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,

Sunday, November 30, 2008

Giving it away

I had an awesome weekend.
The Gators are one win away from the National Chomp...ionship. One small problem... ALABAMA.
I can't tell you how hard I have tried to get tickets to this game. With absolutely no luck. Apparently, I don't know anyone with any sort of power (that includes all of you).
But the Gators look so good and right now I am on cloud nine.
One more thing, I am almost a lock for a ticket to the National Championship game in Miami.
My friend is able to get tickets, so if we go, I am going. Man this is exciting. I can't even contain myself.

We had a great Thanksgiving. As you may know I come from a big family (I have 4 brothers and sisters). Getting together is always exciting. But everything went great. We enjoyed each others company and had a wonderful time. We even went around the table and told each other what we are thankful for.
My mother was not able to be there so she wrote a two page letter that I read when it was her turn.
I fried my first turkey and it came out pretty good, if I don't say so my damn self. (see photo below,this is my frier)
My wife is an exceptional cook and makes the best sweet potato casserole and pecan pie.
All of her stuff went straight to my badonk-a-donk.

Okay today I want to talk to you about giving it away.
I am talking about dentistry.
As you may know I am a give it away kind of guy.
I have made it known to most people that if they have a friend or a friend of a friend that is having a tooth problem and doesn't have the money to pay for it...I am the one to turn to.
As you can see that there are many problems with my philosophy.

First of all, there is so much need I can't do it all.
Now that the word is out, alot of people are coming to me.
There are a lot more problems and I will get to this but let me give you an example.

I was walking out of church a couple of weeks ago and my pastor is talking to a visiting pastor (now this guy is my pastor's friend. He has his own church but he was just visiting). I walked by and said goodbye.
My pastor is always joking about me being a dentist. He says as I am walking away, "If you ever need a dentist, there is your man."
The wife of the pastor says, "Oh my gosh, we need a dentist to help us." I thought she was kidding and I said while walking away, "I am your man, just call me."
Turns out she really needed a dentist. My pastor called me and told me they have a need.
Here it is...
They have a 20 year old autistic kid, Aaron. There is a program called Best Buddies. I don't know if it is a national organization or not but it is here in Orlando and it is a program like Big Brother, Big Sister but with special needs kids.
The one that volunteered to be Best Buddies with their son is K. K is this 18 year old girl from some Latin American country. Her parents came over on some visa 20 years ago. She and her brother were born here. They are American citizens but their parents aren't. So the parents had to go home. She has lived here with her older brother for the last 8 years without their parents. She is working her way through community college, with no more help from her folks, and in her spare time volunteering at Best Buddies.
Now she has gotten to know the parents of Aaron. And they have come to find out her story and one of the finer points of the story is that her teeth are hurting her and she can't afford to go to the dentist.
Now to me this sounds like and exceptional individual, much deserving of a break.

But lets take a step back here.
The pastor, I don't even know this guy. Okay so he has his own church, are there not any dentists in his congregation. Okay if there isn' about his personal dentist.
No, lets just ask a perfect stranger.
Remember, I have a philosophy of helping people but this philosophy doesn't really have any rules.
What do I say, "No, I won't help a very deserving person in pain"?
Okay, I will see her. I tell her people to tell her to call me. I talk to K.
After I told her that I am looking forward to helping her she started to cry. She said, "thank you" a hundred times.
So she goes on to tell me that she had a couple of fillings done and the doctor that did the others said she had more cavities to have filled.
I asked her if the cavities hurt of the fillings hurt. She said both.

So I will end here.
But I will leave you with a couple more questions.
What do I do?
Do I do all the fillings?
What if she needs a root canal?
Do I give a cleaning first and a full series of x-rays?
I mean we are talking anywhere from $200-$4000.

Lets talk about this again on Wednesday,
ps I usually do a spell check at the end of a blog, so I don't look like an idiot (okay more of an idiot) and this was the first time there were no spelling mistakes. An early Christmas present.

Wednesday, November 26, 2008


I don't even know what to say.
I sit here in my office and think about all that I am thankful for and don't even know where to start.

I mean you all know how I feel about living in this country.
I can't help to feel lucky every time I turn on the world news and see other countries suffering so much. We are the best, most caring, most philanthropic country in the world.
Much has been asked of us because much has been given to us.
We have a government and economy (I know it doesn't seem like it right now) that is the envy of the world.

I am kind of a spiritual man and I am thankful for knowing God and the opportunity I have to go to heaven.
I am thrilled that my family will know they will have the same.

I have a beautiful wife that loves me even with all my faults (don't say anything). She loves me when I am great and she loves me when I am an a-hole.
I am thankful for our relationship. I seem to love her more and more as time goes on.
God has truly blessed me with this soul-mate.
Speaking of kids.
I have three of the most wonderful children. I couldn't of created better ones on the computer.
Having children is so much more rich than you can imagine. And talk about screwing up...I do on a regular basis, I am just hoping they see my love for them through all my mistakes.

