Staying Fit on the Road

April 8th, 2014

By Dr. Uche Odiatu, B.A., DMD, NSCA Certified Personal Trainer

woman deciding whether to eat apple or chocolate

Travel, whether it is for business or pleasure, does not necessarily mean throwing all of your hard work in the gym out the window. There are proactive steps that will ensure your trip takes you closer towards your health and fitness goals rather than farther away.

“Twenty years from now you will be more disappointed by the things that you didn’t do than by the things you did. So throw off the bowlines. Sail away from the safe harbour. Catch the trade winds in your sail.  Explore, dream, discover.”

~Mark Twain

  • Affirm to yourself the importance of staying true to your nutritional goals before you leave. Remind yourself of the hard work and effort you have put into your training. Decide ahead if and when you will allow yourself to have a treat night. This will give you peace of mind and the strength to say no to the free airplane cookies.
  • Call the hotel and find out if they have coffee makers in the room. This will be very new for you. You can use this to prepare hot water for instant oatmeal, which you can easily bring in a Tupperware container (bring your own electric kettle if there is no coffee maker). Pack a plastic bowl and a spoon for easy in-room dining. This will save you time and money in the morning. Mix in some tasty chocolate whey protein powder and/or nuts for a great start to your day!
  • Call ahead and pre-order your airplane meals at the time of booking. You can request meals that are low in fat, kosher, vegetarian, or sodium-free to name a few. The bonus about special ordering is that you are often served before everyone else.
  • Pack healthy snacks in your carry-on luggage. Vegetables, fruit, rice whole wheat pitas, nuts, protein bars, and meal replacement shakes will come in handy if you are delayed. Don’t forget your “shaker bottle” for the protein shakes!
  • Drink plenty of water before you leave and remember to stay hydrated during the trip. A well-hydrated body is less prone to jet lag, headaches, and water retention. Avoid alcohol and coffee on the plane as they both can dehydrate you.
  • Don’t let boredom tempt your taste buds into mindless eating. Bring your laptop, a book, a journal, or a copy of your favourite dental or fitness magazine to keep you occupied. Did you know there are many inspirational books available for your Kindle or Kobo?
  • Hit the grocery store as soon as you arrive at your destination. Stock up on non-perishable food items for your hotel room. Excellent choices are bagels, apples, rice cakes, bananas, nuts, rye bread, tuna, and salmon (buy the cans with the pull-off lids if you forgot a can opener). This idea will save you from the late night “hotel vending- machine munchies”.
  • If you are travelling with people who have free license to eat and drink, ask for their support before you leave. Sharing your goals will get them on your side and will save you from the teasing as you reach for your filtered water and your fifth can of wild salmon or Greek yogurt.
  • Maintain your discipline at restaurants by asking for special food preparations. Ask for grilled or broiled meat, sauces and dressings on the side, egg white only omelettes, and steamed vegetables. Everyone will admire your willpower.
  • Make sure you are well rested on your trip. It is easy to make poor food choices when you are lacking energy. Like Vince Lombardi (famous football coach) said: “Fatigue makes cowards of us all.”

There is more to travelling than wining and dining. Remember to have FUN and to create some lasting memories of your trip. Instead of focussing on food, try different activities, meet new people, and enjoy your surroundings. By keeping your self promises you will increase your focus and strengthen your commitment to your personal health goals. Everyone will be amazed and surprised when you return from your trip in better condition than when you left!

 

OdiatuDr U.Odiatu DMD is the author of The Miracle of Health and Fit for the LOVE of It! This busy dentist is also an NSCA Certified Personal Trainer and a professional member of the American College of Sports  Medicine. Www.fitdentist.com

Forensic Odontology

March 3rd, 2014

By Dr. Rick Cardoza

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The field of forensic odontology is that area of dentistry concerned with the application of law in both criminal and civil proceedings. There are two disciplines within forensic odontology, postmortem identification and bite mark (pattern injury) analysis.  Forensic odontologists also assist authorities with multiple fatality incidents, age determination based on tooth development, recognition of child abuse/intimate partner violence (IPV) and participate in civil proceedings as an expert witness.                                                    

    

Dental Identification

As forensic dental identification specialists, we are typically the last conventional option for postmortem identification.  DNA is also now utilized but due to its high cost and the extensive time required for analysis, it is used sparingly or when absolutely no other option exists. Other forms of postmortem identification include visual, personal effects, fingerprints, scars, marks, tattoos, and medical radiographs.

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Forensic dental identification has been successful because of the nature of the human dentition.  The enamel is the hardest substance in the body and the only exposed portion of the skeletal system (fig. 1, 2).  Teeth are very resistant to thermal damage, blunt force trauma, and the dentition remains stable during tissue decomposition.  In addition, the dentition is unique to a specific individual.  This includes not only the morphology of the coronal portion of the tooth but the morphology of the roots, pulpal chamber, and their relationship to their surrounding structures (i.e. sinus proximity, mandibular canal proximity, interproximal bony trabecular patterns etc.).  Following the natural dentition, if you add man made dental restorations, the unique combination for any given individual can factor into the millions.

