Friday, December 19, 2008

I feel like poop

Well, I have made it through the week, but just barely.
I have run myself ragged this week and now I am paying for it.
I am sick as a dog and want to get to my bed.
Problem with going to bed is I can't get comfortable in my bed either.
I am hot then I am freezing. It totally sucks.
I take Ibuprofen and then Comtrex.
Then I will get home and take some Nyquil.

Sorry but no blog today because I can't even think straight.
I know what you are thinking...that I don't think straight most of the time anyway. Ha ha, not funny.

I hope to write at least one time before the end of the year.
Have great Christmas.
Remember what the real reason for the season is.
Don't get too caught up in shopping and making sure this person is happy and such.
It is really about what God has done for us. And that we are nothing without Him coming as the baby.
Don't forget this when you are late for church or when you family member is 90 minutes late for dinner.
Don't forget this when your kids are unhappy with their gifts or all the other crap that sometimes goes along with the holidays.

Thanks for a great year,

Wednesday, December 17, 2008


Hey all,

Before we start I want you to look at this image.
I want you to appreciate how pretty this person's smile is.
Now I want to do this exercise with me. Could you improve it?
Would you improve it?
So lets play....
All of you non-dental people I want you to double click on the image and try to find all the things you don't like about this person's smile.
All you dental people I want you to think about how you could improve this persons smile. Could you improve on the beauty that God gave this person?
We will come back to this in a while.
Now I will talk about me for awhile.
I know you think I crazy but I signed up to be the coach of my son's basketball team again.
If you are not a reader from way back you might know my trials and tribulations in 3rd grade basketball.
We were 1-6 and the last game of the season we got beat by a team that never won a game.
But the parents kept telling me how much the kids enjoyed it and they couldn't wait to be on coach Gammichia's team.
The two kids that were the toughest to control are not on the team this year but one of the better kids isn't playing either.
It is going to be another tough year. But I have to keep telling myself that, "its for the kids".
I can't get discouraged. I went to the 6 and 7th grade practices this week to see how disciplined they are and to scout some drills.
I am going to try to be the best coach I can be and stop worrying about all the other stuff.
Only two more days of work until my two week vacation.
Nothing yet on the National Championship ticket search. It is going to be real tough ticket.
But I am doing the best I can. Don't any of you have family that works for FED EX.
Help a brother out.
Okay the topic.
Did you look at the picture?
Don't you think this person has a beautiful smile.
Okay here is the deal, I got the 2008 American Academy of Cosmetic Dentistry "Special Edition"
this week.
You know that I think I am a pretty good dentist. You know that I can also appreciate it when someone else is a good dentist.
Now I look through this magazine and I feel like a shmuck.
The dentistry in this magazine is really good. I look at this stuff and feel like I still have a ways to go.
If my work is a 5 this work is an 11.
I read alot of the articles and see the types of materials the dentists in there use. It is really good stuff.
I am not jealous but...okay, I am a little bit.
Occasionally I have a problem with some of the stuff that someone does.
In this particular magazine I have a problem with someone's work.
It has to do with the above picture.
This was the BEFORE picture of the cover model of the magazine.
Gordan Christianson wrote a STATE OF DENTISTRY article about 5 years ago.
I don't remember exactly what it said he was addressing the cosmetic locomotive that was dentistry and he said there was way too much over treatment going on.
I believe in the AACD and what it represents. I am happy they are educating their students. I am thrilled by the strict hoops the dentists have to jump through to get in the academy.
They are making great dentists (the beauty in the magazine proves this). But I have to agree with Dr. Christiansen sometimes.
Okay before I go on here is after photo.

