HAPPY NEW YEAR!

I am happy to share with everyone that we are adding more hours to our dental hygiene schedule. This will open our practice to accepting and welcoming new patients into our practice. Our current hygienists both have requested to add more hours to their current schedules, so we our inviting new patients and referrals to fill her expanding schedule.

Dr. Foy and staff have been practicing in the Riverside Professional Building Suite #806 since 1981 and we accept most dental insurance plans. We have enjoyed being part of the Riverside Campus and hope you will keep us in mind for you and your families dental care in 2008.

We want you to have a healthier new year, but we also want to make it a little brighter. As a small token of appreciation for all new patients scheduling for a “New Patient Intake” will offer a free professional strength Crest Supreme White Strips.

Please ask for your complimentary kit after you get your teeth cleaned.


We look forward to meeting you and your friends, making it a happier and healthier New Year.

Happy New Year
Patrick J Foy DDS

END OF THE YEAR PLANNING

Did you know that each year insurance companies make millions of dollars off patients who forego necessary and preventive dental care? Many individuals who are paying for dental insurance do not realize that their plans provide coverage up to a certain dollar amount annually. Consequently, some patients are not scheduling the dental treatment they need, deserve, and have insurance to cover. Thus, the insurance revenues allocated to pay dental claims on many patients are never used, and, unfortunately, those dollars cannot be carried over year-to-year. The bottom line: what the patient does not use they lose.

HAPPY THANKSGIVING

This has been a difficult year for many families in our community, but today we need to be thankful for many things. If you have your health you have everything. Our office family are grateful for our health and the privilege of serving the wonderful people in our practice. It has been very rewarding to be a small part of so many interesting lives.
We have been witnessing people sliding on their normal re-care appointments and have suffered some unfortunate adverse outcomes. Tooth aches, abscesses, gum infections and other totally preventable events are becoming more common due to this current trend of procrastination. Give the gift of health during the holidays. Get a check-up or a re-care appointment with the dentist and bring a family member with. Start or maintain an exercise program. Watch your diet (After today). Give your whole family a hug. Thank God for all your gifts. Sincerely Happy Thanksgiving.

ADA'S CEBJA

The American Dental Association has a Council that is called "CEBJA" by dentists famililar with the Council structure of the ADA. CEBJA stands for the Council on Ethics, Bylaws and Judicial Affairs. I am attending my third meeting on this Council this coming Friday and Saturday in Chicago. The name reflects the nature of this council very accurately. Last Friday I attended and all day workshop at "The Loft" in Minneapolis, Mn. The presenter was Mary Carrol Moore who had survived two bouts with cancer. With her past experiences her workshop "Healing through Writing" was very inspirational and educational. I am always learning.

Evidence-Based Dentistry

The Friday Oct. 30 th, 2009 Presentations went off without a hitch.
Clinicians are finally starting to get a better handle on the importance of Practice-Based Research in Dentistry. It is intended to add more credible evidence into clinical practice, but it is not intended to replace clinical judgement, patient choice and practitioners skills. The Minnesota Dental Association presents...
Practical Research for Clinical Excellence:
Be Better - Be Smarter - and Be Part of the Process!
Friday, October 30, 2009
University of Minnesota
St. Paul Continuing Education and Conference Center
1890 Buford Ave., St. Paul, MN 55108-6092
Cost: $75 Per person - must be paid in advance. *(Mail in check or fax us your credit card number.)
Time: 8:00 AM - 1:30 PM
Buffet lunch is included!
Highlights:
* “The ADA’s Center for Evidence-based Dentistry: Practical Resources for Scientifi c Evidence”
Dr. Julie Frantsve-Hawley, Director of the ADA Research Institute & Center for Evidence-based Dentistry, Chicago, IL
* “Moving into the Age of Evidence with PBRNs”
Dr. Jane Gillette, Clinical Research Dentist and Private Practitioner, Bozeman, MT
* “Promoting Evidence - based Dentistry Through Practice-Based Research Networks: Learning Never Gets Old!”
Dr. Paul Benjamin, General Practice Dentist in Miami, FL and Practitioner-Investigator serving on
Executive Committee of NIDCR-funded PBRN.
* Round Table Discussions: “EBD - Turning Fear into Empowerment!”
Dr. Patrick Foy, General Dentist and Practitioner-Investigator serving on Executive Committee of NIDCR-funded
PBRN, Minneapolis, MN. by Patrick J Foy, DDS

STANDING OVATION

"The best and most beautiful things
in the world cannot be seen, nor
touched ...but are felt in the heart."

-- Helen Keller


I was preparing a tooth for a new gold crown during my dental school clinical requirements and felt in the zone. I had carefully sculpted the patient's mouth with the perfect crown preparation in mind, a design as pictured in text books. The taper was barely over six degrees as desired and the maximum amount of tooth structure was preserved. With immense pride and confidence, I was anxiously waiting my clinical instructor to verify my perceived talent.

He looked into my patient's mouth, thoroughly inspecting the tooth with high powered magnification loupes, tilting the mirror in several different angles. At last, he told the patient, "That is the most perfect crown preparation I have seen in years. Dr. Foy has really done you a great service."