I have this awesome job and get to share it with my dad.
He is a great partner and an awesome supporter of me and what I am doing. He is fun to work with and easy to talk to.
I love my job and the people I work with. It is one of these loves that I would do it for free if I could (I asked my wife and she said NO).
I love teeth and the people that have them. I feel like God has put me here and I use this "talent" in a way that is glorifying to Him.
I have always thought about this...Why did God make me a dentist? But as I started seeing the mission field that I am in, it is becoming very clear.

I have a perfect house in a great neighborhood. I have great friends.
I have a great church and a great church family.

I have a mom and brothers and sisters that love me (okay, maybe like alot). And we are all in pretty good health.

So, yes there is somethings that are not rosy all the time but when you look at the big is pretty nice. Okay, real nice.
We sometimes have a tendency to look at the bad stuff but I think this is a mistake. We forget to really look at all our blessings. We are so hell bent on finishing this task or getting to this event we forget to "stop and smell the roses".

So when I am sitting at the table tomorrow and my mom is eventually going to say, "Let's go around the table and tell each other what we are thankful for", I guess, in the interest of time I could just say, "EVERYTHING".

Lastly, I am thankful for you. I really do enjoy this thing. It is like therapy.
Okay one more thing...I am thankful that the Gators are going to win the National Championship.

Have a great weekend.
Football, basketball, turkey, sweet potato casserole, pumpkin pie, (I am salivating just thinking of tomorrow) family and naps...what more can you ask for.

Friday, November 21, 2008

My associate

Hi all,
I hope you had a good weekend.
Thanksgiving is only 3 days away.
Wow do we have a lot to be thankful for. Lets talk about this on Wednesday.

I started this blog on Friday and never was able to finish it because I had a physical therapy appointment on my Achilles. It is still hurting real bad. Every time it starts feeling better I go for a long run and it starts to kill. I ran out the door and never sent this. So here it is Monday and I am starting over.

First let me get some preliminary stuff out of the way.
Our football team got creamed. 42-6 (on Tuesday) . The half time score was 14-6. But after half-time they opened it up on us.
I am starting to think it is coaching (present company included). The kids don't listen really well. Some of them just don't care. Some of them just want to have fun (God forbid). I think they are having fun and really that is the important thing. I don't think one of them can tell us what are record it. The only time they are not having fun is when they are on the field getting creamed.
(We won on Saturday. We played a team with all third graders, but we played much better).

I finished the book, Beautiful Boy and I will be writing about it next week.

Well I had a weird week.
My father was on vacation this week.
So usually the poop hits the fan when he is gone. I am not saying things are always hectic but I am just saying that when he is here he is handling his issues and I am handling mine.
When he is gone there are twice the issues that seem to make your already hard day harder.
Our practice really is a two dentist practice and there are too many patients for one.
For instance, when he is gone I am doing 27 hygiene checks a day.
This kind of makes for a busy day.

I wanted to talk to you about my associate. I mean my past associate.
We talked last week and decided to end our professional relationship.
One year ago it was the perfect time to bring in someone. It was busy. We were bringing in new patients, we were generating production out of hygiene, people were asking us for treatment.
As I have told you before we interviewed a lot of people and we felt like the we hired the best dentist/person for the job. At the beginning things were looking real good. She was so nice. She got along great with the staff and our patients. And she was a good dentist to boot.
But, like I told you, things are slow.
After a couple of months after she started we discussed pushing her to hourly. She felt like if she sat around the office for 6 hours and worked for 3 it was unfair (I told you she was good like this).
But then the New Patient Exams were drying up, patients weren't asking for dentistry anymore. So anything that was coming in was being put on my dad and my schedule.
There was nothing for her to do.
At the beginning we spoke about her going to get her own patients. Well this turned out to be harder to do than expected.
You think that if you join the Chamber of Commerce, the Rotary and the Woman's Club people don't start flocking in right away. You have to build relationships. These relationships still don't equal immediate response. Most people have dentists. Most people are comfortable in their present situation. But you want to be the guy/gal that is there if something goes south in that relationship.
So it may take a couple of years.
So a week or so ago, we sat down together. She sees the schedule, I see the schedule and we look at each other.
I tell her I really like our relationship but I realize I am probably holding you back from finding a job that is more lucrative.
She said she was seeing the writing on the wall. She also said she like our relationship and loved our office but that ain't paying the bills for her.

She was awesome and she will continue to be part of our family. But in the end we concurred that we couldn't work together any more. We left it at that and we agreed to revisit each other when things get busier.

It sucks...totally sucks.

I will talk to you on Wednesday (maybe),

Wednesday, November 19, 2008

Photo blog

This blog is going to be nothing but photos. (remember you can double click on the photo and it will become very big so you can see better detail. If you want).
I have wanted to show you pictures in my blog but when I am at home writing about my week,
my pictures are at work.
And when I am at work, sometimes they are at home.
You get it?
So here are some photos of the last couple of things.
Most recently,
Noah's first Gator game.

Now the three of us...just a little closer.
The Marine Corps Marathon...this was at mile 17. Look how many people are around me. I am the guy in the white shirt in the middle of the pack.