This patient was a hygienist/model.
I walked around my office and showed everyone the before picture and asked if they thought that this person had nice teeth. They all said, "YES".
So then I showed them the after.
Then I asked them if this person walked into the office and wanted veneers what would you say.
I can tell you I am really on the fence with this one.
I know in my heart of hearts that this woman has a beautiful smile.
I know that if I stand on firm ground and tell her that I don't want to mess with the beautiful smile God gave you.
She would leave my practice and go to the dentist down the street and get the veneers done.
I know that I can give her what she wanted. I know that I can do a good job for her and I know that she would be thrilled but....
So what is she thinking...that if I have a straighter, whiter smile, my career is really going to take off.
My assistant talked about the plastic surgery field. People have this perceived need...I hate my eyes or my nose is too big, I hate my double chin, my butt is too flat.
If the plastic surgeon doesn't do cosmetics he is getting past by.
But thank goodness we are not plastic surgery.
What is this woman/hygienist/model going to make it big because of this new smile. I don't think so. I mean she is beautiful. She is beautiful without the veneers.
What door is going to open up because her laterals are 1mm longer?
How is she going to feel about this decision when she is having them replaced for the third time when she is 75?
Now I am going to end this and I don't want you to think that I am bashing anyone.
I have not really made my decision about what I would do if this woman walked in my office.
I do know that if it was my daughter, she wouldn't be doing veneers.
My wife has 4 composite veneers because of peg laterals. My father and I did them about 16 years ago.
Does she need veneers right now? No
Could I do veneers now? Yes
Would they look great? Yes
Am I struggling with this? Yes
I mean they look pretty good. No non dental person would ever know.
But I know every dentist probably knows.
Okay enough back and forth for today.
What do you think?
ps I did a lecture in North Carolina (about 5 years ago)and asked this very question to a bunch of dentists.
If a patient came in with nice teeth and wanted veneers would you do the veneers. I think about 95% of them would NOT do them.

Monday, December 15, 2008

Christmas Party OH NO

Hi all,
I hope everyone had a restful weekend.
I only have one more week of work until Christmas Vacation. 2 weeks off. It is going to be awesome.
Also this means our first year of blogging is coming to a close.
If you are a reader and have some comments or see somethings that you think I can improve on...let me know. ....anytime.

My son got his cast off today. Yeah, you remember the roller skating accident about 7 weeks ago.
He played the entire flag football season with a broken arm.

I watched a couple of movies this weekend.
Namesake. It was okay. It was with the Middle Eastern looking guy from Harold and Kumar. It was a serious movie with a guy from the modern Cheech and Chong movies. I give it about a 4 and a half.
I saw Atonement. Another disappointing movie. I heard great things about this one and it wasn't that good. I thought it was going to be a chick flick and my wife would get all emotional and cuddle up close to me and....this is a family show so I will stop. But nothing.
She was like, "This movie is about an eleven year old screwing up her sisters life."

We had our Christmas party last week.
I know what you are thinking...."is he crazy?"

But....It went pretty great so I wanted to tell you about it.
This year the local mall put in a restaurant in the mall. On of those that is on the outside but it is connected to the mall. It is called the Elephant Bar.
I decided that we would do it after work on Thursday. Thursday is half our staff's Friday. So it is a much easier day to coordinate than Friday (especially close to Christmas).
We were to meet at the bar at the Elephant Bar about 30 minutes after work. We were to have a "happy hour". We were going to have a drink and enjoy each other's company.
After the "happy hour" is where the fun would begins. I was going to give each staff member $120 dollars to shop at the mall.
Here are the rules. You have this money and you can only buy gifts for YOURSELF. You have one hour and you have to spend all of the money. If you don't spend it all...You have to give it back.
I kept all this a secret until the day before the party. So on the day of the party someone downloaded the directory of the mall and they all started scheming out their plans for the one hour. They all loved the idea and it really was lots of fun.
Then after the one hour shopping, we were to meet back at the restaurant and have dinner. At dinner I was to collect all the unused money (yeah right) and then everyone was to show what they purchased.
It all went without a hitch and a ball had by all.
It was a great time. I truly enjoyed everyone company and I think they all had a great time.
The restaurant was perfect for what we wanted and we all left so full (you know the full when you are done with dinner and you unbuckle your belt. Then the server comes over and asks if you want desert. And you all perk up and say, "Well what do you have?") and feeling great about a really hard year.

I am so thrilled that it went so good. You know what is great about parties like my dad.
He really has a great time at these kind of things. He lets himself have fun. He is the life of the party and it is so nice to be able to sit by his side (or down the table) and watch him enjoy himself and his staff.
Good times....good times.