My pride and ego soared. I completed the impression and cemented the temporary crown. After my patient left, the instructor came over and said, "That was a nice job. But when you are out in the real world don't expect a standing ovation from your patients. Most people value quickness and lack of pain, not line angles and perfect margins. They will never see or appreciate that type of quality. You’ll have to motivate yourself to continue to maintain it, and break your own arm slapping yourself on the back.”

One of my patients, a maintenance man in his early sixties, had volunteered to go with a group of medical missionaries to the poor areas of Guyana, Africa. Larry had a full head of wavy hair, snow-white with age, and the Guyanese people exalted him as possessing great powers, looking up to him in a godlike manner.

During his stay he met and married a young African woman named Lily. My dental journey with her was one of the most surprising and gratifying of my career.

Our American emphasis on personal esthetics can be extreme to someone from an impoverished country. Larry’s new bride had a hard time adapting. She was extremely self-conscious, but at least she could speak a little English.

As with many immigrants Lily had little or no previous dental care, but she was free of any fillings. First, we treated some gum disease and instructed her on proper oral hygiene techniques. After she mastered a self-care routine, we were able to restore minor decay. In the beginning we were simply trying to build the foundation for cosmetic dental care. Lily was compliant and eager to fix her anterior teeth.

She had grown up in an area of Africa where the water supply was rich with fluoride at a level so extreme that all of the people had severe fluorosis. This condition caused their teeth to take on a reddish-brown color.

When everyone around you has similar teeth you do not stand out, but in America the prominence of white teeth made Lily ashamed of her smile. She covered her mouth when she spoke, and this was crippling her ability to adapt. Larry asked for our help.

After a consultation, Lily decided to cosmetically enhance her smile. Diagnostic casts were made to plan for size, function and space management. Despite all the discussions and pre-planning, it was still difficult for her to completely appreciate and comprehend the result.

The day of final delivery was a day that I will never forget. Local anesthetic was used and Lily was cooperative through out the procedure. When everything was cemented, cleaned and polished, I handed her a mirror. At first, she remained expressionless, and tears began to roll down her face.

I was confused by her reaction. Were these tears of joy, tears of shock or disappointment? I waited nervously for her opinion.

Lily remained stoic as she peered into the mirror. Suddenly her face lit up with a beautiful grin. She leaped out of the chair and started doing a little jig, dancing in circles around the small room. Then she dropped down on her knees and began kissing my feet.

I quickly bent over, grabbing her arms, trying to lift her up, protesting, "No, no, no, no, no...." when Larry walked into the room.

It is odd to have a husband witnessing his wife on her knees kissing your shoes.
Larry laughed, and as Lily jumped up and showed him her new teeth, he exclaimed, "Wow! I cannot believe it." She shrieked and ran into the waiting room, going from chair to chair to show her new smile.

Some things are better than a standing ovation.

YOUR CHILD'S TEETH AND ORAL HEALTH

A common question or misunderstanding in dentistry; “When should I bring my child to the dentist.” There is not a specific age, but as a general rule, it is at about one year of age. Prior to one year of age if a parent is concerned about a discoloration on a new erupting tooth or any other unusual findings in the mouth , then a short “look see” would be appropriate to rule out any potential developmental problems. A “look see” is a short exam by the dentist to determine if there are any specific concerns or abnormalities.

In April of 2007 the CDC (the Center for Disease Control) released a Report that for the first time in their recorded history in the USA that the decay rate among children ages 2 to 5 years of age has increased. This is a wake up call for all of us. Therefore, new parents need to implement and maintain oral hygiene habits for their kids as soon as the first tooth erupts. Also, we need to re-look at public health issues in this troubling area of the increased incidence of tooth decay in America.

In a diverse society the message to new parents should be culturally sensitive, so all sectors of the population will have access to the information needed to maintain good health.

As soon as the teeth start to erupt into the mouth it is recommended that parents seek professional advice on how to maintain oral health in their child’s mouth.. The goal is at a minimum to remove all the plague from the teeth at least on a daily basis. Twice a day would be more desirable. This can be accomplished with an infant’s toothbrush, wash cloth or even a piece of gauze. Toothpaste is not necessary at this early age. The sooner your child adapts to you cleaning their teeth for them the better. Young children may resist at first, but this is important battle that each parent must win in order to prevent unwanted tooth decay.

Baby bottle tooth decay is also a common occurrence that can be avoided by taking a few simple steps at or before bedtime. Never put your baby to bed with a bottle containing milk, formula, fruit juices, sodas or any sugary liquids. Even though some of these liquids are needed for proper nourishment they can destroy or decay the teeth if left on the teeth for extended periods while sleeping. Brush the child’s teeth before bedtime and only offer water after the teeth had been cleaned at bedtime.

BY PATRICK J FOY, DDS

I WANT TO BE A DENTIST

The secret of joy in work is contained
in one word -- excellence. To know how
to do something well is to enjoy it.

-- Pearl S. Buck


The night I told my dad that I wanted to be a dentist, he shook his head. "Oh shit! You'll grow up to be a Republican."

The smell of the stockyards permeated the close summer night. My father was sitting in his over-stuffed green chair in the TV room, dentures lying bare on the desk, sucking the knuckle of a pickled pig's foot. No person with hearing could stand that sound, but it was time to pound out my career plans.

