Archive for the ‘ODC Speakers’ Category

Staying Fit on the Road

Tuesday, 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

Monday, 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

Tuesday, 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.