Everyone has something special they can share

What do you do when you get writes block??

A dear friend of mine posted this question on facebook earlier this week. I don’t consider myself a writer so I really didn’t spend any time thinking about it until now. Why…..because I am sitting at the car wash on a perfectly beautiful morning, trying to be productive working on my portable computer (Ok it is just a pad of paper and a pen) and this is my 4th effort to write something.

Creative writing is a talent that I can really appreciate. I can’t imagine how far in advance you have to think about the twists and turns that a plot has. I am just used to seeing the finish product (usually in a movie form). And after watching TV and movies for so long there is only so much any actor or actress can do for a poorly written script. But look what a well written script can do for an actor or actress. I am sure that behind every Oscar winner for Best actor or actress is a great script.

I look at the first two novels that my brother-in law, Dani, wrote with his brother. I don’t read fiction very often, but the books, “The Unincorporated Man” and “The Unincorporated War” were both about 500 pages and they were so good I didn’t want to put the books down. I think about some of my patients who write (there are so many of you it would be unfair to list any of you in case I forgot one).

I have toyed with the idea of writing something. I have about 5 lines in my head about a script where the good guy is terrified of dentists and of course his wife has to be a dentist. It involves mind control and gold and that is how far I have gotten. I have no idea of how to even get to the next step. Creativity is a gift.

But the truth is every single one of us has at least one really special attribute that we bring to the people in our lives. And I think one of the keys to one’s enjoying life and being fulfilled by it is to know what your attributes are and to share them with those around you. What do you have to offer of yourself that can help those around you?

That’s my message this week, just be who you are and try to bring some happiness into someone else’s life.

Hopefully the apple does not fall far from the tree

I have just finished the week of Shiva, which in Judaism is the week of mourning in memory of my father, Morris, who passed away at the age of 85. For the first few days of the week my brother David was there, but he went back to New York and my mother, sister and I sat through prayers on a daily basis and had many people visit and pay their respects. There were many family members, co-workers of my dad, sister and my world, as well as many people from our respective communities of faith.

I had plenty of time to listen to great stories about my dad and of course, many stories about my family were shared, some of which I knew nothing of before. There was a tremendous outpouring of sympathy and support for which I will forever be grateful for.

But I also had plenty of time to think about what the passing of my dad could mean to me. There are times when I am sad, and sometimes I just get a little teary eyed for what appears to be no reason at all. But for the most, I am grateful to have had my dad for the 53 years that I did, and I know that he was someone who accomplished so much, on so many different levels. I know that even though his physical presence is gone, his spirit will live long.

It also became crystal clear to me what I must seek to do to make sure that what he has started continues to grow, whether it is with family, community or faith. Usually when I have used the apple does not fall far from the tree, it has been regarding poor types of behavior. But in our community my father was not just a tree, he was a very large tree. And I really hope that as the apple I did not fall far from the tree. I know that it is my responsibility now to help the forest grow. It is in this way that I can best honor my father.

I Prefer to be Naïve

This August, I am going to be attending the World Congress of Minimally Invasive Dentistry. The WCMID is a group of dentists who are dedicated to serving the needs of their patients incorporating some of the cutting edge technology of dentistry to provide conservative and predictable dentistry. It will be my third straight year of attending and I am looking forward to another outstanding slate of courses for me to learn and share with my patients.

As I prepare to attend I am reminded of an encounter I had at the first meeting I attended in San Francisco. After finishing her presentation I had the opportunity to talk with Dr. Rella Christensen, who is one of the top researchers in the world when it comes to dentistry. In the course of our talking I let her know how I felt that organized dentistry did not do enough to promote prevention. It was my feeling that just because patients are not compliant we should still keep teaching and preaching prevention, and how glad I was to find the WCMID because this is where they are heading towards. Dr. Christensen in her response told me I was “Naïve”, that patients won’t do it just because of all the benefits it provides.

Flash forward to a few weeks ago when I read a letter from a dentist in one of my journals that I receive. The dentist tells about a conversation that he had with a cardiovascular surgeon about preventive cardiac care and the surgeon basically replied that until someone invents the ‘exercise and healthy diet’ pill he will keep cutting people open. His point was that you can’t change people..they want easy answers not lifestyle changes. Once again, the behaviors of the patients dictate their needs and the surgeon has embraced this and tends to their needs.