"You'll be a painter!” Dad barked.

I had not considered for a second that I would take over his paint contracting business. My oldest brother Mike and I had both painted for dad as soon as we became teenagers, but my father was not big on nepotistic privileges.

He gave us the worst jobs. On the roof of a Texas meat-packing plant, we scraped tallow, the caked grease of boiled cows, off the walls in 100-degree heat. We painted flag poles on top of multi-storied buildings, spent a summer puttying the nail holes on the wood trim of 136 condo units, sandblasted the inside metal tanks of air hoods in sauna heat.

I held out my arms representing his whole world. "I don't want to take over your business."

"You little shit, you don’t know what you want!”

“I know I can be better dentist than Doctor P.” He was our family friend. “And you wanted to become a Vet yourself!"

I was playing dirty now because the Great Depression had denied Dad his personal goal of becoming a large-animal veterinarian. At first, I myself wanted to be a vet, but after few months in an animal doctor’s office, I discovered it was not my cup of tea. Being an independent cuss, I decided that dentistry would give me more freedom than medicine.

“I just want the opportunity to do my best."

Dad set the bare knuckle in a bowl next to his useless dentures and began motioning with his hands as if he were washing them clean.

"Go, go and be a goddamn dentist! Become a shit-for-brains Republican! … I will help you any way I can."
Now, after nearly three decades of dentistry, I’ve decided that my father voted for his yesterdays, and whatever the party, I vote for my tomorrows.

-- Patrick J. Foy, DDS

WHAT WILL YOU PUT IN YOUR BOX?

“Treasure the love you receive above all. It will survive long after your good health has vanished.”

Og Mandino quotes (American Essayist and Psychologist, 1923-1996)


Joe was a fifty-year-old Iowa optometrist who was diagnosed with an aggressive form of brain cancer. He decided to continue to practice as long as he felt capable, but eventually the tumor would win out.

One cold January day, he drove to work as he had for more than twenty years and began a typical morning. After he had completed a few eye examinations, he was startled to find something subtle had changed in his motor skills. It hit him hard to realize that his health had finally deteriorated to the point where he could no longer work. All the years of education and career challenges suddenly stopped; it was time for him to go.

Without notifying his staff, Joe found a small cardboard box to pack up his belongings. He walked around from room to room searching for the treasures of his life, gathering all the personal items that he wanted to take along. But now the common things that he had used daily took on a new and different value. He was amazed at the simple mementos he collected. The picture of his three daughters when they were toddlers crammed into a wading pool, the fathers day present of a mug that read ”World’s Greatest Dad”, framed pieces of art that one of his daughters painted in grade school, and many other small tokens of love from family and friends that filled the box with twenty years of joy. Not one item in the box had anything to do with his career; everything had to do with the people he loved.

Joe walked to the front desk where his staff standing by and quietly announced, "I'm done.” Then he limped to the door, clutching his precious box, and left work for the last time.

-- Patrick J. Foy, DDS

A Class I Missed In Dental School

Immersed in my private practice of dentistry for 25 years, I was fortunate; things seemed to have been rolling along quite smoothly. Until Jesse came into our practice. Jesse was a very serene, soft-spoken, tall, sleek, ravishing young black woman in her early thirties. Her unassertive manner and gracious attitude always made her visits pleasant and delightful. She had perfect dental health with absolutely no sign of any other health concerns. Her only dental concern was that she had slightly narrow central incisors resulting in a diastema (space) between her front two teeth. The small space in her teeth represented the only minor flaw in her goddess-like physical appearance.

Over the years, I have learned that these small defects that a person dwells on can sear relentlessly on the psyche. It does not matter how insignificant the problem may be; it mercilessly affects his or her perception of self. Jesse’s dream was to have that diastema corrected with dental veneers. She was the one driving her own treatment plan. Her radiant beauty was not affected one iota by her teeth, but it was a mental gremlin to her self-esteem.

After long discussions and reviewing all of her options, I finally caved in to her request to veneer her front two teeth. She was correcting the sole blemish that she perceived in her appearance. The case was one hundred and ten percent successful, and she broadcast her beauty and her confidence instantaneously.

Even though the appearance of her teeth I never discerned as unsightly, she, on the other hand, was so grateful and happy with our expertise that it made our day. Gratitude is hard to deny.

Months went by. Jesse was scheduled for a routine cleaning visit, and she failed to show up for the appointment. That was out of character for her. There was no answer on her apartment phone, so a message regarding her appointment was dictated on her answer machine. A day later her mother called. Jesse, she told our receptionist, would not be coming back. She had died of complications from a bleeding gastric ulcer.

Young, healthy, seductive enchanters are not supposed to die. They never told me in dental school that my patients were going to die.

I was numb by the news of Jesse’s death. My dismay evolved into anger. I was feeling betrayed and ill-prepared for the experience of potentially hundreds of patients dying over the years. The relationships I have enjoyed with people make going to work very gratifying. I feel honored to be part of their lives and feel extremely close to many people. Even though I have experienced many patients dying over the years, Jesse was the unexpected slap in the face that made me appreciate the harsh reality of several deaths.