This is me and the fam after the race. I was totally dying in this picture.
This is the next day with the boys. I think Madison wanted to take the picture. And YES I wore my medal for a couple of days after the race.

The next day we went to Arlington Cementary and were able to see the Changing of the Guard at the Tomb of the Unknown Soldier. AWESOME.
Have a great Wednesday...I will see you on Friday.
Ps. Nothing from Sam after last Friday. Hmm.
PPS. I changed the website around a little. I put a bunch of before and after photos and bunch of pictures of the office on it. or Check it out.

Monday, November 17, 2008

Grow a set.

Hey everyone,
I hope you had a good weekend.

I started out Saturday morning with our flag football game. We won. The team we played was not very good so we creamed them. Maybe our team will surprise me but...I doubt it. Luke played. Broken arm and all.
Then from the game me and the boys jumped in the car and drove to Gainesville for the Gator game. So it was me and my five year old and my nine year old. We were meeting someone there that had our tickets. We parked and started walking to the stadium and it started to rain.
This could have been a real disaster but it didn't rain very long or very hard.
We met up with our friend and went to the game.
Noah had a blast. I got him all the food and drinks he wanted. Problem with all the food and drinks is he has kidneys the size of cashew peanuts and soon after it was, "Daddy I have to go poopie".
Oh crap. Have you ever seen the men's bathroom at a football stadium?
But all in all we had a great time. Noah had a great birthday and the Gators are looking so so good.
I am trying to get SEC Championship tickets. If anyone out there in blog world can score me two I would love you forever.

I wrote a blog on Friday....
I don't know if you all get to see all the comments. But I get alerts when someone writes a comment. Sometimes very nice and sometimes...not so nice. I guess when you write a blog you have to take the good with the bad. But this one in particular has got my mind going for the last couple of days.

Sam writes (so eloquently)...
Why would you put up with patients that don't respect your team? They do everything they can to fill your schedule and you call them great but you can't stand up for them? Grow a set.

I have had a couple of days to calm down from my venom that I wanted to spew when I read it.
So how does one respond to this?
Maybe I write a scathing comment back.
Maybe I just ignore it.
I could have done a lot of things but this time what I thought I would do is blog on it.

Hear are my thought. First, he says, "Why don't you stand up for your team." Well I thought maybe he didn't read the blog very well because it says that I did stick up for my staff.
My next thought was that I don't think Sam is an avid reader of the blog because then he would have known how I feel about confrontation.

My next train of thought is...Isn't the Internet great?
Anyone can tell anyone how they feel and never be recognized. It is a perfect society for someone like me (and Sam) where we can say how we feel and remain anonymous.
Sam can say whatever he wants without repercussions. He can learn all about me but we never learn anything about Sam.
I mean there is a chance that Sam isn't even a dentist.
I am not saying you have to be a dentist read or comment on the blog but I think most dentist would agree that we are cut out of the same mould. I think many of us are people pleasers and mostly non confrontation. So most dentists can identify with the way I think, I think.
Next train of thought...
I was thinking that the way that Sam writes. His comments sounds very Gen X.
I don't know many 40 year old guys that would use the phrase "Grow a set".
So he probably is a young dentist.
Maybe he is the DentalTown know the one that because they have a computer they have become an expert on all subjects.
Maybe Sam doesn't even own his own practice.
Maybe he doesn't know that because you own your own practice there are things you have to do that you don't want to do.
Like putting up with mean people. Like working on people that you don't like. I mean if you fired all the patients you didn't like or didn't think the same as you...well, you couldn't pay the bills.
I want be happy and I want my staff to be happy but I also know everyone likes eating.
(I know I am exaggerating, but you get my point).
I told you in previous blogs (that Sam probably hasn't read) that this economy breeds even more "service before self" kind of philosophy.

So in hind site I could of done a lot of things about this comment.
Even though I have been doing this for almost a year (wow, time flies when you are constantly writing blogs) I am still learning.
I am learning that this can be so fun at times and not so fun at other times. I guess this is like life. I guess it is a little like owning your own practice. Right Sam?

Have a great Monday,

ps Our office got broken into on Saturday night. They broke a glass door walked in, stole the 42 inch plasma in the reception area and walked out. We are the 5th dental office to be broken into this week, all with the same story.
One office has a surveillance camera and the dude was in and out of his office in 49 seconds. WOW!!
Ownership....great fun. Right Sam? (enough already).

Friday, November 14, 2008

I have this patient

No fluff today I am going to get right to it.
I wanted to talk about the "difficult" patient.

I have this list of possible blog topics and I have had this on the list for a long time.
It has increased in importance since the proverbial bottom has dropped out of my practice.

