Hey hey hey. It’s me. I don't know if you remember, but I traded blog days with Dr. Joyce when I was on vacation. So here I am on Monday. It worked out well because I am working today. By the way, this working on Monday thing stinks, but, I digress.
I have seen a couple of movies that I wanted to tell you about. I saw "Black Swan." Hated it. I saw "Horrible Bosses," like I said. It was very good, but don't see it with the kids (I saw this at the regular theater at regular prices. Wow. We saw the 4:15 showing and for 4 of us with popcorn and drinks, it was $65.) I saw Soul Surfer (at the dollar theater, with 4 kids, popcorn and drinks galore for $19). I saw "American Pyscho" with Christian Bale, and I hated this one too. And yesterday I saw "Thor." This is, by far, the worst Marvel movie so far. I have really liked all the others and this one just wasn't good.
I am almost done with my book on Bonhoeffer. It was 570 pages of histooooooooooorrrrrrrryyyyy… Sorry, I fell asleep for a second there. It was like reading an encyclopedia. There was zero action. No plot. No big ending. Just history. Anyway, next up is Tim Tebow's Through My Eyes.
Okay, topic of the day. I am a big sealant person. I think sealants are the bomb. I think when done well, they are so good at preventing decay. That being said, there are some problems with them. At least with me.
You know I use the Design for Vision 3.5's and I use a headlight (Perioptix - totally recommend them). I see very well. When I do exams, I see through a tooth. Do you all get this? I look at the color of the tooth. I look past the enamel. I am almost looking at the dentin. I get what the color of the enamel is so I want to see what color is coming through the enamel. I am feeling a tooth with an explorer but I almost trust my eyes better than my explorer.
So something that doesn't stick does not always mean there is nothing there. Sometimes, I will go into a tooth that I see an issue with. I still doubt myself sometimes, but almost all the time (I can count on two fingers when I was wrong) there is decay.
Going back to sealants. I am doing an exam, and I see a sealant. First, I am locked out of the tooth. I have no tactile sense on this tooth anymore. All I have is my eyes. But you know what goes on. We see virgin teeth and we want to seal them, as fast as possible. I check to see if I get a stick, and if there isn't any, I am sealing that puppy. What if there is a stained groove but no stick? I seal it. But we all know what that sealed tooth looks like. It looks like there is color coming from the dentin. Hmmmm?
What do I do? Do I start cutting through sealants every time I see color through them? I love sealants, but my assistant feels the opposite. She hates sealants because she sees the disasters. The disasters are the ones with color that I watch. Next thing you know, it is 3 years later and I feel that the color is getting bigger. I cut through the sealant and KA-BOOM, there is so much decay under this thing it is almost a pulp exposure. And it is usually on a 12 year old or something.
I did two today that were exactly this. I didn't watch them, but I saw this girl who was a new patient. The sealants looked great but the color didn't seem right to me. Got in them and HELLO. So this girl who "has never had a cavity before" has two giant fillings in her mouth (that look spectacular, if I don't say so myself).
While I was filling up these big holes I decided to do sealants on her second molars. I checked and checked with an explorer before I did them. We used to go under the assumption that even if there is a bit of decay and you seal over it, the sealant will starve the decay and it won't get any bigger. Sound familiar? I still do buy that, but what can I do but doubt sealants now? I just can't. One of my pediatric dentists does fissurotomies before every sealant. I think this might be a little overboard, but at least he knows before he puts the sealant on. I believe in them. I do them on my kids. But you can bet that I am checking their teeth before I put them on. And nowadays, I check them double after.
Thoughts? Let me know how you do sealants, and on whom. See you Wednesday (Mondays suck).
P.S. I think a rating system comes up at the bottom of the blogs now. (At least it does when I go back to them). Do me a favor and rate the blogs after you read them (email people won't be able to do this). Then I can start to know what you like the best and do blogs that way.