I was unable to shake the shock of Jesse’s death. It haunted me and forced me to recount my previous experiences with patients dying. The pain caused by a loved one dying played out several times in my dental chair. The variety of emotions expressed after a loss has been enlightening. We as humans grieve in our own ways, and there are not rules of grief or established social norms. Listening to my patients vent, mourn, laugh, cry, celebrate, distress, and share their personal feelings has given me an education that very few are privileged to witness.

Unfortunately, early in my career I was not as adept at managing the correct words for a grieving family. When I purchased my practice, I inherited a family from the previous dentist which included three teenagers. Their mother was going through chemotherapy for breast cancer. I had seen their mother only once before she died as a result of her cancer. Stymied by ignorance and inexperience, I fumbled for words of sympathy, but I still remember feeling awkward and incompetent. It forced me on a journey of a lifetime to be a better human in this most painful time of life.

I developed a healthy curiosity around how families differ in their process of letting loved ones pass. I watched my own family and my wife’s family react in completely different ways. I began to soul-search my own experience with death. I relived my childhood experiences with the death of grandparents and pets. I recounted how relatives, parents, and siblings processed the experience of grieving. Knowing that each family and each person develops his or her own “culture” in this area helped me to accept my own helpless ignorance.

I cannot pretend to know what each person honestly needs or wants at this hard time in life, but acknowledging their loved one is a great start. Also, expressing your thoughts, memories, and sympathy is always appropriate and welcomed by the grieving. Offer your willingness to listen or offer to help in any way possible. This is the least you can do for people you have shared a relationship with over the years.

Shortly after the shock of Jesse’s death had subsided, another of my patients, Jane, came in for a minor dental repair. Jane had lost her 16-year-old son in a motor vehicle accident years before. Her son had been a happy, slightly rebellious, robust, energetic teenager. I remember his great smile and his boyish sense of humor. We had not ever talked about her son, Christian, had not spoken of him for years. It was during the Christmas season, and I realized as a parent that the holidays stimulate many memories of the past. In the spirit of acknowledging Christian’s life, I asked Jane, “How old would Christian be today?”

She lifted her chin and smiled. Her eyes focused on my eyes. There was a peaceful glow that emanated from her face. With joy and gratitude in the tone of her voice, she shared, “Christian would be 35. We really had a lot of fun together. I loved him so much.” There was absolutely pure exuberance and celebration of the opportunity that she shared her life with her son. I received another gift of her insight in return for my inquiry.

All of us hope that we are remembered after we leave this earth. After the tears vanish, the families on my dad’s side immediately start celebrating the life of the deceased. We laugh and tell stories of fond memories that we all enjoyed together. We rehash events of the past that touched our lives in many ways. I remember many funerals where laughter was so prominent that it was hard to imagine sorrow was present.

In this process of soul-searching in the area of death and grieving, I realized that we as dentists experience loss in more ways than just death. Patients and families leave our practices for many reasons, but it still feels like a loss. When a patient leaves our practice, it is a mini-death. That loss is real, and stimulates an emotional response. Understanding how you personalize that sense of loss and the emotions that may surface as a result of that loss is an experience that is unique to each one of us. Therefore it is important to acknowledge and recognize those feelings for the benefit of your long-term mental health. Many emotions of grieving are possible many times through out our careers, among them anger, betrayal, loneliness, depression, and rejection. Grieving is an area that should be addressed as part of our education, but the subject has never been addressed in my entire career.

Many dentists complain that we have not had enough business classes or are not trained to run a dental practice. I contend the emotional void may result in a more harmful result.□

*Dr. Foy is a general dentist in private practice in Minneapolis, Minnesota. E-mail is riversidedental@qwest.net.

WHY ARE YOU DENTISTS OFFING YOURSELVES?

In the Doctors Lounge of our office building, a table of seven physicians were sharing lunch together when I plopped down in the remaining chair. I knew some of the men, but several were strangers and a stately old gentleman introduced me around.

After hearing I was a dentist, a young orthopedic surgeon went into a tirade, "What's wrong with you dentists? This guy operates on hearts. This man is doing limbs. That fellow is buried in old people and you guys are just drilling teeth. You dentists are offing yourselves. What is up with that?"
I lashed back, "When you make a mistake, you can bury it; but when we make an error, we see it every six months!"

DENTAL VENEERS VS DENTAL BONDING?

Dental Bonding—This is a process where a composite material is applied to the tooth surface by simple process of etching the enamel with a weak acid and followed by a bonding resin. This is usually a one visit procedure. This bond allows the dentist to place the dental composite material onto the enamel without destroying tooth structure. The dental composite materials are strong and color stable, but they can pick up stain and have a greater risk of fracture over time. A dental composite is a material that is a blend of a plastic resin material and hard porcelain particles. The composites are improving over time due to the dental industry’s hard work and dedication to research in this area of restorative materials. The increasing popularity and demand for an ideal composite has driven the dental companies to develop a wide variety of composite materials that can be used for a variety of dental solutions. Dental Veneers—This is a process where a thin custom manufactured hard porcelain is bonded onto a tooth that is minimally prepared or in some cases with no preparation. . This is usually a two appointment process. The first appointment, after the teeth are prepared or modified an impression is taken; the case is sent off to a dental laboratory for construction of a custom designed smile. There are many variables that go into smile design, but the most important part of the process is communication between all parties involved. Patient-to-Dentist communication is a bi-direction discussion clarifying dreams, wishes and expectations. The dentist needs to explain the risks and possible complications of the procedures and hopefully realistically meet the patient’s expectations within the limitations of the materials currently available. The Dentist and the laboratory will work out an esthetic result that will not only create a dazzling smile, but will also function properly. This planning process is important in order for everyone to have a clear understanding of the anticipated outcome. Smiling is a wonderful way to experience life. Patrick J Foy DDS