Personally, I spent some time with another dentist some years back. I was letting him know that I felt there was much more that could be done in his practice in regards to education and preventive dentistry just in his practice. I thought the sincerity of really caring about the patients would roll out into the local community and make it a magnet for patients who care about their health to come to for their dental care.. His response just floored me, he basically said I tell them to brush and floss once, if they don’t do it that’s what he is there for…to fill and drill

What it all boils down for me is that I know that prevention is the only way to keep ourselves as healthy as possible. There is no short cut to eating well and exercising (certainly surgery is not an acceptable shortcut). Yes, it takes time to brush and floss your teeth, but there is no shortcut to oral health either. If my choices are to be a drill and fill dentist (like the dentist I describes above) or a naïve dentist who actually hopes he can make a small difference in someone’s life…than I would rather be NAÏVE all the time.

To your health

Sometimes, the advertisers get it right!

Over the years there has been several times where I have written about the ‘brush your teeth twice a day and see a dentist twice a year’ advertising campaign back in the day for a tooth paste.  And even though there was no scientific basis for this over the years this was the accepted standard.  Today, we know that for many people, twice a year is not enough to maintain health; they need 3-4 visits a year.

 

But I read a great article about why the brush twice a day is actually correct.  There are the obvious benefits of home care (brush, floss and oral rinses) such as prevention, elimination of bad breath and cleaning the mouth of the food particles.  But according to Dr. Richard Nagelberg, in an article published in Dental Economics, there is more to it.  It involves a better understanding of how bacteria colonize around the teeth and gums, something we call BIOFILM FORMATION.  In the past I have blogged a lot about the biofilm in relationship to cavities. But today I talk about the biofilm and gum disease.

 

According to Dr. Nagelberg, the bacteria always start congregating the same way, with the earliest colonizers always being good bacteria (non-pathogenic).  These bacteria are considered important for healthy gums. This biofilm is on the gum tissue and it can be  different than the biofilm that is on tooth structure. If this biofilm is not eliminated (almost impossible to do) or at least adequately dismantled (this is where brushing come in to play) then the bad bacteria can start to colonize on top of the good bacteria.  These bad bacteria are floating around in the mouth, but they cannot harm you until they are attached to the gum tissues.

 

It only takes 3-12 weeks for the bad bacteria (the pathogens) to become the predominate species within the biofilm.  If you are susceptible to gum disease (genetics and an active chronic inflammatory response are a few of the factors that increase your susceptibility) then gum disease might develop.  And there are numerous studies out there to show a link between gum disease and multiple other health issues, most notably HEART DISEASE AND DIABETES. 

 

So brushing your teeth, at least twice a day is how we recommend that you disrupt the biofilm formation so that it starts at the base level, which is always a healthy biofilm for the mouth.

 

Here are some important tidbits on brushing your teeth to make sure you do it in a favorable way for your mouth, improper brushing can actually cause damage to both teeth and gum tissue.

 

1.  Always use a soft tooth brush
2. Use gentle circular strokes making sure you are angling the bristles into the gum near the neck of the tooth.
3. Never scrub your teeth, it is like taking sandpaper to your teeth, it will abrades away tooth structure (as will medium and hard toothbrushes or even a soft one if you scrub too hard)
4. It is now recommended that you do not brush your teeth after drinking or eating anything that is acidic (including fruit juices, sodas, Gatorade and the list goes on) for at least 30 minutes.  This acidity will allow your tooth brush to abrade away tooth structure much easier.  You need to give your mouth time to neutralize the acidity that it has been exposed to.

It’s The Start of Summer

Yes, it is Memorial Day weekend.  The un-official start to summer  if memory serves me well, which it often doesn’t..Summer starts around June 21).  I remember always getting out of college before Memorial Day, it gave me a head start for getting that summer job before the UC and other colleges got out here in California.

 

With summer comes the relaxing in the sun, picnics and Bar B Ques, baseball games etc.  And the heat.  And in the past it has been no problem for me to suck down a 6 pack of diet coke a day.  Now I know that diet coke is not good for you.  Just the acidity of it can help you wear down the enamel of your teeth.  And who knows what evil the artificial sweeteners really do to you.  But alas, I am also human and I still break down and drink diet coke.