There are numerous important reasons for identifying the deceased.  A legal certification of death is necessary to consummate legal matters such as life insurance, wills, etc.  There are family and personal reasons as well (closure).  In criminal investigations, it is important to establish the identity of the victim in order to proceed with the criminal investigation and to identify the suspect.  In a fire for instance, the bodies are often burned beyond visual recognition (fig. 3).  Personal effects are also destroyed or lost in the fire. Even if the personal effects are recovered they may not be considered reliable due to the typical calamity which surrounds a fire.  A forensic anthropologist will examine the remains of the skeletal system and can then determine age, race and sex of the victim.  Positive identification is best performed by examination of the surviving dentition by the forensic odontologist.  In a fire where the temperatures may be very high (1000°C) even the dental remains may be destroyed.  Crowns may fracture or explode leaving only the roots.  The bone may also be completely consumed leaving only scattered roots with no bony sockets for reference.

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Forensic dental identification is most often accomplished by the comparison of the radiographs of the teeth of the decedent (postmortem) with the dental radiographs obtained from the dentist of the suspected victim (antemortem) (fig. 4, 5).  Ideally the antemortem radiographs furnished should be the original full mouth series.  Often this is not the case.  Children’s radiographs are typically bitewings only unless they have orthodontic records as well.  Often times duplicate radiographs, not the originals, are sent and have been either poorly duplicated and/or are not labeled right and left for orientation.  In addition, the antemortem radiographic image may be of poor quality due to improper operator technique (cone cuts, overlapping interproximals, elongation/foreshortening, etc.) or poor processing (contrast, burned images, etc.).  When poor antemortem radiographs are compared to an ideal postmortem radiograph, the two may not appear consistent. This could seriously hamper the identification effort.

In forensic dental identification, we stress that good quality, properly mounted and labeled original antemortem radiographs be sent for comparison.  In addition, copies of the victim’s dental treatment progress notes should be submitted as well.  This allows the forensic dentist to verify dental treatment that was performed subsequent to the date of the radiographs.

It is important as practicing dentists to keep complete patient records on file and continually update them, including the radiographs.  One of your records may be needed for the purpose of a postmortem dental identification.

Bite Mark Analysis

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The study of bite marks involves the analysis of teeth contacting another object or medium. Thus, bite mark analysis is a type of forensic pattern analysis similar to tool mark analysis.  Unlike dental identification which is a quantitative analysis, bite mark analysis relies on the odontologist’s interpretation of the pattern therefore bite mark analysis is primarily subjective in nature.  It is for this reason that bite mark opinions, though based on scientific methods and principles, can be highly variable based on the individual’s interpretation of the pattern injury resulting in experts often giving different levels of opinion on the same pattern injury.  The consequence we see today is that bite mark analysis has become highly controversial and in the United States there have been twenty four exonerations by DNA testing of individuals after they had been previously charged or convicted where the charges/convictions were based partially on faulty bite mark evidence.

The study of bite mark analysis involves the comparison of the pattern injury or bite mark to the suspect biters dentition.  The classic appearance of a bite mark is two semicircular or ovoid arches that oppose each other with a central ecchymosis (fig. 6).  The bite mark pattern is photographed from multiple angles with a scale present for reference.  In addition, the bite mark is swabbed for possible suspect DNA.  On the biter it is necessary to take full arch dental impressions of both the maxillary and mandibular arches.  In addition, complete dental charting of all the present, missing, and restored teeth including charting anomalies such as fractures, spaces, rotations, etc., wax bites, and intraoral photography.  If the accused suspect biter is in jail then collection of these records will require a court order and the individual has the right to have his attorney present (note: the biter could also be the victim who bit their attacker in self-defense).

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Once all the records are collected on the bite mark and the suspect biter then the odontologist can complete his analysis.  The analysis consists of a comparison of the bite mark photo which has been digitally resized to life size 1:1 proportions to an overlay of the incisal/occlusal edges of the suspect biters teeth.  This is accomplished by creating a digital hollow volume overlay of the dental models by scanning the models, using a flatbed scanner, into the computer (fig 7).  Then with the use of photographic software the incisal edge overlay can be inverted and superimposed onto the bite mark pattern photo for comparison and analysis (fig 8).

Finally, the odontologist will submit his report to the entity that retained him.  In this report the odontologist will list all the steps he took to complete the analysis and formulate an opinion.  The range of opinions include: The Biter (absolute), Probable (more likely than not), Possible (cannot be excluded from suspect biter population), Exclusion (did not make the bite), and Inconclusive (not enough data or poor quality data to formulate an opinion).

In summary, forensic odontology is an exciting field where dental health care professionals can utilize their skill and training in dentistry for a field complete outside of dentistry.  Choosing a career path as a forensic odontologist or forensic dental autopsy technician (the auxiliary’s role in forensic dentistry) should not be viewed as a hobby but in fact a second career in addition to your primary career in the field of dentistry.  The hours can be long and the monetary return low or even non-existent but the personal reward and satisfaction can be great.

 

Cardoza

Dr. Cardoza is a forensic dental consultant for the County of San Diego Office of the Medical Examiner, County of Imperial Office of the Coroner, State of California Department of Justice and is the Director of the California Dental Identification Team (CalDIT).  Dr. Cardoza graduated from Northwestern Dental School in 1985 and maintains a general dental practice in El Cajon, California. Dr. Cardoza is a Fellow of the American Academy of Forensic Sciences and is a Diplomate of the American Board of Forensic Odontology.

 

Oral Cancer – A Patients Perspective

February 4th, 2014

By Eva Grayzel

Eva Grayzel, a professional interactive performance artist, was diagnosed with late-stage oral cancer at age 33 and told she had a 15 percent chance of survival. A non-smoker, she was bounced among dental professionals while the ulcer on her tongue grew more prominent and painful. “It was two years and nine months from my first appointment with a dental professional until the day I was finally diagnosed with stage IV squamous cell carcinoma of the lateral tongue. During that time, no one EVER mentioned the words ‘oral cancer’ as a possible cause. Finally, I made an appointment with Dr. Mark Urken, the chief of head and neck surgery at Beth Israel Medical Center. I took the bus into Manhattan that fateful day of April 1, 1998 not having the slightest idea that what was on my tongue was remotely serious, and received the cruelest April Fool’s joke of my life.”