RESPECTED IN LIFE AND IN DEATH

'The human face is an empty power, a field of death ...
after countless thousands of years that the human face
has spoken and breathed, one still has the impression
that it hasn't even begun to say what it is
and what it knows.'— Antonin Artaud (1896-1948), artist, from a text to introduce an
exhibition of his portraits & drawings, Galerie Pierre, July 1947.


Cadaver is a strange noun. The word does not convey the reality of a lifeless human body. It gentrifies the leathery, formaldehyde-soaked corpse succumbing to our intimate dissection.

The Gross Human Anatomy course offers a comprehensive understanding of all physical aspects of the human body with a combination of classroom didactics and laboratory dissections. An entire year is devoted, with memorization of all the body pieces and parts.

I approached the class and cadavers with curiosity and trepidation. My own human form made it more relevant than most of my dental courses. But I had some anxiety about my ability to cut up a body and how the act might affect me.

Our first lecture began with a lesson on respect for the dead. Some altruistic person had donated the use of their body to help others gain valuable knowledge. Respect for these human remains must never be violated, with reverence for the solemn result we all reach.

Our cadavers were wrapped in green cloths to retain the moisture with formaldehyde, and the smell was more revolting than the sight. The first exposure we saw several bare backs and some de-skinned musculature. But the view was not distressing, and we were relieved that none of us threw up or passed out.

With the exception of the head and neck, we were gradually introduced to all body parts. Soon we became desensitized to the odor, spending hours manipulating and dissecting the dead. Even as our classmates were humped over a smelly, exposed cadaver it was not uncommon to snack. No body parts were allowed outside the lab, and if tempted, a student would be expelled.

I loved learning about my body through the looking glass the cadavers offered. The black lungs of a smoker and the ravages of cancer were opened and on display for all of us to experience. Here was physical evidence that we may have to live with what we do in life and what we eat.

It reminded me of what the Catholic nuns used to drum into our heads -- our bodies are God's temples and we need to treat them as such.

However, disease is not a judgment, and the anatomical and genetic variations are totally out of our own control. Death was addressed only briefly as a rare outcome of poor judgment or a failure to activate emergency services during a heart attack. This was my introduction to clinical death and daily living with the eventual human mortality.

The heads of our cadavers were unveiled during the second half of the year. Each face was a unique structure with its own distinctive shape, a summation of individual features, nose size, projection, lip fullness, width, eye shapes, hair color, length, hairline, forehead, cheekbones, chins short and long, all singularly spaced to create the silhouette of their humanity. Curiously, the teeth did not seem to matter anymore.

Most troubling to me was that suddenly each individual's face took on the reality of a human life. For months these cadavers had given us hands-on experience with the working organs of what we knew were dead people; but the face revealed a personality and an identity that I was no longer able to deny. The lady with multiple surgeries altering her organ anatomy looked like my seventh-grade teacher. The body known for his well-defined muscle structure was revealed to be an innocent-faced young man

For weeks I was preoccupied about why these people had shared their deceased bodies with science. Should I share my organs, eyes, body parts and pieces that might further the quality of life for someone? Our bodies only decay after our death, so why not help mankind with knowledge that may positively affect the future?

I finally came to grips with the great gift these people were sharing with our class. In their death, they gave the gift of knowledge that allows us to give better treatment for hundreds of our patients now and in the future.

The temples of these anonymous lives were our teachers, and their souls are left in God's good hands.
-- Patrick J. Foy, DDS

The Smile of Your Dreams

Bleaching teeth has become a common procedure in most dental offices and it has grown in popularity over the years. There are many over-the-counter bleaching products, in-office bleaching and a wide variety of methods and techniques currently available. The efficacies of bleaching products are dependant on simple chemistry. The amount of time the bleach is left on the tooth and the concentration of the bleach product will determine how fast and effective the whitening process will be. If you have had fillings or crowns in your mouth you should be aware that the bleaching products will not alter the color of your previous dental work. Therefore it is wise that you consult with your dentist before you begin to use any of these products. In some cases the bleaching process may cause an increase in sensitivity especially if there is gum recession present. These special circumstances can be successfully managed with consultation and planning with your dentist. Recently, I personally have become an enthusiastic fan of the new Crest Whitestrips Supreme that is available through your dentist’s office. They are about 80% more effective than the over the counter Whitestrips. There are other professional bleaching products that can be placed in custom mouth trays and this process in some cases may be more desirable. Whatever bleaching technique you decide to use, I recommend discussing with your dentist the options available and the risks and benefits of each system. Today it has become easier and more economical than ever to have the smile of your dreams. Patrick J Foy DDS

WHAT WILL BE IN YOUR BOX?

“Treasure the love you receive above all. It will survive long after your good health has vanished.”