Remember the blog I wrote last Friday, that is in virtual blog heaven, well it was all about how my practice was dealing with this slow economy.
In the past I have told you how lucky I felt because I come to work and I have had full days.
But about three weeks ago the bottom has dropped out from under me. There are days when I come to work and I will not have a patient until 10am (remember I start at 7am) and it could be spotty after that.
For the record, even if my staff told me I don't need to come in, I usually still come in. I am that kind of guy. I don't miss work. I might not have anything to do but I am coming to work. I can do other things than patient care.
But three weeks ago all the patients went away. Even our hygiene schedule is very iffy. Last week, with three hygienists, we had a day when there was 8 open hygiene appointments.
Our hygiene has always been the rock that this office stands on and it is showing signs of weakness. Our people up front are working hard, doing some creative things, to fill the schedule.
The last couple of weeks have been pretty good but I think it is going to be like this for awhile. Taking the good with the bad. Trying to cut costs and not buying anything to extravagant for awhile.

Which brings me to the topic of the day. Remember a couple of weeks ago I talked about how this tough economy breeds better service. The people that are out spending money, be it on a staycation or fixing a small dent in their car or getting their carpets cleaned... are getting better service. The one providing the service now has time to do a better job. He recognizes the need to keep and impress every single customer.
And at our office we have this mentality. Exceed expectations. I am a big service guy. Treat everyone like you would like to be treated...and then some.

So what do you do with the "difficult" patient.
I am not talking about the one that doesn't do all their treatment. I am not talking about the occassional grump. I am talking about the man that is degrading to your staff. The woman that looks down at the "help".
Look, we are in a service industry. We work with people. All people don't fit into this "nice" box.
Now I will give you what my gut says and then I will tell you what I do.
I am the kind of guy that can handle anyone. I kill them with kindness and if that doesn't work. Then I still suck it up and treat them. I might not like them and cuss the whole time but I still treat them.
I realize some people are just unhappy. What can you do? Nothing.
So people are just mean. What can you do? "Thank you sir, may I have another."
Where did it every say in dental school that you are only going to work on nice people that appreciate you and will do everything you say?

The staff usually comes to me in a united front and says, "That guy is an a-hole and he is mean to the hygienist and WE don't think SHE should have to put up with it."
This particular man has been a patient of mine for about 11 years (keep in mind I have only been practicing for about 13 years). He has always been a turd but it gets tiring. He likes our office and he likes me and the hygienist (so his meanness is not about us) but he is getting meaner.
Me, I usually blow it off, but now I have to deal with it because everyone is looking at me to back them up.
I genuinely want people to treat my staff well and I want everyone to be nice but to do this it would involve confrontation. Now, as you know confrontation is not my strong suit. It isn't even a suit in my book.
I love my staff and I hate confrontation. Man this sucks.
I have to do this but not in a way to make him upset with me and to see that his anger is upsetting people that are only trying to help him.
I do it. I sit him down and tell him I like him and I thought we have a good relationship. I tell him the hygienist just wants the best for him and blah blah blah.
He nods. He says, "Yeah, maybe I have been a little hard on her." He thanks me for bringing it to his attention. He stops by the hygienist's room and apologizes to her. He tells her he likes her and asks her for his forgiveness.
Wow. That worked out great. I hated every minute of it.

I know this is getting long but I have one more story.
This woman is successful by all standards. She has a great job and lots of money. But she comes in and immediately degrades the front desk staff.
Her first words are "I know how to fill out a form" while taking the health history from my people.
And it only got worse, she is snippy and condescending.
But when she is with me, she is fine. But every time she is with anyone else she is a complete bee-och.
Again, the staff came to me as a united front. I tell them I don't see it because she is so nice with me.
But she is really upsetting ALL my staff.
No one wants to deal with her and no one wants to clean her teeth.
By the by, her husband is about the nicest guy you will ever meet (isn't that always the case).
I have to call her to address this issue. I call her up and let her know, very gently, that I appreciate her I really like having her here but...I told her how it is important to me that my staff treated with respect and when it comes to her treatment they are integral part of it. It is this balance between I want you as a patient but you can't continue being the way you are.
I hated every second of our conversation.
She was very nice.
The next morning her administrative assistant brought us cupcakes.
I thought this story was over but now it seems that every time she comes in she is meaner and meaner.
Everyone walks by the room she is in and hears her chewing out the hygienist.
It looks like I might have to have another talk with her. I feel the hairs on the back of my neck standing up as I write this.

Have a great weekend,
Can you believe the week after next is Thanksgiving?
Christmas is right around the corner.

Wednesday, November 12, 2008

I finally did a Cerec Crown

I know what you were thinking?
Where the heck have you been?
Well here is my excuse....Friday I was writing a blog, I was going pretty good.
I went to see a couple of patients and I came back and it was gone. I was so ticked.
This website use to save the blog as I was writing but for some reason not any more and it was gone.
Now, remember I am coaching football again and the practice is at 3:15 and I don't have time after work to write.
So I couldn't write again, so I said forget it.
Monday came along and it was just a busy day. I take the kids to school in the morning at 8:15 and pick them up at 3:15 (I pick Noah up at 1pm) and it seems that this 7 hours goes like lightning.
I lost track of time and next thing I knew I skipped another day.
Oh, by the by, there was practice after school on Monday too.
I am an assistant coach. It is so much easier. I don't know if I told you about my head coaching days. It is really tough on me. I wouldn't sleep because I was so into it.
(I know I have problems, you don't have to remind me. )
We had our first game yesterday and we got creamed. It is a lot of fun.