Well it is getting late and I have to pick the kids up at school.
Have a great Monday,

Friday, December 12, 2008

Giving it away III

Okay back on track.
By the way How I Met Your Mother is getting so funny.
This season it started slow but the last couple of episodes I have laughed myself off the couch.
If you are not watching it, you are missing a very funny show.

I am reading Jane Eyre right now.
Everyone who I talked to loved this book. I have never read it. And now I know why.
Okay here is the deal with old books (Jane Eyre's copyright is like 1847) they are written for smart people.
There, I said it. I am not very smart.
I am on page 7 and I haven't known about 50 words.
So I am sure in high school I picked this up and read the first page and said, "Hmm, NO"
I think I am going to like it but it is not like any other books that I like. For example, The Firm. You pick up the book and it is action from the first word (and by the way you recognize the words) but this kind of book is different. It actually makes you think. And it is weird I think it may make me smarter.
I was in dental school and my friend, who was very smart, said one of his favorite books was Dante's Inferno. I said, "Let me give if a try."
Anyone every read this? I didn't make it past page 5.
So now I am in a dilemma and it has to do with my kids. Do I make my kids read a book that is challenging and hard to read and eventually make them smarter (but may make them hate reading) or do I let them read a books that are fun and not challenge them?
Parenting...the hardest job on earth.

Remember I told you that this world is going to Hell in a hand basket...well now I am convinced. There is a sign on our major highway in Orlando that shows a guy in a business suit slipping and all the sign says is . I am not kidding (and don't you dare go to this site).

Now...the topic...
About the young lady week. None of you commented on it. BIG HELP YOU WERE.
I did however talk to everyone I could about it. Dental people and non dental people. What would you do?
Would you just get her out of pain or would you give her the full monty?
Well overwhelmingly, "all the way" was the answer.
In this case I have infinite amount of resources but what if I didn't. What if too many needs came to my office?
Would that change people's opinion?
The girl came in this week. I took care of all her operative (fillings) needs. Her teeth are cleaned and then I picked up the phone and talked to me orthodontist. He graciously agreed to help her. So probably before Christmas this young lady will have begun orthodontics.

I also heard from the pastor that originally called me. He didn't know what to say. He talked about how awesome it is to see how God works. That this young lady is being transformed physically, emotionally and spiritually, before his eyes. He calls it a blessing to be able to sit on the sideline observe.
To me, I can't tell you how it blesses me to be able to bless others. Ido get a good feeling when I help someone (like with a simple extraction or something) but when I see someone's life changed because of me...I can really feel God's pleasure. I know he is pleased when I use the talents he gave me.

I was asked to do an interview about giving dentistry away and here are the questions the interviewer gave me to prepare...

1) Please explain the type of practice you have.
2) How does treating low-income/indigent patients fit into your business plan, in terms of time, money, human resources, etc.?
3) What are the most common dental problems such patients present, if there is such a category of problems?
4) Beyond providing dental care, do you provide any kind of education or other effort meant to help the patient beyond the dental office, and if so, what does that involve?
5) What are the benefits to the patient and to you?

Wow, these are great questions.
I mean this is what we have been talking about the last two blogs.
But I want to talk to you about question #2. How does this fit into your business model?
Isn't this a funny question?
I know it is important but where does it ever say in the Bible..."When I was naked, you clothed me and you did it all within your business model."
Yes, we are business people. Yes, we can't just give with reckless abandon. Or can we?
I have been doing it for 12 years.
I don't budget for it. I don't set a limit.

I think as someone settles into his or her profession, he or she will let it become their identity or part of their identity. There is a big difference.
Tim Tebow was given a humanitarian award last light and he claims it is his greatest accomplishment. This is young man that is not defined by football. He is a young man that is person before he is a football player. He uses football for means to get out their.
This is a young man who in the next couple of weeks win (God willing) his second Heisman trophy and his second National Championship (God willing) and this is only second to what he does outside of football.
He wants to defined by what he does off the field.
Like I want to be defined by what I do "off the field" (see how I just compared myself to Tim Tebow...nice).