Og Mandino quotes (American Essayist and Psychologist, 1923-1996)


Joe was a fifty-year-old Iowa optometrist who was diagnosed with an aggressive form of brain cancer. He decided to continue to practice as long as he felt capable, but eventually the tumor would win out.

One cold January day, he drove to work as he had for more than twenty years and began a typical morning. After he had completed a few eye examinations, he was startled to find something subtle had changed in his motor skills. It hit him hard to realize that his health had finally deteriorated to the point where he could no longer work. All the years of education and career challenges suddenly stopped; it was time for him to go.

Without notifying his staff, Joe found a small cardboard box to pack up his belongings. He walked around from room to room searching for the treasures of his life, gathering all the personal items that he wanted to take along. But now the common things that he had used daily took on a new and different value. He was amazed at the simple mementos he collected. The picture of his three daughters when they were toddlers crammed into a wading pool, the fathers day present of a mug that read ”World’s Greatest Dad”, framed pieces of art that one of his daughters painted in grade school, and many other small tokens of love from family and friends that filled the box with twenty years of joy. Not one item in the box had anything to do with his career; everything had to do with the people he loved.

Joe walked to the front desk where his staff standing by and quietly announced, "I'm done.” Then he limped to the door, clutching his precious box, and left work for the last time.

-- Patrick J. Foy, DDS

Controlling The Cost Of Dental Care

"I just don't have the resources now," is commonly heard during tough times.

The best way to control dental costs is to use aggressive preventive measures. Keep up on your regular cleaning appointments, and ask your hygienist and your dentist what they recommend to keep your teeth and mouth healthy.

Unfortunately, even with good planning and good preventive care, unexpected dental needs may arise. What is one to do? Delaying treatment may lead to more pain or more expense. Poor oral health has been linked to many systemic ailments including heart attacks, diabetes, low-weight births and other issues. But, it is never too late to improve your health.

This is a time to ask your dental office for a strategy for current and future health. Some offices have payment plans and arrangements with credit companies to help patients during this time of need.

More people lack dental insurance than medical insurance. The structure of dental insurance is a "defined benefit" of the specific services it will help you pay, from a few hundred to a couple of thousand dollars per calendar year. However, it is not designed to insure you against major, unanticipated problems.

For those who pay out of the pocket, dental care is generally a good value, a bargain in maintaining your health.

John P. knows something about dental bills and costs; he is an accountant who is finally having dental implants to fill in the gaps of missing teeth at a cost of $7,000. His dental insurance will cover only $1,500.00, his maximum benefit for the year.

As a successful accountant who is informed on the tax laws, John is using two accounts to help cover his portion of his dental expenses. First, his employer has a flexible-spending account and he has set enough pre-tax dollars to help with this "planned expense.”

Second, John has a high deductible health insurance policy, so he has the ability to fund an HSA (Health Savings Account), which was set up a couple years ago and can be used for health-related expenses. He knows if he does not use the dollars in his HSA each year, the account can grow through investments (tax free) for years to come.

"I want my mouth to be whole again," John said.

You can have the smile you deserve if you make dental health a priority, and understand that a healthy mouth is a life-long gift. If you look good, feel good and you are healthy, then you are wealthy beyond means.

Evidence-Based Dentistry in My Practice

The American Dental Association defines Evidence-Based Dentistry (EBD) as: Evidence-based dentistry is an approach to oral healthcare that requires the judicious integration of systemic assessments of clinically relevant scientific evidence, relating to the patient’s oral and medical condition and history, with the dentist’s clinical expertise and the patient’s treatment needs and preference What does that mean in regards to our patient’s dental care now and into the future? Does the evidence limit the patient choices of treatments? EBD should only be looked at as just another “tool” in the decision making process in the practice of dentistry. It is far from a cookbook to treatment plans, but it may allow dentists and patients an opportunity to review the body of evidence that exists before clinical treatments are rendered. Patient needs and patient’s preferences must always be considered in determining what ultimately acceptable dental treatment for each clinical situation. Sharing and informing the patient of the body of evidence that exists in the area of their treatment needs is good way to incorporate EBD into practice. It is also important to inform the patients of what and when reasonable alternatives exist, so the patient can be fully be involved with the decision making surrounding their dental care. The internet has become a great resource for information, but sometimes it can be used as a marketing tool for new products. Therefore knowledge of the science and its applications is crucial in evaluating the credibility of the “so called” studies and the validity of the body of evidence presented. It is also important to understand the principles of scientific studies and how their results should be weighted in their clinical relevance to a specific clinical question. Simply put; Does the study results apply to my current clinical problem? Co-diagnosis and treatment planning should be an open dialogue that takes into consideration all aspects related to dental care. Second opinions and consultations with specialists should be considered, more information is always welcomed when their expertise or opinions would offer alternative treatment options that could benefit the patient’s outcome.