Eva

Eva endured a partial tongue reconstruction, a modified radical neck dissection and a maximum dose of radiation therapy. Through an extraordinarily successful treatment plan, Eva not only survived but also regained her ability to speak clearly. With a second chance at life, Eva couldn’t let the same thing happen to someone else. A champion for early detection, Eva founded Six-Step Screening™, an oral cancer awareness campaign for dental professionals and the general public. For her initiative, she was recognized by the American Academy of Oral Medicine and awarded honorary membership.

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After speaking at the 2003 ADA Annual session, Eva realized the impact she could have on saving lives by sharing her personal story. The audience doesn’t just hear her story, they ‘experience’ it, as they travel the journey with Eva from a delayed diagnosis of late-stage oral cancer, through the surgery and treatment. When dental professionals hear Eva’s presentation they say, “I never want what happened to Eva to happen to any of my patients.” Because of the personal nature of her story, and the fact that someone such as themselves could have prevented it, motivates them to change how they practice. In contrast to the clinical perspective at educational conferences, Eva humanizes oral cancer, inspiring the audience both professionally and personally. “I share my personal story hoping it will inspire dental professionals to perform oral cancer screenings on all their patients, as well as demand them for themselves and for those they love. Together, we can save lives. It’s more than my mission to educate. It’s my tribute to all those that came before me and my obligation to those that will follow. By publicly sharing my personal journey to help others, I’m gaining back all the years and more of life that oral cancer took from me.”

 

GrayzelMs. Grayzel a nationally recognized Master Storyteller was diagnosed at age 33 with stage IV oral cancer and given a 15% chance of survival. After regaining her deep vibrant voice, Ms. Grayzel applied her stage skills to communicate the depth of her experience in a unique and powerful way. A champion for early detection, Eva founded the Six-Step Screening™ oral cancer awareness campaign for which she was recognized by the American Academy of Oral Medicine. Ms. Grayzel is the author of two children’s books, ‘Mr. C Plays Hide & Seek’ and ‘Mr. C the Globetrotter,’ in the Talk4Hope Family Book Series.

Teeth Healthy Snacks for Kids

January 6th, 2014

By Dr. Andrea Beltzer

Happy carrot chomping girl

Feeding my kids isn’t always easy.  As parents, we are constantly bombarded with information about what is healthy and what is potentially harmful for our children’s little bodies.  As a parent, I take these decisions very seriously knowing that the choices I make for my kids now will likely impact the choices they will make for themselves when they are older.

I have two children, Lucy who is five and Charlie who is two.  They couldn’t be more different in their eating preferences and habits.  Lucy has a major sweet tooth.  We were recently at her friend’s birthday party at OaksPark.  There were lots of treats being served, including lemonade, fruit punch, cotton candy, chocolate cupcakes, and cups of ice cream.  The kids were sitting at a long picnic table, and the adults were chatting at another table.  It was crowded, and I wasn’t really keeping a close eye on what Lucy was choosing to eat at the other table.  As the kids’ table emptied out, Lucy was still sitting there finishing her chocolate cupcake after having a cup of lemonade, most of her cotton candy and the cup of ice cream.  Most of the other kids had abandoned their treats half-eaten, but not Lucy.  This was her chance, and she was going to consume as much sugar as possible in one sitting, since I wasn’t right there to monitor what she was eating.  I went over to her, and we had a little conversation about making good choices, and how eating all of those treats so quickly was probably going to make her feel a little sick later on.   Then I proceeded to try to wipe off all of the gooey chocolate and sticky cotton candy that was all over her face and hands and have her drink a cup of water to try and neutralize some of the acid that was being produced by those sugar-loving bacteria in her mouth.  Some of the parents who were standing around us chuckled with me knowing that I am a pediatric dentist, and it’s my kid who is the last one sitting at that picnic table trying to devour every last gram of sugar that she can.  Parenting fail?  No, not really.  I was more amused by the situation than embarrassed.  I know that what really matters in the long run is the every day choices that we make, not the very occasional big treat that sometimes happens during special occasions and holidays.

Charlie, my two-year old, is the exact opposite of Lucy in many ways, including his eating preferences.  He enjoys something sweet here and there, but will typically have a few licks of a popsicle after dinner in the summertime, and then decide he’d rather get down and play instead of finishing his treat.  My challenge with him is that he’s a grazer.  He is two years old and easily distracted, so unless he is starving, mealtime can take a very long time, and sometimes can result in him not eating much at all.  As a result, he likes to snack or “graze” in between meals.  His top choice of snack would be crackers or chips, and he could graze on chips and crackers all day long if we let him.  We know though that a diet of chips and crackers is not good for his body or his teeth!

