the office without taking you off your medication. We have a lot of techniques including more minimally invasive surgical techniques as well as wound closure techniques that make postoperative bleeding a non-issue. If you or your doctor have concerns about wound healing I’m happy to discuss it with your doctor. But my guess is that now the risk of “rebound” is much greater than the risk of postop bleeding.
So here’s the deal: DON’T STOP TAKING YOUR ANTICOAGULANT MEDICATION WITHOUT TALKING TO YOUR DENTIST AND YOUR DOCTOR. Even if you stopped it in the past.
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I don’t think that these labels are actually meant to educate smokers about the health risks of cigarettes. Everyone knows that cigarettes are horrible for you in many different ways. What the gruesome photos are meant to do is remind you that you’re making a poor decision right at the time you’re making the decision (when you’re going for a cigarette). Will it help? I’m not sure,but I expect the new regulation will trigger a boom in cigarette case sales.
Dentistry’s version of “everyone knows it’s bad for you but does it anyway” is pop. Or soda for those of you in the northeast. Coke, Pepsi, Mountain Dew, Sun Drop. All that stuff is a double whammy for teeth. The acid in it causes the pH in your mouth to drop, which makes cavities. The sugar in it causes the bugs in your mouth to create acid, which lowers your mouth’s pH, which makes cavities.
Just like cigarettes, there’s no redeeming value to pop, except that people like to drink it.
So why not require a label on each and every soda can that reminds the drinker that they’re making a terrible choice every time they choose to have a pop?
I suggest this:
Admit it. You might put down the Mountain Dew if you saw this.
I just saw a news item about a new dental discount service called "brighter.com."
I'm not able to see exactly how it works, but it seems to be a "dental discount plan" administered by a company. The company is clearly aiming the service toward those individuals or families that do not have dental benefits to help defray the costs of dentistry. You pay a certain amount to brighter.com and they give you a list of brighter.com dentists that will give you discounted prices on services. Membership doesn't appear to include any services, they just entitle you to discounts. You pay the dentist directly at the time of service. The service boasts that you will be able to see how much a service costs online so you can comparision shop.
The idea is intriguing, but let me see if I can take a little wind out of their sails:
The plan is limited to the dentists that have signed up with them on their website. I would expect that in a larger metropolitan area you may find more dentists who have signed up. Around us (Saginaw Bay area of Michigan) the pickings appear to be limited.
The fees listed on the site (they listed "prices typical in Freeland, MI 48623) were all over the map and didn't seem consistent with fees that I charge for procedures.
They listed nonspecific procedures with a fee. For instance, they quoted a fee of $254 for a "cavity." A cavity is not a service. A cavity is a hole in the tooth created by acid from oral bacteria and dietary acids. A cavity can be small or large and can be fixed in a variety of ways. I couldn't tell you how much it would cost to restore a cavity without diagnosing the problem first.
This is a business model put together by bright people who don't know all that much about dentistry. They understand that people without dental insurance are looking for discounted dental care. The concept is good. The idea of being a loyal, paying patient in return for a discount just makes sense. But why does a third party like brighter.com need to be involved? In fact, doesn't paying a third party a monthly or yearly fee add to potential costs?
"Well," you say, "dentist's certainly aren't offering this kind of a discount plan."
You're right…I'm not offering this kind of a discount plan. I'm offering a MUCH BETTER ONE!
The Mead Family Gold Club is an excellent option for those without insurance who are interested in top notch preventive care and would like a discount on dental services. You can find the details here or just go to www.meadfamilydentalgoldclub.com. But here it is in a nutshell: for one low price you get cleanings, x-rays and exams for a whole year and a killer discount on other dental procedures.
Interested? Email me at email@example.com or call the office at (989) 799-9133. We'll give you all the information and get you on the road to dental health and great discounts!
I got an email from my cousin last week. He described going to a new dentist. He liked the office and thought the dentist was a good guy.
My cousin is a pretty level headed guy. He’s certainly not distrustful of professionals that I can tell, but he didn’t have a relationship with this new dentist. He was concerned that maybe his dentist was trying to oversell him on dentistry. The dentist was suggesting some pretty expensive treatment that he had never had before.
Health care professionals have a dilemma. There’s an inherent power imbalance in the doctor/patient relationship most of the time. The doctor is highly trained in a very specific area and the patient usually doesn’t have a lot of knowledge in this area. Last year National Public Radio aired an interview with an economist by the name of Dan Ariely that infuriated a lot of dentists. The interview essentially described what a lot of people believe about dentists. Since dentists diagnose dental problems as well as treat them, there seems to be a distinct conflict of interest. Why wouldn’t a dentist represent problems as bigger than they are if they’re going to get paid more?
Dentists got mad. Really mad. The story challenged the dental profession’s ethics and integrity. I have to admit that I was pretty mad about the story myself. You might notice that I commented on Dr. Ariely’s blog and was disappointed that he never replied to the fact that data he quoted in this interview doesn’t seem to exist.
However…when I took a step back I realized that his major point is worth thinking about. Why wouldn’t a dentist take advantage of such an opportunity? There’s no way to standardize dental diagnosis. One dentist might see a cavity where another dentist might want to “watch” the area for changes.
I suggest that there are things you can do as a patient:
Have a relationship with your dentist. If you don’t feel comfortable asking your dentist questions about the condition of your teeth and the treatments that they offer, then you’re probably at the wrong place. This one is pretty tough if you’re in a new town or going to a new dentist.
Ask them to show you: if a dentist or their office staff cannot explain and show you the problem that they’re asking you to fix with expensive treatment, then be skeptical. It doesn’t make you a jerk, it makes you a smart customer. A dentist confident in their diagnosis and treatment will take the time to make sure you understand and believe in the treatment.
Get another opinion: I know for a fact that most dental patients won’t do this. I’m convinced that they think that their dentist would be offended. Perhaps some would be. I’m not. I know that a patient that understands the treatment that I’m offering them is more likely to be happy with the treatment. If they check with someone else and they say, “yup, that’s what I would do” then everyone wins. If they take a look and say, “whoa, I’m not sure I agree” then the patient can gain more understanding and perhaps make a better treatment choice. Dentists don’t all treat dental problems the same way. A disagreement with treatment plans doesn’t mean that one dentist is doing it wrong. Second (and third, and fourth…) opinions make for better understanding.
This Saginaw dentist is happy to be a second opinon. Further, I will happily give a second opinion at no cost to the patient or nominal cost if we need more diagnositic information is necessary to reach a diagnosis. We need more patients making excellent decisions about their health and they shouldn’t avoid getting second opinion because it’s very costly.
So are you wondering what happened with my cousin? After we talked (actually IM’ed on Facebook) he actually emailed his dental office and asked for his x-rays because he was seeking another opinion about the proposed treatment. They obliged him and he emailed me his x-rays. Although I couldn’t render a diagnosis simply by looking at x-rays I was able to explain that the treatment his new dentist offered didn’t look out of line from what I could see on the x-rays. You know what’s even better? The dentist called to make an appointment with my cousin apologizing for not explaining the treatment in more detail.
Second opinions make for better treatment decisions. And no one stole anyone’s patient and no one got hurt. Isn’t building relationships with your dentist grand?
Do you need a “cousin” in the business in the Saginaw Valley? I’m happy to do it for you. Email me at firstname.lastname@example.org or call the office at (989) 799-9133. If you’re not from around here I don’t mind doing some leg work to make it happen. Patients who are better informed make better decisions and that’s good for everyone!