One way to keep patients in line

Here's a story of a German dentist who decided to take matters into his own hands when his patient decided not to pay for her work. (This guy is what the locals would call "verrückt").
Basically, the lady's insurance wouldn't pay for two bridges and she decided it wasn't her obligation to pay for them. The Zahnartzt from Neu Ulm (I think I rode a train through there once) then breaks into her home, ties her to a chair, and reclaims the bridges.
From the article:

"The dentist is being investigated for assault for the way he forced open her mouth, and theft for taking the bridges," said Christian Owsinski a police spokesman.

Personally, I think the theft charges should be dropped. Think about it - he payed a lab fee to have the bridges made so if they belong to anybody then they are his, so this might be more of an OJ Simpson-forcefully-reclaiming-my-stuff type situation.

I do feel that he should lose his license. You simply can't perform a dental procedure (such as removing a bridge) against the patient's will. That's one of the least ethical things a dentist can do.

The creepiest part? According to the victim, he did all of this without even saying a word.

UPDATE: Court decision here. Dentist found guilty of assault and fined 6000 Euros. Patient too traumatized to wear dentures.

"The Clinic" - Loma Linda Office Spoof

The season premiere of The Office is this Thursday night. I'm looking forward to it.

If you are also a fan, might I suggest checking out this sweet video, done entirely by classmates of mine (written by this guy). It was our entry for a skit competition at the annual dental student retreat. Needless to say it was a big hit.
Without further ado, the video:

Click here for the high quality version, or watch below for the quick and dirty version (with audio delay).



Follow up: Enjoy the sequel here!

Tooth Prices Dropping

At least in the UK, that is. Their current economic crisis dubbed the "credit crunch" has forced the tooth fairy to become slightly more stingy then she was six months ago. This article states that the average price of a tooth has gone from £1.22 to 87p, with 38% of Brittish children receiving absolutely nothing! 1000 parents were surveyed to find out what the tooth fairly had left their children.

Why is this? My theory is that the Tooth Fairy foolishly got locked into an adjustable rate mortgage. Think about it - the tooth fairy is always all dolled up in her fairy clothes and waving around that fancy fairy wand. Her hair and makeup is always perfect. She's obviously concerned with what others think of her and to keep up appearances she splurged on a mini-mansion she really couldn't afford. What other explanation is there? Gas prices shouldn't matter - being a fairy, she has the ability to fly. The worldwide increase in food prices? She's six inches tall, how much can she eat? Silly pretentious fairy. Now British children have less money for their Bertie Bott's Every Flavor Beans and Fizzing Whizbees.

The silver lining? This should encourage more Brits to keep their teeth! Zing!

"Laughing Gas" fun facts

Here's some stuff you probably didn't know about the "laughing gas" you get from the dentist. I just finished taking my Nitrous Oxide competency exam and decided to pass along the more interesting trivia to you folks.

• It was discovered in the late 1770's by Joseph Priestly. In 1779 Sir Humphrey Davey was the first human to inhale it and described it as "very pleasurable" and "euphoric." He was the one who coined the term laughing gas.

• It wasn't originally used in a medical setting. From 1800-1844 it was mainly used at social gatherings and sideshows for entertainment.

• In 1844 a dentist named Horace Wells was attending a demonstration. A peculiar incident happened involving a volunteer who inhaled the gas and began freaking out. (Not everybody reacts the same, and some people really don't like it.) Anyway, this guy started running around the room and gashed his leg open. Horace the dentist astutely observed that the man didn't even react to his wound - as though he didn't feel any pain. The next day Horace had his dentist buddy extracted his abscessed tooth using the gas. Horace felt no pain and proclaimed this to be "the greatest discovery ever made."

• Originally the dentists had difficulty in delivering high concentrations of the gas due to the crude delivery systems available to them. What were these delivery systems? Ox bladders. (Don't click unless you really want to see an ox bladder.)

• Wells, who is credited with the discovery of anesthesia, became addicted to the laughing gas and committed suicide at age 33.

• The exact mechanism of nitrous oxide is still unknown.
  

So there you have it. Personally, I first had laughing gas when I was 17 and absolutely loved it. I told my dentist that if I had known how great it felt, I would have stopped brushing long ago! I also distinctly remember the feeling of having the dental room rotate around me while I was getting my wisdom teeth extracted. The song on the radio was "When I fall in love" and I remember the experience every time I hear that song.