I am a person before I am a dentist. I don't mean this to be condescending to anyone. If you don't give anything away, I am not saying you are not a person.
Being a dentist is so awesome but it is not all I have. I don't want to work to retire and then realize I don't have any other interest. I don't want to "die in the chair".
I may be doing dentistry until I die but it is surely not going to be in my office trying to finish paying off my mortgage.
I don't want dentistry to be all I have. I want dentistry to be a means to something bigger and greater.
But that something bigger might be doing dentistry for free. It might mean doing dentistry in a poor country. Or in a clinic in poor part of town.

It might be to teach. Oh, Lordy he did not go there.

Okay, this is getting long for a Friday.
This may be over but I may say some final words on Monday.
I do covet your comments. What do you think?
Have a great weekend,

Tuesday, December 9, 2008


I interrupt this blog series to let you know about my weekend and gloat.
You knew this was coming....The gloating blog.
Yes, the Gators are back in the Chompionship game.
(This blog has lots of pictures so remember if you double click on the pictures you can see them bigger)
Has this been an awesome year or what.
Before I forget...My "sure thing" ticket for the National Championship game just went kapoot, so I am back on the prowl for tickets again.
This is what happened...
I have Gator basketball tickets and I have a friend that has Gator football tickets. The big games are always me and him. So when the Gators went to the Final Four in basketball, TWICE, I took him. So when we talked about this year he said, "Yeah, we can't break up the team." So I was pumped. Turns out he did get two tickets to the big game but now he says he is going to take his son.
I don't think it was entirely his fault. I think his father, who really has the tickets, put the screws to him about going with his son. So what are you going to do?
But if his kid should "accidentally" fall down a bunch of stairs and break something...I am back in.
So my buddy and I left for Atlanta on Friday at about 4pm.
It was about a six hour drive. We took my minivan (it gets about 28mpg on the highway). Let me tell you two dudes driving down he street in a minivan...real manly.
We stopped for some steak on the way and got into Atlanta about 11:30pm.
We stayed at my friends in-laws house about 35 minutes from the stadium.
This is the view from their back yard. Not a bad gig if you can get it.
We awoke to some danishes and coffee and some good conversation. Then we were off to the Georgia Dome at about 9:30am.
We drove up to the stadium at about 10:15am (the game was at 4pm) and the first parking lot we saw was $40, and as we got closer it got as high as $60, we drove about 50 yards more and there it was "Public Parking $8".
We couldn't believe it. So between the $50 and $40 lots was an $8 lot.
We scored, big time. Here a picture of how close we parked to the Dome.
We have a cigar (I know it is bad for my gums) and a beer. Yes at 10:30am.
We first went into the Convention area next to the Dome for a hour or two. They have this thing called "Fan Fair". Well it is this huge event that has all these games that you can participate in. (This was in a huge area. It was so big that there were more than 3 half football fields in this area. There were over 50 different things to do.) Throwing footballs through the sausage in order to get a free T-shirt. You could sign up to get on a flag football team and play in a round robin tourney. All sponsored by big companies. Give aways like crazy. We did as much as we could.
They had autograph signings with old Gator players and quarterback challenges.
Oh and in there they sold beer.
(there were all kinds of fans at this "Fan Fair", here is a good example of some crazies)
We then got a text from on of my buddies friends saying he is at this bar around the corner. So we went back to the car to drop off all our crap. Yes, I got the free T-shirt with a sausage on it.
Then we went to the bar.
Now as you can imagine the bar was jammed. We waited outside in a line were you could buy beer while you waited.
This bar was unbelievable. It was 4 levels. In one of the levels there were booths. Now these are not any kind of booths. These are booths that seat eight but in the middle of the table were not one but two beer taps in the middle of the table.
The server would come over and turn the thing on and there was a digital read out of how many beers you have had. Genius, pure genius.
Where was this bar when I went to college? I guess I am glad this bar wasn't around.
We stayed in the bar for about an hour or so and saw some of his friends around one of these tables with the taps on it. In addition to the free flowing beer the server was just walking around handing out bottled beers. He asked me if I wanted one. I said, "uh well I don't know the guys in this party, yes I want the beer."
So my friend talked and I drank.
But we never found his original friend. The guy I was with knew a lot of people.
We walked around the bar and after a text we found out that this guy was upstairs in the private balcony. So up we went. Food everywhere and again free flowing beer. It was outside but there were space heaters everywhere.
Like I said...great bar. It was called STATS.
We were having so much fun drinking and eating and messing with the Alabama fans. I would say they were too.
We started making our way to the game at around 2:45pm.
I have been to the Georgia Dome before (remember Final Four last April) but never to a football game.
It is such a nice facility.
As I started to look at the landscape it started to appear the Gators were out numbered about 55-45.
We were sitting in the end zone and up on the third level. (Hey, we were there.) Come to think about it there were a lot of worse seats. The end zone is not a bad place to watch a game. You can see all the plays...playing out.
The game was a real nail biter. A great game. I asked the guy sitting next to me if he thought they provided AED's this high up. They say that it was an instant classic.
The Gators won.
That is all that mattered. It is the reason I came. This made the rest of the trip so much better.
So instead of sulking and going straight home it was a victory cigar
and then back to the greatest bar in the world...STATS.
It was 8pm and we were wiped out but we didn't want it to end. But we had our limits. My friend had a reservation at Ruth's Chris at 10:30 but we just couldn't do it. We started making our way back to the car at about 10. We were wiped out.
Home at about 10:45pm and straight to the TV to watch the end of the Oklahoma game and more football talk.
Up and out by 7am the next morning and home by 1:30pm.
A total blast.
Back to the topic on Friday.
Go Gators