Many parents are surprised to learn that even snacks like crackers can contribute to tooth decay.  Any snack that is rich in carbohydrates can lead to tooth decay, even it’s not necessarily considered a “sugary” snack. This is particularly true for kids that tend to graze all day long on carbohydrate-rich snacks, including crackers, chips, cereal bars, fruit snacks, raisins and dried fruits.  Studies have shown that it is not only the quantity of sugar consumed that can lead to decay, but it is also the frequency with which the sugars are consumed.  It is much worse for a child to sip on juice or snack on crackers if they are sipping or snacking over a long period of time, than if they were to have a few ounces of juice with their breakfast.  I’ve alluded to the role that bacteria play in tooth decay.  We all have bacteria in our mouth and some of these bacteria are responsible for contributing to decay.  The bacteria consume the sugars that we consume, and then produce acid which breaks down tooth enamel causing cavities.  If the bacteria are fed all day long by those who graze on carbohydrates throughout the day, they are constantly producing acid, and the mouth remains at an acidic pH for long periods of time which results in tooth decay.  Preventing your children from grazing throughout the day on carbohydrate-rich snacks is important for the health of their teeth.

Limiting juices, flavored milks, and other sweetened beverages, as well as encouraging your children to drink a lot of water in between meals can go a long way to prevent cavities.  Chewy snacks that are high in sugar, such as fruit snacks, raisins and dried fruits should be avoided in general, but especially for children with deep grooves on their molars.  These snacks really stick to teeth and are hard to remove from teeth even with good tooth brushing.

I have discussed a lot of things to avoid, so now I will talk about some of my kids’ favorite “teeth-healthy” snacks.  My kids love avocado, and that makes a great snack all on its own or sliced lengthwise with sliced turkey or ham rolled around it.  If your child is old enough and doesn’t have any nut allergies, nuts are a great snack food too.  My kids love almonds and cashews.  Whole fruits (not dried) and veggies are great.  My kids really started taking more of an interest and were more adventurous with trying different fruits and veggies when we planted a vegetable garden.  They love picking strawberries, cherry tomatoes and yanking carrots from the ground in their own backyard!  Other favorite fruits and veggies in our home are celery sticks with cream cheese, apple slices, Satsuma oranges, and carrot sticks.  Bananas are always a good portable snack when you are on the go.  They are nutritious and filling.  For kids that can tolerate dairy, cheese sticks are another easy “tooth-healthy” snack.  My kids also really love hummus, and almost any veggie tastes good dipped in a little hummus.  Costco sells boxes with individual servings of hummus that are very convenient for snacking.  Olives are popular in my house, not only because you can have fun putting them on your fingers but because they taste good too.  I also try to ask Lucy for ideas when I think she is getting bored with our usual lunches and snacks.  She often sees her friends at school eating things that I would never think to pack for her!  One of her school friends often enjoys red peppers stuffed with tuna salad for her lunch.  I would never think that a 5-year-old would enjoy something like that, but Lucy was interested in that because she saw her friend eating it.  Now she loves red bell beppers!  For some reason, kids always think their friends’ lunches look better than their own, so ask your kids what their friends are eating, and if they are interested in trying some new things!  You might just be surprised at what your kids will eat!

 

090725PTTBBELTZNERA11Dr. Andrea Beltzner received her certificate in Pediatric Dentistry from the University of Connecticut in 2007, and became board-certified in the specialty of Pediatric Dentistry in April 2008.  Along with her husband, adorable children and  two adorable dogs, Dr. Beltzner lives and works in Portland, Oregon. Passionate about helping underserved children receive the dental care they so desperately need, Dr. Beltzner volunteers regularly at Creston Children’s Dental Clinic, on the Tooth Taxi, at the annual Children’s Health Fair along with being a co-lead for the pediatric department at Oregon Mission of Mercy, and a volunteer on the Emanuel craniofacial team.

Dental Emergency First-Aid

December 12th, 2013
By Dr. Weston Heringer, JrTooth First aid

Dental emergencies, especially with children, can happen any time.  Listed below are the most common types of emergencies and what action to take following the emergency.   It is always better to be prepared!

  • TOOTHACHE Clean the area of the affected tooth thoroughly.  Do not place aspirin on gum tissue or aching tooth. If face is swollen, place cold compress to the outside of the cheek.  Contact a Dentist.
  • CUT OR BITTEN TONGUE, LIP OR CHEEK If there is bleeding apply firm but gentle pressure with a clean  cloth or gauze. If swelling is present, apply cold compresses. If bleeding doesn’t stop readily or bite is severe, contact a Dentist.
  • BROKEN TOOTH If center nerve of tooth is exposed or center shows pink color contact a Dentist immediately.  For comfort, the injured area may be covered with a moist warm cloth.  If edge or corner is broken seek care at your convenience.
  • KNOCKED OUT PERMANENT TOOTH   Time is critical, find the tooth.  Quickly rinse the tooth, if possible, and reinsert it in the socket.  Have the patient hold the tooth in place. A tooth that cannot be reinserted should be kept moist.  The patient must see a Dentist immediately.
  • KNOCKED OUT BABY TOOTH  Primary teeth are not reimplanted, if you have questions about the injury, contact a Dentist.
  • BLEEDING AFTER BABY TOOTH FALLS OUT  Have the child bite on a folded gauze placed over the bleeding area for 15 minutes.  If bleeding persists contact a Dentist.
  • BROKEN BRACES AND WIRES  If a broken appliance can be removed easily take it out.  If it cannot ,cut it off.  Cover the sharp or protruding portion with cotton , chewing gum or wax.  Loose or broken appliances do not usually require emergency attention.
  • POSSIBLE FRACTURED JAW If suspected, contact a Dentist immediately or take the  individual to Hospital Emergency Room.
  • COLD/CANKER SORE  Over-the-counter preparations often give relief. Stay away from salty or acidic foods.  If sores persists over two weeks contact a Dentist.

 Editors Note: Please consider this non clinical advice and always consult your dentist with any questions or concerns.