Let me know your thoughts or any funny stories involving laughing gas. Maybe next year I'll give away a free nitrous oxide treatment to the person with the best story. Maybe.

Tales from the clinic floor

Today was rough. Next time you have a dental appointment and maybe you're not really looking forward to it, just think to yourself, "at least it's not an 8-hour appointment."

That's right, today's patient drives from far away so to keep his trips back and forth to a minimum (insert token gas-prices complaint here) we decided it would be a good idea to book him for my morning and afternoon sessions. I prepped three teeth for crowns and tried (and failed) to have that be my bridge competency required for graduation. When attempting a competency, I do all the steps without help and then have two faculty members grade my work. Things kept going wrong and I seriously think I made about 20 temporary crowns before I had three that worked and I was happy with. Ugh.

Anyway, since I'm on the topic of dentistry, here's three amusing stories that happened to me lately:

Sidewalk
A couple weeks back I was getting ready to place a space-maintainer in the mouth of a really curious seven-year-old. He had been asking questions all along and I was happy to answer them, but he really threw me for a loop when he asked why I was going to put sidewalk in his mouth. Sidewalk? I was so confused - then I remembered that I had told him the next step was to "cement" the space maintainer onto his molar. It's funny how kids think sometimes.

Ipod
Recently we had mock-board exams and were required to find a patient had a specific type of cavity - a class II lesion if you were wondering. The week before the exam I was doing a pediatric rotation and came across a 13-year old with the perfect class II lesion. I convinced her and her mom to help me out but was a little concerned about whether the patient's attention span could last the whole 4-hour exam, so I told her I'd bring my video Ipod and she could watch stuff while I worked.
When exam time came I had her take a seat while I finished setting up and she started watching the Andy Milonakis Show and some stand-up comedy. The resulting scene was pretty funny - to appreciate it you have to picture the tense exam atmosphere with 100 dental chairs and hardly anybody talking. Except for a few dental drills whistling in the distance, everything is silent. Then you have this loud teenage girly giggling happening like clockwork every 20 seconds coming from cubicle 74. Soon people started turning their heads trying to figure out what was going on. All I could do was shrug my shoulders and say, "Hey, I'm that good."

What's that smell?
Working on a crown competency last week, I determined that I needed to do a minor electro-surgery on the patient's gums. To do this, there's a machine you plug in and have the patient hold a metal plate, and when the end of the handpiece makes contact with the tissue it completes the circuit and basically fries the tissue. (Keep in mind the patient is numb so it's really not that bad). After doing this for a minute I explained to the patient (who grew up in El Salvador) that I was using the high volume suction so that it didn't stink. Having already caught a whiff of his own crispy gums, he smiled and told me he thought it smelled like carne asada. I told him it sort of was.

Sorry this post was all words and no pictures! I never read posts like that. Here's a totally awesome picture to try to get you to read:


(click for the bigger, more awesome version)

Puffer fish underwent emergency dental procedure

Crazy as it sounds, I'm not making this up. It happened in England. Here is the full story detailing how the fished damaged his dentition in a bout with a sting ray. It sounds like the fight busted off part of a tooth, which in and of itself would have been ok, except that puffer fish are like rats in that they need to constantly be gnawing to keep their teeth worn down. After the fight the lazy puffer fish did all his gnawing on the side with the broken tooth, allowing his other tooth to grow to the point that it started damaging his lip.

Crazy.

After the procedure the fish was relocated to Germany - I'd like to think that it was part of some sort of fish witness protection program to keep him safe from the sting rays.

Baby Epiglottis

Ever wonder how babies can drink and breath at the same time? Think about it - you can't drink and breath at the same time (try it if you don't believe me), and nursing babies don't come up for air once they "latch on".

I was studying this very concept for my board exams just over a year ago, at the same time my son was just a wee infant. The answer lies in the epiglottis. Here is an illustration of the epiglottis of an infant:
The key difference is that the shape of the baby's throat allows the epiglottis (the green shaded area) to come into contact with the soft palate (yellow), thus allowing air (shown in light blue) to enter the trachea, while milk (shown in pink) can flow around on either side.

I was recently reminded of this concept during our summer break at my parent's house when Jordan was drinking from a sippy cup and started coughing. I looked at him and asked if he got some down the wrong pipe and then realized that this had never happened to him before. I realized my little boy is growing up - his epiglottis is no longer touching his soft palate when he drinks! He'll just have to alternate between drinking and breathing just like the rest of us now. I think this is a milestone in toddlers lives that most parents are unaware of.