 

For me it goes through a similar pattern.  I can go diet coke free for a few weeks or even months, then I walk into the 7-11 and when I see I can get diet coke instead of water I become a consumer who wants the best value for his money and I will start with a diet coke.  And eventually it works its way back onto my diet until I go on another cycle.

 

Well, I just started another diet coke cycle.  Prior to it I noticed how my weight has actually climbed a little bit.  And I seemed to recall that I had seen articles about how diet coke may not actually help you lose weight so I did a little internet surfing and a I found an article written by Shane Ellison.  He holds a Master’s degree in biochemistry and said the following about diet coke.

 

Diet coke contains artificial sweeteners that researchers at Purdue University found disrupt the feeling of satiety, that is, the feeling of being full.  In other words, you will eat more than you should because you don’t feel full when you are drinking diet coke.

 

The other issue with diet coke is that it is sweet and it causes an insulin spike.  The problem with the insulin spike is that insulin can inhibit the fat burning hormone called HSL (hormone sensitive lipase) Instead of your body releasing fat into the bloodstream as a full source the body will begin to use amino acids (from muscles) and carbohydrates for fuel.  This can leave you tired and grumpy at the end of the day.

 

I have about an hour drive home from work.  And many times I would stop for the diet coke on the road home.  Maybe that’s why when I got home I would feel hungry and tired at the same time.  I am going to see how being diet coke free feels when I get home. 

 

Until my next blog..stay healthy

Probiotics and Dental Health: A Wellness Partnership

Can Probiotics work for you?

What are probiotics?  Live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.  Probiotics are commonly consumed as part of fermented foods with specially added active live cultures; such as in yogurt, soy yogurt, or as dietary supplements.

Now there are probiotics that have been specifically designed to improve oral health.  Over 30 years in the making comes the Probiora3 (developed at the Harvard affiliated Forsyth Institute) probiotics system.

ProBiora3 is a revolutionary new application of probiotics, which have traditionally been used to support digestive and immune health. ProBiora3 is the first probiotic mint specifically designed for complete oral care. This all-in-one product supports gum and tooth health and naturally freshens breath while gently whitening teeth.

The unique blend of  bacteria in ProBiora3 has the ability to help suppress the levels of s. mutans in the mouth.  S. Mutans is one of the major culprits in causing cavities in the mouth.  The bacteria in ProBiora3 also produce hydrogen peroxide.  The hydrogen peroxide helps inhibit the growth of the bacteria that cause gum disease and can also help to whiten your teeth.  The bacteria also oxidize the volatile sulfur compounds that are responsible for bad breath.

Who can benefit from these probiotics?  Here is a list of some people who might benefit from the probiotics:

1         Elderly patients (especially if they have diminished salivary flows).

2         Patients ho have excessive areas of root surface exposure.

3         Patients with high risks for getting cavities.

4         Patients who have lost some of their dexterity in being able to brush and floss.

As with everything, compliance is a must.  Usually the system is started right after a hygiene visit.  The first 10 days you dissolve a single EvoraPro mint (only available at dental offices) in your mouth, after that there is a maintenance dose, the EvoraPlus (available through dental offices, pharmacies and online), that is actually dissolved twice a day in the mouth.  After each hygiene visit you should start with the EvoraPro mints to best utilize the added strength  if possible.

If you have any questions, please go their website at Oragenics.com to get their info.  We have started carrying the EvoraPro (which also comes with a one month supply of the EvoraPlus).  If you are interested in trying these products please let us know at your next hygiene visit.

It brought a tear to my eye

Some of you may know that my family is dealing with the deteriorating health of my father. It is something that none of us have any control over. And it is very easy for me to escape into the world of a health care provider and say that’s life. But today I had something happen that threw me into the world of son and is a memory that will last for as long as I live.

This story revolves around a religious event so please indulge me a little here. Today was the bris (the ritual circumcision) of the 8 day old son of the Rabbi of our temple. The ceremony was at his house and was followed by lunch. The Rabbi has several other Rabbis in his immediate family and some of them were also at the house. One Rabbi who spoke during the service earlier in the day was his wife’s uncle, Rabbi Schwartz.