SILVER FILLINGS There has been a lot of debate around the risks and benefits of silver fillings, especially over the fact that the amalgams (silver fillings) still contain some elemental mercury. The amount of studies conducted over the years on silver fillings would have one think that all the questions regarding its use in the oral cavity would be answered by now. Guess again. It is un-ethical for a dentist to remove an amalgam that is intact and serviceable, unless a patient specifically requests that specific service knowing that its removal also has some risks. Many old amalgam restorations can last for several years. If the tooth or the filling is cracked and if there is leakage with decay associated with an old amalgam, then it is wise to remove it and restore the tooth again. Choice of materials today is much different than it was only a few years ago. Some insurance companies have a much higher co-pay if the patient chooses something other than amalgams, but the costs should not be the only consideration when it comes to “ideal treatment” for your specific tooth. Other insurance companies will cover composites at a higher level than others. The insurance industry seems to be in a state of flux at this time in this area. The look and feel of your teeth and mouth is a personal choice. Large silver fillings have a tendency to make the tooth appear gray and even darker over time than the rest of your teeth. Also when choosing the color of the restoration you should ask yourself if you are happy with the current color of your teeth, if not then before your choose a restoration you may want to consider a color change before a colored restoration is placed. There are simple inexpensive bleaching techniques that can lighten your teeth quickly and easily. Silver fillings can last a long time and they usually can be done in one visit. They may be a little more sensitive to hot and cold initially due to an increase in thermal conduction. In rare cases some people may actually be allergic to the amalgams. If you are concerned about the presence of Mercury in your mouth then please talk to your dentist about those concerns. Together you can decide what would be in your long term best interest. The FDA has an advisory posted on their web-site at http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DentalProducts/DentalAmalgams/default.htm and the American Dental Association also has information on filling choices at http://www.ada.org/public/topics/fillings.asp

STATE FAIR FERRIS WHEEL My dating experience as an adolescent was like a small child touching a hot stove. Regardless of my intellect and hoards of advice from my older brother to not touch, I always seemed to end up with my ego burnt one way or another. The boyish desire for a girl to “like me” drove me to behave irrationally during that dreaded mating season of life. The painful memories of personal acts of stupidity and my complete ignorance of women and their mysterious needs still haunt the current perception of my male machismo.
I find it ironic that the following poem by one of my favorite humorists uses the word “promising.” I would replace it with the word “humiliating” in light of my memory of a blind date at the Fair.

I see nothing in space as promising as the view from a Ferris wheel. E. B. WHITE

Back when we were teenagers, a close friend and his girl arranged a blind date. They set me up with the girlfriend’s best friend. They thought that we would make the perfect couple. Plans were set to attend the State Fair that was in full swing. I love roller coasters, sky rockets, Ferris wheels, and rides that go up and down; but I can not handle rides that spin. Our blind date progressed along in a very cordial manner with us enjoying Pronto Pups, snow cones, and mountainous pink clouds of cotton candy. She was impressed with my adept skills while playing the games of the Midway’s arcade. I took pride in winning trinkets and keepsakes with which she could adorn her beautiful body and would serve as mementos of our perfect first date. We did seem meant for each other. The infatuation was untarnished until it came time to decide which rides we would experience together. She loved the rides that spin endlessly and I like the rides that go high. She hated heights, but she sought to be dizzy. Dizzy in my world translated into motion sickness, so this was the first test to this fresh relationship.
She insisted to make her happy she needed to spin and I reluctantly acquiesced in order to please her. The compromise we mutually agreed upon was that I would go on the Scrambler with her, then she would go on the Ferris wheel with me.
The Scrambler ride was just as I expected; the thrust and spins pushed our hot bodies crushingly together as we spun around and around. I would have enjoyed my body being rhythmically pressed up against this woman’s body if it were not for my stomach feeling as if it were ready to erupt. I exited the ride looking and feeling green with motion sickness. Trying desperately not to reveal my real pain, we proceeded to my preferred ride, the Ferris wheel.
The bright lights and multicolored splendor of this massive Ferris wheel invited couples to line up in order to be strapped in the rocking seats, cheek to cheek. There was not an empty car on the Ferris wheel as we began to rotate high into the cool dark evening skyline. Once we were hovering over the love birds seated immediately below us, my stoic self-control failed. I blew my cookies far and wide; showering the crowds with my stomach’s contents, splattering their heads, clothes, and anything exposed to my line of fire. I still can hear the groans of disgust from the unlucky victims from below.

"I see nothing in space as humiliating as my view from the Ferris wheel " Pat Foy Needless to say, I did not get a goodnight kiss and my ego was too fried to attempt any recovery from that regretful night’s first date. Life is learning; and sometimes it takes some spins on a Scrambler to really get that lesson across.

