Tuesday, September 29, 2009

Sunday with the Monkeys


Wow did I have an eventful weekend.
I ran in a 15k race on Saturday morning. Florida is such a wonderful state. It is the "Sunshine" state. Only one problem with sunshine...it brings heat. I was driving to the race at 6:15 am, and it was 81 degrees. The sun was not even up yet.
It was so hot. I finished the race at 8:20 am or so, and it was 86 degrees.
This is the time of year that really sucks in Florida. I watch the Red Sox on TV and people are in sweatshirts and long sleeve shirts, and it is so hot outside during the day. It is so hot that I only go outside in a thong.
About this race. It turns out I ran this race two years ago and my time got worse by two minutes. I am so glad I am training so hard.
I ran it at about 9:20 a mile for 9 miles. My target time for the marathon is 9:09 per mile and that is TWENTY-SIX miles. Not looking good.
Then, I came home and showered and went back out to watch Luke's soccer game at 11:15. It was 93 degrees.

I watched a movie called The Weight of Water. Sean Penn, Elizabeth Hurley and who cares who else because Elizabeth Hurley was in it. It was okay, but did I tell you Elizabeth Hurley was in it. I am not going to even tell you about it.
It was too complicated.

Before I forget....I have been looking for someone to bounce ideas off of. I want to be sensitive to the different races and cultures in my community and patient base, so if an African-American dentist and a Muslim dentist wouldn't mind me asking him/her a couple of questions, please email me at Jgammichia@aol.com
I have to tell you about Sunday, so I will get right to it.

Topic today,
It is a long story, so this may go until Friday.
5th grade at my church is the first grade you can be involved in youth group.
So we were so excited for Luke to get to do church stuff that might be "fun,"
Much to my dismay, he told us a couple of weeks ago that he didn't want to do it.
He said it was "for girls." I told him that if he gave it a try I would get involved.
What I meant by "get involved" was that from 5-6 pm everyone got together and had the talk of the day. You know like talking about a Bible verse about gossip and then writing down "Words that may hurt others and words that would hurt you." How I know what they talked about...I will get to that later.
So from 6-6:30 the boys and girls break up and do gender specific games. This is where I come in. I was going to be in charge of getting the boys outside and having fun.

So it was official that on Sunday I was in charge of boy fun.
So I thought of my youth and what game I liked to play. So for me it was the EGG TOSS.
So we couldn't throw eggs at each other for a half an hour, so I added some things that would complement the egg toss.
So the first game was going to be the egg toss but with a tennis ball. Just to get them warmed up.
So then I thought we would do a water balloon toss and then we would crescendo to the egg toss.
That was the plan.
I dropped my kid off at 5 and everyone is in a room getting ready to sing.
The singer is warming up, the boys are grab assing and the girls are in a circle whispering.
I leave.
When I return, the boys are ready to go. They basically sprint out of the room and go to the field outside. Except one, he is getting a talking to from the facilitator. I kind of overheard words like, "when you say stuff like that to me, it really hurts my feelings." This should have warned me about what was up against. You see, I was blinded by the fact that I knew all these boys. I have been their coach. I have been to BBQs at their houses. I know their dads.
I get the stuff and meet them out there.