Dr Weston Heringer

Dr. Heringer is a retired pediatric dentist and has served on 19 overseas dental trips. He operated a private practice in Salem for 30 years with a satelite office in Lincoln City for 26 years. For the last two years of his career he was the full time dentists on the Tooth Taxi, a mobile dental van providing free care to children in Oregon. Dr. Heringer is a past president of the Oregon Dental Association and is a board member of the Dental Foundation of Oregon.

 

 

Weight-training…an Anti-Aging Tool?

November 4th, 2013

By Dr. Uche Odiatu, B.A., DMD, NSCA Certified Personal Trainer

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Many dental professionals are strategically mapping out their future financial security. They are tax planning and using the 10% solution to save and invest their hard-earned money. Freedom 55 used to be the catch phrase championed by many financial advisors. But with the recent economic challenges I can easily see it being called Freedom 75. The irony is that most people over fifty do not enjoy excellent health and physical fitness. How can anyone indulge in their monetary abundance without the ability to physically take care of him or herself?

Robin Marantz Henig, Scientific American magazine writer reported that almost half of North Americans over 75 require some assistance with their daily tasks. Unless there are major advancements in senior fitness levels, aging North Americans may spend their latter years in conditions of debilitating dependency.

Dr. Steven Lamm (author of Younger at Last) found that non-active men and women lose one percent of their muscle mass every year after 30. This will result in many consequences in the quality of life: lack of ability to take care of your dream home; inability to enjoy travel; problems with posture; and greater incidence of falls with diminished leg power for balance and movement. Less muscle a (very active tissue) means slower metabolism, which will eventually result in more bodyfat (inactive, useless tissue).

It is downward spiral. The less muscle you have, the fewer calories you burn each day. And the less strength you have the weaker you become. Daily activities like going grocery shopping and climbing stairs become more challenging. Result? You become even less active.

Do these sound like dire consequences? What can you do to stem the tide? Try adding strength-training or weight-training to your weekly activities. That’s right – those dumbbells and barbells in the gym are not just for the bodybuilders on the beach!

Recent research has shown that one of the most important steps in not just retarding the aging process, but in reversing the process, is resistance or strength training. It is not just a suggestion, it is recommended! Studies at Tufts University have shown that people in their 70’s, 80’s and 90’s have benefited from safe and effective strength training in many ways, especially their balance and motor skills.

Can resistance training help you fight chronic illness? New research by the American College of Sports Medicine has shown that a simple 12 week resistance training program decreases inflammation (a key player in every chronic disease) in the body. In Medicine & Science in Sports and Exercise Journal November 2012 a study showed that after just three months of a moderate intense weight training program circulating C Reactive Protein (CRP) decreased 33%, leptin 18%, and TNF (tumor necrosis factor) by 29%. Don’t those numbers get your workout juices flowing? If not now…when?

Sadly, only 10% of all regular exercisers include any strength training programs. The types of exercise they choose for the most part are aerobic in nature: walking, running, cycling and dance classes. These are excellent activities for maintaining cardiovascular health and fitness, but they do not contribute in a significant way toward maintaining or building muscle mass. The best exercise program combines aerobic activity, flexibility and strength-training exercises.

Why not include physical fitness to ensure your enjoyment of the golden years? Seek out a certified personal trainer or join a strength class at your local health club. Remember, always check with your health care provider before starting any new exercise program.

See you at the gym.

 

OdiatuDr U.Odiatu DMD is the author of The Miracle of Health and an NSCA Certified Personal Trainer. This busy dentist is also a professional member of the American College of Sports Medicine. He lectures at the largest dental conferences in North America. www.fitdentist.com

How To Rank High on Google

October 7th, 2013

By Ian McNickle, MBA

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Have you ever wondered why some websites rank higher than others? It’s a really common question. The world of online marketing can be very confusing and hard to understand. The goal of this commentary is to explain how it works, and what you can do to improve your website ranking.

How Do Search Engines Work?

Google and other search engines rely on very complicated and frequently changing algorithms to sift through millions of websites to determine which websites should rank higher than others for given search terms. Amazingly this happens in a fraction of a second.

Since Google is by far the largest search engine with about 65% of all search volume we’ll focus on them for our understanding. Google’s search algorithm has over 200 variables that it looks at to determine where a website should rank. Fortunately many of these variables are somewhat understood, although the algorithm changes often.

Search engines read a website like we read a book. As it reads your website the algorithm is looking for dozens of specific items in the code and content to help it understand what the website is about, what each webpage is about, and how important the website is compared to other websites.

In addition, search engines look at incoming links to help determine how important your website is. An incoming link is a link from another website that links back to your website. For example, if the ADA had a link on their website that linked back to your website that would be considered an incoming link for your website.

What Can You Do?

With the experience of optimizing hundreds of dental websites we have learned what works, and what doesn’t. The following items should help your website improve its search engine ranking. It is worth noting that densely populated areas like Seattle and Portland are very competitive, but these strategies should improve any website’s ranking for search terms.