Wednesday, December 3, 2008

Giving it away II

It seems lately I am running in circles. You know the when you have over committed yourself...I go from this place and do this thing, then jump in my car and go somewhere else.
I seem like I am never home. It seems I don't even have time for a haircut.

I left the house at 6:15 yesterday and didn't get home until 9pm. Football game.
Speaking of...we won again. In spite of us. I am telling you we are not very good but the teams we are playing are a lot worse. Maybe I am not giving the guys enough credit.
We played last in 39 degree weather. It was cold. The weird thing is that it was 78 this weekend and it is suppose to get to 68 this afternoon.
This morning I was scraping ice off my windshield. That's a rarity.

I GOT TICKETS. SEC Championship here I come. I have never been to this game. I hope I don't jinx the team.
I was starting to think I wasn't going to be able to get them. And no thanks to all of you (well one person thought she might be able to help but it was another dead end...shout out DS).

I haven't been watching to much media lately (except sports) but I did watch this movie Valley of Elan. It was very good. I mean real good. If it not on your queu it is a definite winner.
I am so behind on my TV I don't know how many weeks behind I am. But I caught an episode of How I Met Your Mother and I was laughing out loud again.
It was the Naked guy episode. I am still laughing when I think about this one part. That guy Marshal is so funny.
I still think Worst Week is funny. I think the physical comedy is not that funny but I think the show is funny.

Okay to the topic. Giving it away.
I don't know if you guys get to see all the comments but I wanted you to see this one.

How many days a year do you just open your doors to people who cannot afford to pay? I mean, there is only so much time that you can donate your services. You also have to make a living. Why can't she come during one of those days? Anyway, I really admire what you are doing and you have inspired me to take one week off per year and volunteer my services to the poor. I am starting in 2009. I will be volunteering in Jerusalem at a welfare clinic. Jews and Palestinians are both served there. You can check it out by googling Dental Volunteers in Israel. They also have a video running on You tube. But I really can't afford to give my services away to everybody that can't pay. I won't be in business very long.

This comment is packed full of jewels.
Lets talk about them. He asked how many days do I open my door? Unofficially...everyday.
I kind of made it known that I am the one I want people to come to.
I have a patient that is a principle of a local middle school. She told me she was having trouble finding a dentist to help some of her students that were in dental pain and didn't have money get them out of pain.
I was kind of insulted. I said, "HOW ABOUT ME?!!!". (I wasn't really insulted but I was thinking somehow I am not getting the message out there.) Maybe they think that since my office is nice, or that because I am not a clinic (I am thinking out loud).