I am reading this book called Beautiful Boy right now and I am almost done. I am going to write a whole blog on it...maybe Friday. It a true story about a man who has a son. Basically at 18 the kid was addicted to Meth.
So it starts from this kids birth and how this kid grew up. It talks about how the dad found pot in his backpack at the age of ELEVEN. It talks about the rehab and how the fathers love for this kid saves him. But it talks about how a family was destroyed because of it.
Amazing stuff. I have to tell you about it.

I have seen some movies...Rendition...pretty good. And I have just started Expelled.
But with TV going strong, movies are on the back burner. I am behind on my TV and haven't watched in a couple of days. Most of my Saturday is all about college football.
Speaking of...Noah turns five on Saturday and I am taking him and Luke to a "real" Gator game.
It is going to be great.

Okay, I have to tell you about my CEREC experience.
The local Patterson CEREC rep has been trying to get into my office. She came one week with my Patterson supply rep.
My supply rep has told her not to talk to me about money. I have told them in the past that I think leading with, "this thing can make you so much money" is a turn off for me. Talk to me about how good it is for my patient's oral health. Talk to me about how it is good for them and then we can talk about money.
So she leads with, "I know I am not suppose to talk to you about how much money this can make you..."
But she came in and told me anytime I wanted I could have a patient come in and she will bring the CEREC and the milling machine to the office and we will do one together.
That very day I saw this 20 year old with two of those Stainless Steel crowns on her permanent molars. (I think when a tooth comes in all mottled and a dentist didn't know what to do, they would just cut it down and slap one of those on there, Maybe it was a pediatric dentist. It is not a bad restoration, just not a permanent one).
I told her everything about the CEREC machine and if she lets me do this she can save $300 off the cost of the new onlay.
She said okay.

We set up a date and I removed the stainless steel crown and prepped this tooth for an onlay.
Simple prep because there wasn't any decay.
The rep was there the whole time. I was prepping and she was making phone calls. When I was ready for her she kind of took over.
She did the spray and I took the picture (impression).
Now she spent the next 5-10 minutes with the CEREC computer telling it what to do. So she would say out loud but not necessarily to me, "...that is too much contact..." click, click, click.
Then say, "...lets take this out..." and "...lets move this..." click, click, click. "...we can just do this.." click, click, click.
Every once and a while she would say to me, "You see what I am doing here? I am reducing the height of contact.....blah, blah, blah"
Now as a dentist without the CEREC I take all the laboratory does for granted. I haven't thought of this stuff, dimensions of a crown, since school.
I usually take an impression or five and send it off to the lab and expect it to come back perfect.
She asks me, "where do you want the height of contact?"
Duh, I don't know.
"Where do you want this cusp tip?"
Duh, I don't know.
"Do you see here, that the thickness of the crown is going to be a little on the thin side, what do you want to do?"
Duh, I don't know.
She continued talking, but not necessarily to me "Lets move the height of contact up to the occlusal one third but you see then it is going to make this cusp look to bulbous. So lets do this..." click, click, click.
It was amazing to watch. My head was spinning.
Now I have heard from users that there is a learning curve. Now I can see why. I can see why someone would call up Patterson and say, "take this back." Now because of the product but because of the intenseness (is that a word) of the machine.
It is a lot of stuff.

But for me, she did it all.
This did take a lot of pressure off of me and it was nice to just sit and watch her work. Don't forget that she has been doing nothing but CEREC restorations for 3 straight years. She is good at it. I don't even want to think about learning the stuff that she has already forgotten.
And I imagine the only way to get good at it is to start working on it in someones mouth and I think this is were it might suck real bad.
Okay...back to the crown...
I told her I wanted the Lee Culp anatomy in this crown. She said no problem and 400 clicks later she was done.
Then it started to mill and 7 minutes later...Viola.
I put the thing on and man was it good. REAL NICE.
The margins were so good.
(I forgot to tell you a part of the story. She had 3 of these SS crowns on her molars. A couple weeks before I prepped one of them and on the day we were going to do the CEREC one, we were going to cement the regular porcelain onlay that I have already made.
So this was good because I got to compare the CEREC crown with the porcelain crown I was doing on another tooth.)
I have to say the margins on both were exceptional. The CEREC crown got the edge though because it was like glass, I kid you not. I was impressed.
Here is where the porcelain crown won. The color.
This particular block that the CEREC crown was made was not very translucent.
Although the margins were great and the occlusion was great and it looked good. The final look was surpassed by the regular, I can adjust the translucency, crown.
Now there could be more blocks of porcelain that are more translucent that the rep and I didn't talk about.
That was the only thing.
The kid and her mom were thrilled. I was thrilled.

Now I don't think I could justify this machine right now, considering I am doing 1 onlay every two weeks or so but it was cool.
I can see what people love about it. Now if I did 5 a day I might really consider getting one.
But because of where I am at, I think I will continue to stay a interested observer.
It was fun, a great experience.