  1. Unique Content – If your website was purchased through a high-volume website company then most likely it is template based, and has duplicate content. The problem with duplicate content is that search engines penalize websites with content that is the same as other websites. If you rewrite all your content to make it unique your rankings will improve.
  2.  Individual Pages – Most dental websites have an overview page with dental services such as a Cosmetic Dentistry page with a list of those services. This is ok for website readers, but bad for search engines. When Google looks at a webpage it attempts to determine what the topic of that page is about. If a page lists two or more topics then they basically cancel each other out, and the page ranks poorly for all terms. Make sure your website has individual pages with unique content for each dental service topic and your website rankings will improve.
  3. Site Map – A site map tells the search engines where all your webpages are located. About half of all dental websites do not have a site map which definitely degrades the website’s ability to rank well. If your website does not have a site map, then have your webmaster add one immediately.
  4. Incoming Links – One of the most difficult things to do is build incoming links to a website. When it comes to incoming links the more the better. Links from other dental websites are better than non-dental links. Links from high traffic websites are better than low traffic websites. Most dental websites have fewer than 10 incoming links, but ideally you should have at least 50 to 100 (or more depending on your competition). Take some time each month to ask other websites to link back to your website.
  5. Code Issues – Search engines look at website code to understand everything about your website. If your code is not properly optimized (title tag, meta keyword tags, meta description tag, alt tags, header tags, etc), then your website has little chance of ranking well. A web developer well versed in code optimization is critical when constructing a dental website.

 

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Ian McNickle is a Partner at WEO Media where he leads their sales, marketing and business development activities. Ian has developed significant expertise in online marketing, search engine optimization (SEO), search engine marketing (SEM), social media, and online reputation management. Ian speaks nationally to dental societies, study clubs, and conducts numerous seminars and webinars on these topics. Ian brings over 17 years combined experience in technology, sales & marketing, business development and operations. Ian has a BS in Mechanical Engineering from Washington State University and an MBA from the University of Washington.

If you have questions or would like a free analysis of your website, please contact Ian McNickle at WEO Media. Email: ian@weomedia.com  |  Phone: (503) 708-6327  |  www.weodental.com

 

Stress Relief: I’m Outta my Mind, So Feel Free to Leave a Message

September 3rd, 2013

By Kelli S. Vrla 

Bankrupt

Never fails: after I tell a passenger seated next to me I teach stress-relief seminars, my luggage is lost when we land. She smiles at me and asks, “What are you gonna do now, Stress Lady?” I do what I always do: smile and breathe deeply- several times.

Some folks are convinced that stress is still good for you. Here are a few reasons I’ve heard on why you should stay stressed

  • It helps you seem important.
  • It helps you keep your personal space and avoid intimacy.
  • It help you avoid responsibilities.
  • It gives you an adrenalin rush.
  • It helps you avoid success.
  • It help you keep that authoritarian style you love so much.

If you buy into this theory, here are a few ways to stay stressed:

  • Eat anything you want.
  • Gain weight.
  • Take lots of stimulants.
  • Personalize all criticisms.
  • Toss your sense of humor.
  • Become a workaholic.
  • Toss food time management skills.
  • Procrastinate.
  • Ask stupid questions…repeatedly.
  • Worry about things you can’t control.

Granted, some stress is good – if it kicks you into high gear. Yet, if you want more stress-free days, you have to create a new set of habits. Not all your days will be perfect, yet it’s a good start to a more balanced life with better health.

Here are a few stress-busting habits to try:

  1. Expect the unexpected and be ready to roll with it. Most of us are married to a certain outcome: how a person will act of react, whether our plane arrives on time, or when we will receive that report we requested. If we are ready for any outcome, we can quickly roll to Plan B in the event that our original wish list did not come true, So, instead of being married to an outcome, think of it as a “prenuptial agreement” with flexibility.
  2. Mentally rehearse a Plan B. Adopt an adaptable mindset. Make adaptability a part of your daily routine. Think of yourself as a Ninja Warrior in a video game with obstacle whizzing at you. To win the game, you have to quickly fend off and move onto the next level, always moving forward, getting ever closer to finishing the transaction at hand. Entertain different scenarios, much like an airline pilot would in the event you lose an engine. Visualize what you would do if the day completely fell apart. You will be more ready to take on scenarios you have previously thought about, rather than avoiding them altogether.
  3. Neutralize any situation with these magic words: “That’s interesting.” This evokes a mindset of curiosity, not of position. Instead of polarizing your thoughts into good or bad, it allows the neutral frame of reference. When times are tough, you need to get out of your emotional, knee-jerk response mode and immediately go into a problem solving flow. Your body will follow the mindset you initiate.
  4. Accept the rhythms of your business. All days cannot be perfect, nor cal all days be the absolute worst. To quote one of my favorite bumper stickers, “Some days you’re the windshield; some does you’re the bug.: Relish the good times and treat the challenging times as moments for growth. If you’re not uncomfortable, you’re not growing- and may be coasting. Don’t let your mind get stagnate.
  5. Hang out with adaptable, less-stressed folks. Know people who seem well adjusted and non-plussed by life’s curve balls. Watch them and see how they handle little surprises. If you were to write a short report on their observable actions, what verbs would you use? This is a  key to understanding good modeling survival behavior.
  6. Practice Stress-Busting Phrases. If you face a potentially stressful situation, try on of these forward thinking phrases:
    1. What’s Plan B?
    2. 100 years from now, all new people.
    3. At least we don’t work for Enron (or Martha Stewart, Inc…fill in your fave)
    4. Things could be even worse!

What will you do differently this year to make a difference in your professional and personal growth?

Some stress is good. Harness your good stress and work on getting rid of the bad stress. You’ll soon be on the road to stress relief, and no one will have a clue why you’re smiling the next time you’ve lost your luggage.

 

VrlaKelly Vrla is a Rockies-based Leadership Consultant and Keynote Speaker and a Road Warrior for Humor in the Workplace. Her festive deliveries help you people have more fun and get more done. She can be reached for keynotes and workshops at www.kelliv.com or email kell@kelliv.com 214-987-HAHA(4242). Stay light and practice, practice, practice!

