Yesterday I had a 92 year old woman in my chair. She has been a patient of mine for about 12 years, and we have had a great relationship. She has always been so nice and gracious to us.
She is having some health problems. Her main problem appears to be her eyes; she has macular degeneration, and can't see very well. They have told her to stop driving (even though she made it to the office driving herself, probably hitting four cars in our parking lot). She is moving about 3 hours away to live with her daughter, and told us this would be her last appointment.
Before she left, everyone hugged her and told her how much we appreciated her and how much we like her. She then thanked us for taking such good care of her teeth, and that was it. It seemed like I was at her funeral but she was still alive. It was hard.
This makes life seem so short. Our mortality is so right in front of us in times like these. And as my 42nd birthday is a mere 4 days away (if you are looking to send me birthday cards with gift cards in them, you can get my office address off our website. I am not saying I am expecting that, but it would be real nice), I can't help but think of my life. It is going so fast.
I want a remote so I can press the pause button. I love my life RIGHT NOW. I don't want my kids to become teenagers (I heard their heads spin around). I love when David (16 months old) hears my voice and stops what he is doing and comes running.
I love coaching my kids and driving them to school/practice/church/whatever.
But hugging Mrs. Jones yesterday means it is all going to end, and 40 more years seems too short. I know heaven is supposed to be so much better than this and I know that Jesus is sitting up there laughing at my simple mind. But what I know is this and I like this, and to be totally honest, leaving here kind of scares me (but that is a whole other blog). I was told once that life is like a roll of toilet paper: it starts off really slow but at the end it goes really fast. I agree.
Sorry about that. On to today's topic.
I have a friend that is also a patient. Well, he was a patient first but we got along so well that it led to families coming over for BBQs and such. He has been to my birthdays and such, so you know, a good friend.
He has always had issues with his teeth. The first thing we did for him was about 6 fillings, a couple of crowns, and an implant. And he is in his MID-30s. "Okay," I said to him, "I don't know where you have come from, but we now have a clean slate." We gave him a thorough oral hygiene protocol: brushing, flossing, rinsing with chlorhexidine. He has jumped on board with the whole thing.
Let me back up and tell you that people come in all the time with what they call "soft teeth." And every time they say that, I am thinking this is total bulls@#*. "Soft teeth" is a term (to me) that means "I don't take care of my teeth and I eat whatever the hell I want, I drink whatever the hell I want and then go to the dentist and try to blame my teeth." People think they take care of their teeth but they don't.
I know you hear, "I usually floss all the time, but I haven't in a couple weeks because I ran out."
"I usually floss, but my gums started bleeding so I stopped."
"I brush all the time. Should I be brushing in the morning, too?"
You have sugar-coated candy with an energy drink shooter for breakfast. For lunch, it is a bologna sandwich with some kids' cereal in there (to make it crunchy, like The Breakfast Club) and wash it down with an alcoholic energy drink. Then for dinner it's bread, bread, and more bread, and oh a gallon of soda. They you let it sit in there and fall asleep on the couch and forget to brush before bed. Well, this isn't "soft teeth."
Back to my friend. He has stuck with the plan we gave him and things are not that much better. His gums are still not beautifully pink like people on this routine usually are. So when he comes in for an exam and we tell him things don't look that good, he kind of gets dejected. You know the face that says, "This sucks, I work and work and I do everything you tell me to do and it still is not that good."
I sit him up and tell him that it is what it is. You have something going on that is beyond everyone's control. I think you are one of two people in my practice that I tell, "Do the best you can, but you are going to get decay. It is always going to be a battle and if you didn't do the regime that we gave you it would be a lot worse. You are going to do everything you can, but you are still going to get cavities."
I will be as conservative as I can, but don't get mad at me when I tell you it is time to fill a cavity. I tell him that I don't know why it is happening, but we will continue to communicate and try new things as they come out.
Do you have patients like this? We do rinses, we do fluoride trays, high-concentration toothpaste. Nothing seems to work. They claim they have cut out the soda and are strictly water. What else can I say to them?
I just read an article in this month's AGD impact about Proactive Prevention and I learned about a lot new things I might start trying.
Have you heard of these Salese™ lozenges? Me neither.
How about pilocarpine lollipops? GlyLic™ lollipops? Arginine mouthwash? Anyone doing a saliva analysis? Do you have your patients brush with baking soda - straight?
These are all new to me, but what the heck? I am going to try it. I just don't want to be writing a blog 25 years from now telling you about that I just finished putting in 12 implants for my friend.
How is it with you? Am I the only one that feels helpless to these kind of patients?
Have anyone with "soft teeth?" What are you doing about it?
Have a great Wednesday. See you in a couple of days.