The next challenge is to figure out how we are going to make teams. How do I not let the two best athletes be on the same team? How do I not let the two kids that can't throw a ball on the same team?
I split up the 5th graders from the 6th graders. Then I randomly gave them numbers.
They were to match up with the corresponding number in the other grade.
So we have the sixth graders on the left teamed up with the fifth graders on the right.
They seemed to be fair teams.
We started with the tennis balls and the sixth graders started to act up, but it wasn't too bad.
Remember the conversation I was having with Luke about his body changing and his hormones. Well, this all was very evident in the sixth graders. Each of these kids individually have never really been a problem for me, but them all together...now that is a different story.
They are like pit bulls in a pack.
We started the balloon toss, and the first game was okay. See when a team dropped their balloon they were to sit down and wait for the next game to start.
But what the sixth graders, who were sitting out, would do was ruin it for the remaining teams. So when another team was trying to do well they would jump in front of the balloon and try to distract the boy from catching it. Then they would pull on the arm of the guy throwing it.
I had not prepared myself for disciplining these boys. I thought I would have fun games for everyone and they would appreciate my efforts. I guess that was kind of naive on my part.
The first game of water balloon toss was over.
The second game started and the fifth grade boys tossed the balloon to the sixth graders. They are about 3 steps apart. Everyone takes a step back and it is time for the sixth graders to "toss" the balloon to the fifth graders. Well one sixth grader takes his balloon and throws his balloon as hard as he can at the fifth grader and it explodes on his chest.
All the sixth graders erupt with laughter. This kid acts all tough and the fifth grader sits there soaked with water as all the sixth graders are laughing.
I was not laughing.
I wanted to go over to the punk and put him on the ground, but I remembered we were in church. So I just looked at him and said, "Real nice. Now you are out."
I didn't even know what to say to the fifth grader.
The next round, I told all of the sixth graders that they couldn't play and they had to sit away from the action and watch. So they sat away and tried to find things to throw at the kids that were playing the game.
Okay now we were ready for the egg toss.
All the fifth graders got an egg and we were off. I thought this is going to be great.
Well the first egg broke and everyone was having a good time.
Then the next one broke, but this one just cracked. It had some goo coming out but they were definitely out. But then this egg now became something to throw at another unsuspecting kid.
So along with others trying to have fun and play the game right, we have pack of monkeys throwing crap at each other. Running over to the other and smearing egg goo on each other.
I have gone from I want to show Christ to these kids to I want to show the "rod of discipline" to these kids.
The last game was finally upon us.
There were three teams still in it. I said, so for this game let's throw the eggs one at a time.
So the first sixth grader throws it and it breaks.
The second team throws the egg and it breaks.
So the last sixth grader is left standing. I set the stage. "If they successfully throw this egg they will win." I said as he was about to throw, "For the win."
And instead of throwing the egg he decides to PUNT the egg.
I was speechless. I was spent.
We cleaned up and everyone was dispersed.
There was another man/chaperone there and he was stunned speechless. He just sat there and shook his head.

Now, about the exercise before the games. Write on a piece of paper the words that can hurt you and on the other side of the paper was write the words that you say that might hurt others.
So I pick this piece of paper up thinking it was trash and I looked at it.
It had the heading on the top of the paper and it had words like, F@#$%k ,bi!#@$%ch, sh!@$%t , as!@#$%&*hole ,
And on the back was words like stupid, idiot.
Could this one half an hour get any worse?

I am going to stop here, and I will tell you about the fallout on Friday.

Hope your Wednesday is going okay,

Sunday, September 27, 2009


On Sunday the Kansas City Chiefs "played" the Philadelphia Eagles (if you saw even a moment of the game you know why the word is in quotes), at the same time the Kansas City Royals hosted the Minnesota Twins (if Greinke doesn't win the Cy Young he is robbed - there is not a better pitcher on a worse team anywhere). I don't mention this to give you your "bad teams update of the week". Rather I bring it up to provide evidence that God has a sense of humor. See this was the last game at home for the Royals this season and they had planned a "Dog day at the 'K'". Michael Vick is suiting up for his first NFL game in 30 months against the Chiefs and the Royals are hosting a fundraiser for dog rescue shelters - you can't make this stuff up.

On the home front, my 4-year-old daughter (we call her "30 pounds of fury") told me today that I am Santa Claus. I'm sure her 8-year-old brother had nothing to do with it. That said, here's a picture of Santa Claus that makes me believe in the miracle of cryogenics. And not to be a fashionista, but come-on, is the hat really necessary, it only accents the eyebrows - although it is slimming (makes you taller). On second thought, I may have to try that hat out.

Last week Susan was out of town at a meeting and so I got the privilege of spending the week with the kids. I say that without an ounce of sarcasm - we had a blast. Brought a mattress down from one of the bedrooms, put it on my bedroom floor and had a week-long slumber party. I'm sure their teachers at school didn't appreciate it but it was fun for me. That said, I am glad she is back now (I managed to execute a perfect airport pickup), and I have a new appreciation for single-parents. I am very blessed to have a spouse to share in the children duties.
If you want to have a nice example of how insignificant we are in the universe look here. That is the kind of stuff that just amazes me. We think we are so powerful and yet the very height of our technological advancement is but a speck in comparison to all of God's creation.