 

Avoiding Organized Dentistry to Save Money on Dues—Think again!

August 5th, 2013

By: Vanessa Browne, DDS

ODA logo (color)

With the continued rise of educational debt, many dental students are graduating with difficult financial decisions to make. The job market is saturated, many are getting married and starting families, high monthly loan payments are around the corner, and many also are craving delayed gratification for eight or more years of very hard work. It is natural, then, for some to make the decision to delay all unnecessary costs. For some recent graduates, the choice has been to forgo membership in the American Dental Association, the Oregon Dental Association, and their local dental society as a means to save money as they are establishing themselves in the dental community. However, I believe this is the worst choice that a new dentist can make. The benefits of being a member of our dental societies far outweigh the cost.

Dental societies function as a tripartite membership. This means when you become a member, you hold membership at three levels: the national level (American Dental Society), the state level (Oregon Dental Association), and the local level (Oregon has 17 local dental societies). More than 71% of Oregon’s dentists belong to the ODA. While this is an impressive number, the opposite number is staggering. 29% of dentists in Oregon are practicing without the support, network, protection, community, and education that being a dental society member provides. I believe that joining your dental society is a commitment to continued growth as a professional.  Here are just a few ways that organized dentistry can help you:

Peer Relationships

Upon graduation, many new dentists begin working and sometimes lose connections with classmates and the dental community. This is understandable as starting a practice, joining a practice, or becoming an associate is a time-consuming process. However, this is a missed opportunity to seek advice from mentors, learn practice management and clinical techniques from peers, empathize or share experiences among colleagues, and network for leadership, professional, or career opportunities. There are over 2,100 dentist members in the ODA, and 9 staff at ODA working to help provide information, answer questions, and support the profession.

Advocacy

 A portion of the dues paid to the dental societies goes to supporting and protecting the profession. This includes lobbying for specific dental issues. A few of the recent issues facing dentistry include eliminating national license testing with a push toward portfolio licensure for dentists, educating legislators about the negative effect the new medical device tax will have on the cost of oral health care, impeding insurance companies from dictating rates for treatment that insurance does not cover, and providing alternative solutions to the proposed mid-level provider model.

Serving the Community

Being a part of the dental society gives dentists many opportunities to give back to the community. Not only does organized dentistry help educate the public about oral health and the importance of seeking dental care, but it also serves to advocate for changes such as water fluoridation, increased funding for research, dental care for underserved populations and public health initiatives, and increased insurance coverage for dental services. Beyond this, there are opportunities for dental professionals to volunteer in the community through events like Mission of Mercy (November 24-27, 2013) and Give Kids a Smile (February).

Education

Every dental society hosts at least one conference a year with a collection of continuing education courses and a vendor showcase with member discounts. Also available throughout the rest of the year are additional continuing education courses, leadership training, and numerous publications. The Oregon Dental Association publishes its newsletter “Membership Matters” and this blog “The Tooth of the Matter.” The American Dental Association has its own journal “Journal of the American Dental Association” and newsletter “ADA News”. Beyond education for members, these dental societies also provide numerous public health resources and patient education tools that can be used in your office.

Career Protection

Dental societies offer three specific resources for career protection: Insurance for your personal and practice needs, peer review, and a well-being committee. The ADA sponsors life and disability insurance plans at a reduced rate for members. Other dental societies also endorse malpractice insurance companies and other necessary insurance providers. Peer Review is a process by which patients and third party payers can voice concerns or disputes that are resolved by a collection of your colleagues. This allows the dentist and patient to have dental care evaluated in a non-combative environment at a local level. These issues are often resolved at this level and do not have a need to progress to a lawsuit. The Well Being Committee offers dentists who struggle with alcohol and controlled substances an opportunity to get back on track without losing his or her license.

Practice Support:

The ADA and ODA have endorsed programs of products or services and often offer discounts to members. All of the dental societies also have several opportunities to seek employment or place classified ads. These are sometimes the first place individuals will look. Both the ADA and ODA help with patient referrals by listing your practice information on their websites and when patients seek dental care in a certain area, the staff will refer to its members. Additionally, the ADA has a professional product review that provides unbiased dental product information that is scientifically sound, clinically relevant, and user friendly. The ADA also has a center for Evidenced Based dentistry that provides research and gives you access to systematic reviews. Using both of these resources, organized dentistry allows dental professionals to make informed decisions about their practice.

 

So How Much Will This Cost You?

The dental societies realize that new dentists are graduating with enormous debt loans.  To decrease the burden of membership dues, the American Dental Association and most dental societies structure their dues on a graduated scale over 5 years. Usually, membership in the first year in practice is free. This means that even if you don’t know where you are going to practice, it is beneficial to join to have access to this wealth of resources. At the national level, dues are 25% of full national dues your 2nd year in practice, 50% your 3rd year in practice, 75% your fourth year in practice, and 100% your fifth year in practice. State and local dental societies have a similar system. There are also member get a member discounts to encourage dentists to invite their colleagues to join. Depending on your location, full dues for tripartite membership by your fifth year vary from $900 to $1,800. Students who pursue graduate training also have a reduced rate of $30 for national dues and begin the reduced dues five-year program when their graduate education is complete.

Convinced Yet?

Being a member of organized dentistry can lead to career opportunities, referral connections, educational opportunities, practice management support, risk management answers, reduced rates on endorsed products, unbiased and scientific information on clinical products, support at the legislative level, license protection with peer review, social opportunities, and more. The small cost of membership is worth a lifetime of benefits.