I told this woman I want to be the first person you call. Can you imagine being a teacher of a 6 year old that can't eat her food because she has a tooth ache for 2 weeks?
I told this woman that I don't want you to think about anyone else, I want you to call me. I will take care of all of them. I also told her to tell all her teachers.
Now this brings up another point. People know what kind of dentist you are. They now start to think you are a good guy.
Who do you think the teachers want to come to when they need a dentist.
Some people can call this self serving. "Yeah, you are doing the "right" thing just to market yourself". I could understand where they are coming from.
But this is not why I do it... but it is a benefit (I think it is more the Lord taking care of the "cheerful giver.")
You have no idea how many people have come to me for New Patient Exams because they saw my name in the paper "about that free dental day."
You know the principle I was telling you about...well two weeks later she called me with a student who was in pain. I saw the girl and took an abscessed tooth out. It took me about 20 minutes. No big deal, right?
The girl was thrilled and she went back to school and told everyone.
The next day a teacher brought me a bunt cake just to thank me. The next week another teacher brought her daughter in to get her teeth cleaned.
I mean there is marketing and then there is this stuff.
So when the comment-er says, "he can't afford to give his services away"...I don't think I could afford not to.

Now remember the young lady I was talking about on Monday. Well, I saw her today. Her teeth were fine. I mean she had 5 cavities and I will restore those no problem. But her teeth are really crowded. I mean really crowded. Like she is missing her upper laterals and her lower anteriors have three teeth across and one tooth lingual to the three. So what does this mean to me? Well her treatment is not done. I start in on my specialists.
I use 2 orthodontist exclusively. I know them. I like them and we have a good relationship.
I will call one of them up today. I will tell them her story and he will probably give her orthodontics.
I know some of you are thinking, "this is too much". You are saying, "not everyone can afford why do it for someone you don't know. Not everyone who needs braces should get braces. Braces are a luxury." And I would agree with this.

Okay you know I am a Christian and these are the kind of things I battle myself.
Jesus says the poor will always be among us. This means to me that what ever I do there will still be more need. But...
He also gave us the parable of the Good Samaritan.
In this parable a man gets beaten and robbed and is laying in the street. A priest sees him and just moves to the other side of the street. Then the Levite does the same thing. Then a Samaritan was walking on the road and sees this beaten, broken man. He comes to his aid. He washes his wounds and puts the man on his donkey and takes him to an inn. Giving the inn keeper money he tells the inn keeper to take care of this man. Then he says to the inn keeper I will be by back her on my return journey and I will reimburse you if there is any extra expense.
Now we are suppose to just clean their wounds or are we suppose to bring them to the inn and give them a little spending cash.
Oh yeah, about my new patient...
Did I mention she has 4 impacted wisdom teeth?

Lastly, for today, my comment-er says, "you also have to make a living".
This is true but to whom much is giving much is asked (or something like that).
I mean how much is enough. I know I make a great living. How much more do I need? If I make $100,000, which is more than 99.9% of the world, and about in the 98th percentile in America, do I need more? Okay, how about if I make $150,000, would I be greedy if I wanted more? Okay how about $250,000, if I get to this plateau I will start giving more?

Now I am not being condescending to the comment-er because it is a valid statement.
I just look at myself and see how blessed I am. I look at all the excess in my life and I know I can give away a lot more and still not feel pinched.
My favorite movie is Schindler's List. Remember the part where the war is coming to an end and the Nazi's are killing Jews faster and faster and Schindler is trying to buy them. But Schindler is running out of money. He looks at what he has done and to him it still isn't enough. So he starts pulling the buttons and cuff links of his jacket and says, "use these."
He looks at his life and thinks about all the money he has wasted and how that money could have saved one more life.
Man was that powerful to me.

I will leave you there,
I have much more to talk about on this subject.
I am interested in hearing what you have to say,


PLEASE NOTE: When commenting on this blog, you are affirming that any and all statements, and parts thereof, that you post on “The Daily Grind” (the blog) are your own.

The statements expressed on this blog to include the bloggers postings do not necessarily reflect the opinions of the Academy of General Dentistry (AGD), nor do they imply endorsement by the AGD.