I will talk to you on Friday.
Hope everyone is having a good week.

Wednesday, November 5, 2008


Hi all,
I don't want to talk about the election.
But it is nice to not hear a regular radio advertisement again instead of the incessant political ads.

Okay right to the topic.
I only pay for one dental magazine. I get and really like the Journal of Esthetic and Restorative Dentistry.
This month Harold Heymann (the editor) wrote this awesome Editorial/Perspective that I will get to soon. But this blog is going to be about the Ask The Experts section.
It is edited by Ed Swift Jr. DMD. MS
People have a chance to send in a question and Dr. Swift gets an expert to write an article on it.
In the past it has been on bonding agents or things like impression material. Things that mean something to me.
But this month the topic was Evidence-Based Efficacy of Ozone For Root Canal Irrigation and the question was, "As a follow-up to the recently published information on ozone as a means of caries treatment, can you provide some information on the use of ozone in root canal therapy?"

Now I have vaguely heard of Ozone but not much. Have I missed something? Is there stuff going on out there that I don't know of? Is dentistry passing me by? Is there something out there that is good for my patients that I don't have a clue about.
I mean I am on an island here.
I looked at the article again...this time a little closer. Turns out the "expert" has all these letters behind his name that I don't know what they are. And he is a professor at a University that I don't know in Northern Ireland. And the kicker is the Disclosure section at the end of the article.
Professor Ed Lynch is a consultant and principal investigator for research grants from CurOzone USA (which is not even in the USA, it is in Aurora, Ontario, Canada).
So I was a little annoyed. And you know me, I don't let something like this go.
So I emailed Dr. Swift.

But the beauty of the internet is everyone is accessible to everyone.
No one is out of reach any more. And I challenge all of you to challenge people (except me). If you think something is someone. They don't know you. I have done this a couple of times.
I want you to see the email and his response.
Hi Dr. Swift.,
My name is John Gammichia and I am a dentist in Orlando. I am a big fan of the Journal of Esthetic and Restorative Dentistry. In particular I am a big fan of the Ask the Experts section. I think you do a great job with this.
This Ozone one did peak my interest.
I will tell you as someone that thinks he is a fairly "with it" kind of guy, I was surprised by the topic.
I first heard of Ozone about 7 years ago from Ray Bertolotti. As you know he is always a little on the edge when it comes to things. I looked it up a couple of times and didn't think it was going anywhere for awhile. So I filed it.
So when I was reading the article I started to feel like a topic has passed me by. Maybe something in dentistry was happening and I didn't know about it. I read the article and was kind of annoyed with myself that I wasn't doing the best thing for my patients. I mean just last week I went to a study club meeting with local dentist and the topic was endodontics. There was no mention of Ozone and there were 3 endodontist there.
Then I got to the end of the article and read the Disclosure.
This Expert is a consultant and principle investigator for research grants from CurOzone USA. I understand that money makes the world go round. I understand that most "Experts" have there hand in some marketing or are consultants for companies. But I can tell you I am always weary of them.
Bertolotti, Kanka, Brucia,..Don't get me wrong I love these guys and I think they are all great but try to get them to tell you what the best resin cement is? You will get 12 different answers.
So when I want a real answer, when I want an answer that is unbiased I have to go to the guy that isn't in kahootz with a company. REALITY, CRA, even my local dental school biomaterials guy.
But back to the Ozone article...So this expert...Edward Lynch, MA, BDentSc, TCD, Phd Lond, FDSRCS Ed, FDSRCS Lond. I laugh as I try to type all the letters at the end of his name that I don't know what they mean. Then I read he is a Professor of Restorative Dentistry and Gerodontonlogy (I don't even know what that is, I am assuming it is the study of Geriatrics) at Queens University Belfast, Northern Ireland, United Kingdom.
I just don't know.
I use to be the guy that wants to be on the cutting edge but now I just want to read stuff that will help me and my patients. Which you know that is not always cutting edge. I want to say I care what they are doing in Europe but...I don't really. I am sorry that something that is "huge" in Europe should not be written in magazine for American dentists like it is the best thing for our patients.
One of the things that has been constant in my practice for 13 years is my NaOH irrigant. My local endodontists aren't using it. My local dental school is not using it.I am not saying that I don't believe this guy.
But if you have to find an expert that has degrees that I don't know of and he is from a University that I don't know of...maybe this article might be a little premature. I hope you did not take offense to this email. As someone that really enjoys your work I felt like I could give you some constructive criticism.
I would enjoy hearing your thoughts,
Thank you,

So what did you think? Was I a jerk? Did I get my point across? Was I offensive?
Well here is his answer.

No offense taken. Actually, the author of this article is very well known and highly respected. He is regarded as "the" expert in ozone (I am aware, as you are, of his potential vested interest). Ozone is a much bigger deal in Europe than the US, and I admit that I don't know what to make of it either!