How Do I Get Involved?

The best way to get involved in your dental society is to visit the websites and read the newsletters for upcoming events. It is best to start with your local dental society. Look for New Dentist events, Continuing Education courses, opportunities to be a mentor/mentee, or upcoming conferences such as the Oregon Dental Conference or the American Dental Association New Dentist Conference. There are also numerous opportunities to volunteer with events like the ODA Mission of Mercy (November 24-27, 2013) and Give Kids a Smile (held annually in February).

Check out the following website for more information:

http://www.ada.org/

http://www.oregondental.org

 

IMG_6409Vanessa Browne, D.D.S, is a 2012 Loma Linda University Dental Graduate who is currently in her orthodontic residency at Oregon Health and Sciences University in Portland, OR. She is a member of the California Dental Association, the Oregon Dental Association, the American Dental Association, the American Association of Orthodontists, and the Pacific Coast Society of Orthodontists. As a dental student, Vanessa held numerous roles as a leader in organized dentistry including the chair of the California Dental Association student delegation. She is passionate about encouraging dental students and new dentists to join organized dentistry. You can contact her at vnbrowne@gmail.com

Dental Implant Concerns Related To Patient’s Health

July 8th, 2013

Capped Dental Implant Model

By Dr. Don Callan

The goal of dental implants is to provide function, longevity and esthetics for dental patients in an environment that can be maintained with routine oral hygiene procedures. Dental implants are no longer experimental, exotic or rare. Implants are the treatment of choice for an increasing number of people who want the best that dentistry has to offer. Dental implants have proven to be a valuable treatment of choice for replacing missing teeth and have been developed from the anatomy of natural teeth. Dental implants are also subjected to periodontal disease (periodontitis) caused by oral bacteria (periodontal pathogens). Both patients and dentists should be aware of possible complications that can affect the patient’s oral and systemic health when implants are placed, even if excellent esthetic results are achieved. Professional implant maintenance and diligent patient home care are important factors. However, because a portion of the implant is below the gum level (subgingival), patients and clinicians have limited control over hygienic measures to prevent infection. Therefore, implant design is an important factor.

Periodontal pathogens have been linked with increased risk of systemic illness and complications in existing diseases.  Recently, several articles detailing these findings have been published, emphasizing the importance of the association between periodontal disease and systemic health problems.  In fact, recent reports of oral infections have been shown to be associated statistically with mortality. With periodontal disease, millions of oral bacteria are in direct physical contact with gum tissue, which provides an easy portal to the circulatory system.  After entering the bloodstream, periodontal pathogens have been shown to increase the risk of cardiovascular disease, strokes, lung disease, rheumatoid arthritis and may hinder glycemic control in diabetes. Sufficient evidence exists to conclude that both periodontitis and Peri-Implantitis involve the same bacteria. This same inflammatory process can damage healthy tissue and lead to bone loss around the implant.

In addition to optimizing esthetic and functional results, infection (Peri-Implantitis) of gum and bone tissue surrounding the implant is of major concern. These infections have driven many developments in dental implant design and use. Treatment of dental patients is rapidly moving from an approach focused primarily on esthetic and functional concerns toward an approach, which focuses on optimal health as a critical goal. Numerous published studies promote the prevention of oral bacteria harboring around implants as a key outcome in addition to traditional measures of implantation success.

Studies have shown periodontal pathogens surrounding dental implants will contribute to implant infections and is the main cause of implant loss and systemic concerns. Some patients may have significant infection and bone loss with no symptoms and may not pursue adequate follow-up care that would identify those conditions. Researchers have identified specific periodontal pathogens around and within the micro-gap of implant systems as the same seen in periodontal disease. Some implant companies are developing new designs for the elimination of the microgap issue. Therefore, it is important for all implant patients to see the dental professional for routine care and evaluation of the health around the implant.  It is possible for patients who maintain optimum hygiene care to suffer from implant infections if bacteria are harbored within, around, and between implant components.

In summary, the patient, dentist and the implant manufacturer have their respective areas of responsibility to maintain implant success. Infection about dental implants is the number one cause of failure; therefore, the patient must maintain excellent home care procedures of the implant and visit the dental office for routine cleanings. The dentist is responsible for proper surgical procedures and instruction to the patient for home care procedures. The implant manufacturer must be aware of the causes of implant failures in order to change or correct the design of dental implants as needed to promote long-term success. A poor implant design will affect esthetics, function and the ability to allow proper home care as well as professional cleanings of the implant and its restoration. IMPLANT SUCCESS IS A TEAM EFFORT: THE PATIENT, DENTIST AND MOST OF ALL THE MANUFACTURER OF THE IMPLANT.

 

DPCDr. Callan received his B.S., B.A. degree from the University of Arkansas in Business Management and Marketing. He received his D.D.S. degree and a Certificate in Periodontics from the University of Missouri at Kansas City. Dr. Callan maintains a private practice and hospital appointments limited to Periodontics with an emphasis on tissue regeneration and implant dentistry in Little Rock, Arkansas. Dr. Callan has authored 61 publications about dental implants and tissue regeneration. Dr. Callan has presented lectures in the United States and internationally, including the University of Moscow, Russia, China, Japan, UK, Mexico, Canada, Central America, and South America, on various topics including dental implants, Peri-Implantitis, bone regeneration, soft tissue regeneration, implant maintenance, oral and systemic periodontal health, marketing to the dental patient and treatment planning of the edentulous patient.