Friday, October 30, 2009



Hope things are well with you.
Things going pretty well here. My daughters birthday party is today.
And like I told you she IS getting the ridiculously expensive American Girl doll.
At least she will be happy and I will not feel guilty. That is what this is about isn't it.
Us trying to be the most ideal parents. Well what ever happened to teaching them about values? What ever happened to us teaching them about saving?
I guess because our friends won't see our wealth that way.
I am not going to go through this again. I am not. I am stopping now.
She is going to be thrilled. I am stopping now.

I am not talking about the Gators anymore and if I was I would tell you I am going to Jacksonville (FREE TICKETS, for those of you who are checking to see how much I spend on football and complain about toys for my kids) to the "largest outdoor cocktail party". Luke and I are skipping Halloween to watch the Gators play.

Speaking of Halloween, it is dentists favorite holiday. I am not the dentist that gives kids nickels or toothbrushes in silent protest of candy. I embrace it. I go to Costco and buy a couple of the Snickers Big Bars.

I am not kidding. I staple my card to it and write, "If it hurts when you eat this, do not hesitate to give me a call."

I love Halloween.

Let me ask you a question.
Let's say things don't go so good at work.
You and I we care about your work that is out there. We want our signature on all things. We are proud of our work. What do you do when things don't go so good?

Yesterday I had to do a reverse post and core. I think I made up that name but this is what I call it. This is what I do when a perfectly good crown breaks off (usually someone else's crown). You know when the crown breaks off and some or all of the original tooth is in the crown. The crown margins are intact.
This is what I do, I lube up the inside of the crown, I etch and prepare the tooth and then put self curing build-up material in the crown and a little on the tooth and put the crown back on.
Then the material sets up inside the crown. You take the crown off and Voila you have a new build-up that fits inside the crown.
Tell me I am not the only one doing this.
Well yesterday I had a patient that it was #10 (front tooth) and he broke it at the gum line. I did the root canal and then was going to do the post and a reverse core.
Well I think when we were cementing it we placed the crown slightly buccal.
It was all porcelain so when you are cementing it you only get one chance. There is no, "Oh no that is wrong, take it out lets try again." Your finger is on it and you cure it and then you look at it.
Then what do you do. I am not talking major or anything. But you want it to be your best.
Man, I can't stop thinking about it. I hate doing average work.

Oh, I got an email from my friend who is the guy doing ortho.
I have to show it to you.


ORTHO! My favorite subject (occlusion is a close second).
Well, it all started off about 6 years ago when i decided to take an ortho course and learn more about ortho. I wanted to figure out why my orthodontists gave me lots of 'ortho-excuses' for why cases turned out the way they did. The course was Brock Rondeau, probably the biggest name out there for general dentists doing ortho. It looked really easy, and i decided to buy a starter kit from GAC. I started a couple cases on friends that went great. So, i did a couple more that went great, except for the occasional problem that popped up and made me realize i don't know everything there is to know about ortho. So, over the next 5 years i have taken about 400 hours of OrthoCE from about 6 different speakers. I do about 3/4 of my ortho, and still refer out about 1/4. I also couldn't have done it without the help and encouragement of my orthodontist, who has been a great mentor. I'm not sure how many active cases i have...maybe 20 (5-8 are adults). I only end up with about $/year from ortho, but my fees are probably a little low. The main thing is, it's really fun for me, very rewarding, cerebral, and easier than prepping teeth and trying to get a Bitine ring on a 2nd molar. I think the economy has slowed the cases down a bit, with many patients holding off on ortho, which can always be done later.
I'll attach a great case i just finished. Tell me this hasn't changed this 17 yr old's life!

A couple of things jump out at me from his email.
His passion is the first thing. (I don't think he is orthodontist bashing either)
His desire to do well.
He is having fun and helping his patients at the same time.
I love it.

Last thing for the day is of a personal note.
I am going to come clean. I have periodontal disease.
It all started when I was about 27, I got my first 4mm pocket. I began to floss. I started but was not religious.
It stayed. I then went to having my teeth cleaned every three months.
It persisted.
I then really began to floss, like every day. I got a Sonicare toothbrush and for sure it was going to be a 3mm.
This has been over a 10-12 year period. At about 2 years ago it became a five. I was like damn. So I ramped my hygiene up a notch. I have been flossing two times a day for about a year now.
This last time I got my teeth cleaned this one pocket was a SIX MILLIMETER POCKET.
I couldn't believe it.
So I made an appointment at my periodontist office.
I got the full work up. Let me preface this by telling you that in 2001 when this thing was a 4mm I did an exam at his office. He said he wasn't concerned.
Now this appointment was different.
He says obviously it is worse. He wants to do root plainings on me.
Now keep in mind the last thing dental I have had was 13 years ago. I have not been numb in that long.
He is going to numb my whole mouth and do have mouth of root plainings and half mouth with his new argon laser. I am going to be his science experiment.

I go under the knife next Monday.
I have to tell you, I am the perfect example of bad genes. My mother has lived at the periodontist office her whole life. My father has perfect teeth.
I blame her.
This is going to suck but I have to tell you that I am actually looking forward to feeling what my patients feel. I want to go through it so I can be of a witness to the experience.
At least this is what I am telling myself.
That is it. Hodgepodge of stuff.
But Wednesday....I have this awesome story to tell you. It is so crazy (cliff hanger).

Have a great Halloween,

Be careful,

Don't forget to change your clocks on Saturday night.


1 comment:

sharpiemarker said...

Oh no Dr. Gammichia, I'm so sorry to hear about the perio disease! Where are your 6mm's? Good of you to come clean about it, though, it can happen to all of us. Also good to blame it on the parents. I blame my dental issues (a missing 10 is most recent and still in process, but there is so much more) on my father :)

Anyway, now you're patients can have another level of connection with you! You can find a lot of good things in this disease situation, especially after you get it in the maintenance phase.

Good luck Monday! You will have a ball, don't worry! It IS fun in a way to have perio surgery, I think, at least to a really messed up 19-year old pre-dent mind :) Haha, it's been 13 years since you've been numb? Dang, compare that with a dental regular like myself who has gotten stabbed literally more than 10 times this year, at least. Actually we could be in the chair at the same time, cause I am going in for a final restoration of my 'plant for #10 on Monday!

I'd give you tips, but you know them all, so I'll just wish yah luck! Let us know how it goes, okay? Pics would be awesome, too {hint, hint!:)} Can't wait for the awesome story on Wed!


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