Did he just blow me off?
I don't know. I think I was heard. I think he said what he had to say.
I would appreciate anything you guys think.
Let me know,

Monday, November 3, 2008

Just another Monday

Hey all,
Man did I have a great weekend.
The Gators are such on a roll. I have heard from several college football analysts that they think Florida is the best team in the country right now.
And if you saw them whoop up on the Jawga Dawgs Saturday you might have to agree.
Now if they can get through the next couple of potential "let down" games all will be well with me.
But the BCS stuff is so exciting. The Big 12 has got some really amazing teams. Did you guys see the Texas vs. Texas Tech game...WOW!!! (I saw the highlights...I missed the game, see below).
Also if you looking ahead you are seeing a lot of the same when it comes to the Big 10 (or, as we call it in the south, the Big 1). They are going to be in the Championship game because they don't play anyone. So everyone gets to fight each other to see who is going to play Penn St.
Then Penn St. will get creamed in the game and everyone will say they shouldn't of been there.
Ah...isn't this fun.

More good news.
I got my basketball tickets and I MOVED DOWN. I have told you I was in the third level 2nd row. But I was dead center, so I didn't want to move down 5 rows and be behind the basket.
So I kept putting stipulations on my needless to say I never moved.
This year my ship came in.
I moved down to the 11th row in the second level, in the almost center of the court. And I am on an aisle. Man... were the basketball seating selection gods smiling down on me. AWESOME.
I am so excited. Even my wife was excited and she couldn't give two poops about it.

Next thing...
My daughter's birthday was last Sunday. Yeah the day of my race so she kind of got jipped. So I promised I would take her roller skating this past weekend. I don't know what it is but my daughter went to a birthday party at this skating rink about 4 months ago and I can tell you without exaggerating that she has asked me to go roller skating every weekend since the party. I have taken a time or two but since that first party it was a given that she wanted to have a roller skating party.
She had kind of had a big girl party.
She was able to invite 4 friends to go with us. First it was roller skating, then they were all going home for birthday cake and ice cream. Then they were going to get into their pajama's and watch a movie. Then the parents would come and get them at 11pm.
(Why didn't they just sleep over? I don't know. You are going to have ask my wife on that one.)
So everyone came over and we were off to the skating rink.
So it was me, Luke, and 4 eight year old girls.
My sister showed up (who is 40 and still has her skates from the eighth grade) and my mom.
What a great time. The girls were having a blast. It is so great to be able to see your daughter happy.

So we are getting ready to wrap it up and Luke comes skating up with tears in his eyes, holding his arm. I asked what happened. He said he fell and his arm hurts. I am the typical dad and I got some ice but assumed he was just hurt and it would be fine in a couple of minutes.
All the way home he is fighting back tears.
He is in the front seat while all the girls in the back are talking and singing songs. I tell him, if this is a big deal tell me so we can go to the hospital. But if this is not a big deal you better not tell your mom because if it isn't a big deal and you tell your mom, then she will keep you out of baseball tomorrow and maybe out of football next week. He puckers up and says he can handle it.
So the first 20 minutes home he is having cake and ice cream but still holding that arm.
But that was about all he could take...He says, "That is it!! I can't take it anymore!! My arm is killing me." (I am laughing while writing this because this is going to be a story that will live in infamy in our house for a long time. I know when my kids are grown we are going to be sitting around the dinner table at Christmas eve and Luke will be like, "Remember that time I broke my arm and you told me not to tell mom..." Good times).
We went to the after hours Pediatric care place up the road.
He indeed broke his left arm, the radial bone, about one inch from his wrist.
"I would like to take this opportunity to nominate John Gammichia for dad of the year".

He was put in a soft cast, given some Tylenol II (Oh yeah) and given a script to see the orthopedic on Monday.
That is the end of the baseball season...and he had his first football practice last Friday and he was going to be the quarterback. There goes that.
He went to my hand guy and he now has a cast up to the middle of his bicep. He goes in next week to have it evaluated for a smaller cast.
Isn't life great.
Life at the Gammichia house. It is never boring.

I will talk to you on Wednesday.

Friday, October 31, 2008


I watched a show called Kitchen Nightmares last night.
It is the guy from Hell's Kitchen and he has a reality show. He goes into a failing restaurant and tries to fix it up.
Now you have a world renown chef going into a failing mom and pop restaurant and trying to fix the restaurants many ills in five days.
This particular BBQ joint had three owners. A managing partner and a husband and wife "silent" partners.
The restaurant sucks and it is losing money so everyone starts to crucify the managing partner. He starts to lose more money so he starts to skimp on the quality of the cheese. Then the quality of the potatoes, then the quality of the carpet. Then the next thing you know nothing in this place is quality.
I mean this is a place with three dudes as "cooks". They certainly are not chefs. They can flip a burger and throw fries in the deep fryer but they don't know how to "cook".
So he starts in on the poor cooks.
He tells them how to do it right in the afternoon and says we are going to try the new menu and the new attitude TONIGHT.
Then they are suppose to execute things that he has learned in a lifetime of restaurant consultation in one night.
The night is seizure inducing chaos. He is a total spaz but somehow the restaurant makes it through the night. At the end of the night (day five) he says good job, gives them a pep talk and leaves.
WOW. What a crazy show. I think I will DVR it.
Have you seen it?