So when it comes time to sit after getting our food I see two seats at a table, in the shade, next to Rabbi Schwartz. My wife and went and sat down. Now Rabbi Schwartz in not your average Rabbi, he spent over 25 years dealing with college students. He actually told us some pretty funny stories about his early days at UCLA.

At a certain point Rabbi Schwartz and I were talking about where I grew up and my connection to his sect of Judaism. I told him my father was at one time the controller of the Jewish Federation and Rabbi Schwartz immediately asked me what my last name was and I told him Engel. He asked if my father is Morrie Engel and I said yes and his next word’s, the entire table heard were “Your father is a great man, he legitimized Chabad”. Even though I was only about 5 years old at the time I know the stories of how my dad helped set up and support Chabad in those early days and continued to do so his entire life.

I had a tear in my eye as I thanked Rabbi Schwartz for what he said. And I have a tear in my eye now as I write this. My dad will move on someday but I know he has done what very few have done. He made a difference on a global level helping an organization that he believed in. What a legacy.

I only can hope that someday, my children will come across someone and in the course of conversation it might be said that I made a difference somewhere, to someone, to some cause. I have no illusions that I can do something as great as my dad…but somewhere I just want to make a difference.

What’s with the Rain and Food Trucks?

Food trucks are one of the big crazes going through Los Angeles these days.  You can find just about any type of food at a food truck; you just need to know where it is going to be at.  And there are certain communities that you know there will be food trucks at a particular time every week.  All you have to do is drive down Wilshire Blvd in the Miracle Mile district of Los Angeles to see all the trucks on the south side of the street.

Now I am not one of those foodies who have to find a certain truck, for that matter I don’t go to the trucks on Wilshire even.  But when they set up an event that features food trucks where I live in Santa Clarita I tend to go out and see what the buzz is all about. And there is usually a great local charity that benefits from the event.  But there is a strange coincidence that is occurring in the SCV.

In January they had a food truck festival that was postponed one week due to incredibly heavy rain.  It was the weekend of rain that almost had my house float away from out backyard (that’s another story).  So, the following week they held the event at our Central Park and it didn’t rain, it snowed that morning and a little during the event.  Not a good day to try out some incredible looking ice cream

So today was another such event.  And it rained pretty good from about 3 to 5:30 ish in the morning.  I thought there goes another food truck event because of rain. But, luckily I was wrong.

Hats off to the SCV Auto Dealers Association for hosting what I feel was the best community event to hit the SCV in a long time.  They blocked off the street from traffic, had lots of classic cars and over 50 different food trucks so anyone could find the type of food they wanted.  And since the wife and I are kinds getting out feet wet looking for a car to get in about 3-4 months, we had the opportunity to walk into every dealership we wanted to just to see the latest and the greatest. 

But my thoughts are if we ever need rain in the SCV schedule a Food Truck Event. 

Luckily, I did my best to only graze and not over eat (something that is very easy to do at these events) and I am now home and getting ready to work out for the day.  Basketball or hockey….what should I watch.  Either way there is some very physical play going on.  Is it just me or does it seem like they are letting the NBA game get even more physical that ever during these playoffs?

I need to end this blog by saying Happy Belated Mother’s Days to all.  I forgot to mention the most important women in my life last week in my blog and I certainly want to give credit where it is due.  Sandy (my Mom), Ruth (my mother-in-law) and Janis (my wife and mother of our two incredible boys) I ask a simple question.  Where in the world would I be without the three of you?  You all know the answer to that one…..

Till next week, to your health,

Don’t You Ever Wonder?

Ok, I think that I might be getting on a soapbox this weekend but here goes.

For almost 30 years I have been practicing as a dentist in the Los Angeles area and sometimes I just wonder about stuff.  Let me say this straight up about dentistry.  If dentists are committed to doing their job properly we should be slowly putting ourselves out of business.  Isn’t the best dentistry no dentistry and doesn’t every one out there want to get their teeth cleaned and say “Thanks, I will see you again in 6 months”.  And yet we are losing the battle against cavities, as the statistics point out an increase in the number of teeth needing treatment in the teens of America.  And guess what that means…I will still be in business because most of the dentistry done today is replacing dentistry that has failed.  It’s not that you are getting poor dental treatment, it’s just you have already destroyed what nature first provided you… you will eventually destroy what a dentist puts in your mouth.