THE LAST LAUGH

THE LAST LAUGH We sat the patient back in the dental chair and we had planned on repairing a filling that morning when through the humming of a dental office we hear an electronic generated voice “It is now nine o’clock AM.” It was coming from the patient’s wrist watch. I immediately lost my professional poise and pulled away from the patient to laugh uncontrollably. The flashback triggered a huge memory rush that continued for a short while, until I was able to get my composure under control. I knew that my unusual response to her talking watch needed some clarification. I proceeded to explain. Two months previous my mother had passed away quite suddenly in Sioux City, Iowa. Both my mother and my sister lived there in Sioux City. My mother died in her apartment on a Monday evening, but she was not discovered until Tuesday afternoon. The family was notified and we planned over the phone to have a Friday evening wake and a Saturday morning funeral. As soon as I could get to Sioux my sister and I would make arrangements with the funeral Director. I lived in Minneapolis and the trip to Sioux City was about five hours away by car, so we made an appointment for 2:00 PM on Thursday with the funeral Director in his office. Years before my mother had passed she suffered from macular degeneration and she slowly started to loose her ability to see. She lost her vision looking straight ahead, but she could see shapes and shadows only in her peripheral vision. She was able to navigate the neighborhood by herself, but in new settings she would need assistance. She began to use the state services for the blind and the family helped by purchasing aids and tools for the blind. She had a watch that would electronically announce the time every hour, on the hour, all day long. She also could push a button on its side anytime she wanted to know the time. When she first lost her vision she became depressed due to the fact that the local radio and television news were her source of information. The local media’s focus was mainly on tragedies and ambulance chasing. The Iowa Services for the Blind provided her with a cassette tape machine so that she could listen to books on tape. She also could order all kinds of reading material on tape. Vision loss was a gift in disguise because she would listen to books on tape that she may not have read if she still had her vision. Reading or listening to books on tape broadened her perspective on life and counteracted life’s depressing news. Wednesday at 2:00 PM my sister Betty and I were seated in the funeral Director’s office and we were told to wait for the funeral director. It was a dark dimly lit room that had a huge dark wood desk for the Director. His desk was cluttered with samples of funeral paraphernalia, i.e.: copies of printed prayers, sample cover photos that were religious and non-religious, price sheets, and more. We sat there waiting somewhat uncomfortable in these morbid surroundings and anxious to get it over with. The time passed at a snails’ pace. Five minutes seemed like an hour and we did not hear or see anybody. At ten minutes we were restless and wondering if he had forgot about us. We began to roam around the room reading his diplomas and his licenses on the walls. You could not see outside through the window due to the fact that it was frosted colored glass. Finally, the door opened in walked a black suited tall pale man with graying hair. He reminded me of the character “Lurch” on the old TV sitcom “The Adams Family”. I had not met the Director before, so I assumed that this was him. As he entered the room he did not say hello or greet us in any way. He did not apologize for being late. He continued to walk towards us and walked up behind us and finally in a deep, soft, and somewhat hoarse voice he whispered” You never told me that your mother had a talking watch.” Immediately I visualize this man laboring over my mother’s dead body and out of no where a woman’s voice announced “It is two o’clock.” The potential terror and shock suddenly tickled every funny bone in my body. As I attempted to contain my amusement I looked over at Betty and she too had that glimmer of joy boiling over inside. We sat there like two school kids unable to look at him or at each other without breaking out in giggles. Mom had given us one last laugh and we had to share it in irreverent silence.

5 Reasons You Need a Dental Home

5 REASONS YOU NEED A DENTAL HOME by Patrick J Foy DDS 1) Trust 2) Continuity of care 3) relationship-based care 4) Dental/systemic relationships 5) Strategic Long-term Planning; retirement, travel, college and geographic transfer 1) Trust has been the hallmark of healthcare since the beginning of time. That feeling of trust, believe or not, should be mutual in order for patients and their providers to succeed in maintaining optimum dental health. A famous dentist who was considered to be the father of comprehensive care in dentistry stated “Do not treat strangers”. Selfishly I have adopted that philosophy in my private practice, so I attempted to honestly get to know my patients and their families. In return I also try to treat them as if they were a part of my family. I will not recommend dental treatment that I would do on myself or on one of my own family members. I will also attempt to reveal my bias in specific areas, so that patients can make their own independent decisions around their care. 2) Continuity of care; This is an under-valued entity in healthcare today, but in dentistry I have had the extreme luxury to see many of my patients over twenty-plus years. During that period of time you honestly get to know their oral health and the condition of their teeth. When I look in the mouth during a periodic exam I am not only seeing their mouth today, but I have a historical perspective that is invaluable. That continuity allows me to understand if the disease rate is active or stable. Any sudden change in oral health alerts us to some life changing event or change in general health. Trends or a change in health is better than snap shots. 3) Relationship based practice: Relationship ; definition: Behavior or feelings toward somebody else: the connection between two or more people or groups and their involvement with each other, especially as regards how they behave and feel toward each other and communicate or cooperate
Encarta ® World English Dictionary © & (P) 1998-2004 Microsoft Corporation. All rights reserved. The idea of communication, cooperation and respect for each other is the goal that can be achieved when the doctor/patient relationship extends beyond the dental chair. It is mutually rewarding to both parties in the pursuit of their own personal dental health. 4) Dental/Systemic Relationships; Research has revealed that there are several oral health and systemic health relationships. Low-birth weight in some studies has been linked to periodontal disease. Cardio-vascular diseases, Diabetes, digestive issues and many other problems yet to be discovered to have a possible oral connection, but I contend that it only makes sense to keep all systems as healthy as possible. The links may be immaterial if you unable to keep all systems as healthy as possible. 5) Strategic Planning: This is an area that few people consider when they visit the dentist, but you must understand dentists have seen people transition into different life events through out their practice life. That accumulation of re-occurring experience of human behaviors gives most practitioners a unique insight into the future of typical problems and concerns. The normal cycle of life plays out everyday in most dental offices, so your dentist may help you into your next expected or unexpected transition. Patrick J Foy DDS