One thing I do envy is the ability for a person to say it like it is. I am this "no confrontation at any cost" kind of guy.
I envy someones ability to say what he or she is thinking. I know in my heart that things will be okay and probably better if I just tell people what I expect. But that may lead to confrontation and that is not okay.
I am working on it but when I see someone laying into someone it just makes me uncomfortable. Now maybe the dude deserved it and it will make him a better employee but just watching someone else being forceful makes me uncomfortable.
Crazy...I know.

The marathon...
Where was I?
I think I was telling you about the beginning of the marathon. I started with two of my friends and by the second mile they were gone, they wanted to get out of the they bolted. I know that when you are running with 25,000 people there is always going to be crowds. I was using too much energy trying to keep up with them, so I let them go. Okay so here I am 24.2 miles from the finish line and alone.
I was freaking out. Am I just going to run for 4 more hours by myself? Will I be able to do it? Am I going to totally blow my time?
So I just started to run. During my training I run for two miles and then walk for a minute or two. You know for me running is a social event. If there was a lot of people at the water stop I would talk and the next thing you know it is 3-4 minutes later.
So during the marathon I didn't stop. I don't know why I didn't stop. I don't know if I was mad about my "friends" leaving me or I was not very tired or I was just out of sorts.
At mile 10 I started to walk for the first time. I got some water and walked. I used this time to have a GOO and drink without choking.
Remember last week I was telling you how excited I was about seeing all the military vehicles and all the monuments and memorials. Well I didn't see any of it. First there wasn't any Hummers or anything like that along the way. But the things that were there, like the Washington Monument, I didn't even see. I did see the Capital Building but that was at mile 18 and I didn't give a sh#$$!#%&t about it.
All I cared about was the looking for the next mile marker.
So things were going pretty good.
One thing that was golden for me was my shirt. I wrote my name in big letters on the front of my shirt. JOHN
So everyone was yelling at me, "Go John", " Way to go John", "Looking great John".
It was awesome. So some of the other runners would talk to me, "So you are JOHN."
Then we would get to talking. And if they talked to me I would hang with them for as long as I could.
So I finished the half mile and I couldn't tell how I felt. But I did feel okay.
I knew the clock time was 2:07. I was a little disappointed. But I didn't know how far from my chip time was from the clock time. It turned out it took me 7 minutes to get to the start line after then gun.
So it took me exactly 2 hours to do the first 13.1. This is pretty good.
So I was thinking 2:03 which isn't bad but I was not thinking very clearly. I just wanted to hang on.
But according to the clock I picked up speed. I was as low as 9:11 pace. This is pretty fast by my standards. But the other guys are usually my pace cars. They both wear GPS watches. They have the time, your pace, elevation on this watch. During our training runs they would always be the watchers of the pace.
Mile 17 I saw my family for the first time. It was cool. Everyone was so excited. But my daughter was like, "Ewh, don't touch me, you are disgusting."
They ran across the Mall and I ran around it and I saw them again at mile 19.
I was getting close. My wife told me that Rakesh was about 10 minutes ahead of me and Chris was about 5 minutes ahead...the bastards.
So I made it to about 21 miles before I hit the wall. Okay maybe the wall hit me.
I was feeling good mind and lungs but my legs started to go. I mean my calves were starting to cramp up. I would stop a minute and stretch and I could go a half mile or so before they froze up again. At the 21 mile mark I was on a 3:58 pace.
I would look down and I could see every muscle in my calves tight. This was not good.
At mile 22 the course bended on itself. I saw Rakesh and Chris. I was reeling them in.
But when I was running and I could see the other runners behind me I saw the 4:15 balloon. This means if this person holding this balloon catches me...I am pooping out.
I ran the next 4 miles willing myself NOT to be caught by the 4:15 balloon. I was hurting so bad. My legs were in full on rejection mode. They were like rocks. I sometimes run about 10 strides before I couldn't again. I was willing myself to continue. I kept looking back for that balloon. I was convinced she was going to catch me. The next couple of miles were a blur of pain. But next thing I know I saw 25 miles. I only had 5 laps around a track to go. But I might have to crawl to get there but I was going to get there. Even if I had to beat up the woman with the 4:15 balloons.
I saw the 26 mile sign. I am cussing at my legs at this point.
The last .2 miles are straight up a hill. It was a cruel joke. I pushed it. I did it.
My friends were still at the finish line. We all finished 4 minutes of each other. Chris 4:07, Rakesh 4:08 and me 4:11.
I was so happy it was over. I was such a mess.
I didn't cry this time but a mess none the less.
We got some pictures next to the Iwo Jima Memorial and walked to our families.
What a mess of people. It was crazy.
Then I started to realize that I had finished and I cut 19 minutes off my time. I started to process the race.
Wow. What a blessing. A beautiful day, a great time, I got to be with my friends and family.
It doesn't get any better than this.

I have to go
First flag football practice today. I am only the assistant coach this year.
I will be telling you more as the weeks go on.
Have a great weekend.


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