This takes me to a quote that a Dr. Sinatra, a cardiologist, posted on Facebook.

“t is absurd to expect a patient can be successfully treated, while he continues to violate the laws of health .”  Thomas Frazier Rumbold, 1880

First said in 1880 and it is as true today as it was back then.  And it is really all about personal responsibility.

Today I read an opinion page in our local newspaper about NY City Mayor Bloomberg asking the Department of Agriculture to grant New York City a two-year waiver to ban the purchase of soda with food-stamp cards, saying it’s a matter of public health.  This is a tough one and I can see both sides of the story.  But as someone who is dedicated to prevention of disease I know there is absolutely no nutritional value to most beverages on the market and soda is the leader of the pack here.  I think we can all agree that there are healthier foods to use the food stamps on.  I want to say “Good for you Mayor Bloomberg, you are right”  but maybe this is not the right place for the battle.  What about cookies or high sugar items that people will use the food stamps on..what’s the difference between them and soda.  It’s about personal responsibility.

Here is something else that I wonder about.  What kind of example is being set by those who speak about health reform, but take cigarette breaks?  How can anyone who is educated and be any type of leader have untreated health conditions?  And we know it is happening.  And what about our food industry pumping our processed food that actually harms us?

Is it just me who wonders of the hypocrisy of our leaders who claim to know what is best for our country but are unwilling to do what is best for their own health?

To those in position of authority and leadership I ask you…..Stop violating the laws of health.

I’ll get of my soapbox now..have a great week.

All IT TAKES IS A LITTLE HUG

I want to share a little bit about a special lady who came to our office as an emergency on Monday.  This woman is not particularly fond of the dentist as she has had some really bad experiences in the past.  And she was not n a good place in life as I will explain in a minute                      

When I walked in to great her she looked at me with fear in her eyes and confessed that she should have come in to see the dentist a while ago when the tooth first broke.  She had been taking care of her parents and recently had lost her mother.  She was still talking care of her 91 year old father, but the pain had gotten so bad she had not slept much for the last 4 nights. 

So here she was in pain, not loving the dentist and when we took her blood pressure it was through the roof 171 over 115.  Not really a good pressure to work with, but she was in pain.  Long story short we ended up prescribing her some antibiotics and some pain medication and scheduled her to come in a few days.

On Wednesday she came in and she had actually had some relief from the constant pain, but the tooth was still painful to the touch.  And luckily she had gotten some sleep.  And to my amazement her blood pressure was down to normal.  Everything was a go for the extraction.

But here she was more comfortable and yet more emotional.  She really missed her mom who had always been with her when she had dental treatment.  Her father offered to come but he was not strong enough for her to take him up on his offer.  But she was being brave and we were starting to form a relationship, the single most rewarding aspect of be being a healthcare provider.   We had talked on Monday and she knew that my dad has been in the hospital for the past 2 weeks and our common life issues..dealing with aging parents was probably the reason that she came back.  We were in the same place in life.

I got to tell you, she warned me she was hard to get numb.  This is what had soured her on dentistry, the last dentist didn’t believe she could feel everything and kept on working.  That was a simple one to overcome; I told her she had absolute control of the situation, to raise her arm if she felt anything.  And she was hard to get numb, but I did and I removed the tooth without any complications. 

At the front desk she said if she didn’t have the gauze in her mouth she would have given me a kiss (I never had that offered before) but she told me a hug would have to do.  And a hug is what I got and she slept that night without any pain and was a happy camper.

Unfortunately we live in a time where it is easy for us to criticize the efforts of others.  And criticize we do.  But do we take the time to thank others for their service and help as often as we should?  I know how great I felt after the hug and I have actually let that feeling last for 4 days now as it is an intoxicating feeling.  I helped someone and they appreciated it.  How about that for satisfaction on the job.

And all it took was a little hug.  And now I need to be giving more hugs to the people around me.