Do we have any other business owners in the audience? Remember when I first mentioned the manic-depression. I am pretty sure mine is based around the monthly bills cycle. My office is 3 years old and I started it from scratch. We are growing well but are still in what I would call the "hand-to-mouth" phase of the business, and I tend to get a wee bit stressed near the end of the month. What is it that drives us to be small-business owners: sleepless nights, last minute bill payments, the fear of one bad week. But I still wouldn't change a thing. Have you ever tried to explain why we do what we do - we sound like crazy people. Who needs this kind of stress??

OK, enough of the depressing stuff. I'll try to keep that to myself and I'll leave the dental advancement stuff to John. I'll continue the "Single Ladies" theme with a great video that will make you smile.

The voices are a little preoccupied with the bank loan payment due Thursday, so I am going to put them to bed now. Have a great week.


Thursday, September 24, 2009


Hey all,

I have just signed up to be the head football coach of the 5th grade flag football team.
Now, if you have been a regular reader for over a year you know what this means. If you are just joining in well let me catch you up.
My son is in the 5th grade at our little Christian school. I want to live vicariously through my son. I want to turn these little meek boy scouts into lean mean flag-pulling machines.
I have been coaching since the first grade. I don't know what gets into me. When I coach I don't sleep for the whole season. I just get so excited that it takes over my head. Just yesterday I talked to the other coach and we, more like he, decided I was going to be head coach. I didn't sleep well last night thinking of plays.
Last year was great because I took a step down and I was the assistant coach. I slept like a baby. But this year, the head coach is coaching baseball and doesn't want to burn out.
The Christian league that we are in is so competitive. I see the same coaches out there doing the same thing I am doing.
But the thing is...the kids absolutely love it. I see them in school in March and they talk about football. I see them at church and they tell me they can't wait for the season.
Well it is almost upon us.
I need to get me some Ambien CR.

I will get right to it.
Remember I talked to you about how I went to this Florida Academy of Cosmetic Dentistry session? I am not going to talk about the whole thing yet, but I want to talk about this one part.
Well at the very end of the last day the speaker through up some photos of this new way of doing orthodontics called Wilckodontics or AOO (accelerated osteogenic orthodontics).
He showed a before picture of an adult that was a class II open bite (for you non-dental people, this is basically a very tough ortho case), and then he shows us this after that was PERFECT.
Then he says it was done without oral surgery and it only took 6 months.
Apparently this is some wonder treatment. Here is the thing. Before ortho you go to a periodontist, and he cuts slats in the bone between each tooth. I think they put bone grafting material in the slots, but this kick starts the bone to create the cells to move teeth.
Then the braces go on and whammo the teeth move "like butta" (and you have to say that in a Bostonian accent).

I got these two pictures off the Wilckodontics website.

I was impressed to say the least.
Again, you know how I feel about not being in the loop.
I just had an orthodontist tell me about these new things called TADs. Do you guys know what these things are? These are called Temporary Anchorage Devices. This is basically a mini implant that screws in the bone and the orthodontist uses them for anchorage.
So I felt kind of out of the loop there.
I feel like I am just now getting back in the loop and I hear about this AOO stuff.
But this AOO thing is really charging me up.
So I start talking to people.
I saw an orthodontist at church a couple of weeks ago, and I explained to him about what I heard.
He kind of rolled his eyes, kind of like you do when someone says, "This is the next best thing".
(Us dentists, we get so callous to hearing about the "next big thing". As a practicing dentist you can't just jump on every bandwagon.)
So he was not sold on this.
So I called a family friend that is a senior resident in his ortho residency at the University of Florida (Fighting Gators, National Championship in football 2006 and 2008 and basketball 2005 and 2006).
I figured the college of dentistry is just teaching young people to be dentist, and I don't think you would say they necessarily teach on the cutting edge (this is not a knock on dental school, it just is).
But, I figured maybe the specialty schools would be a little different.
We spoke. He told me that right now Wilckodontics is a "little out there."
He said that in most of his treatment planning sessions, with his professors, the TADs are part of the discussion. But AOO is not even in the room.
So the general dentist don't even know about it. The orthodontist think it is another flash in the pan. The residence aren't even talking about it...but the Dawson Center's second in command is talking about it like everyone should be doing it.
Man does this tick me off.
So what am I suppose to do. I see some pictures and it looks awesome. I heard a lecture and he says it is awesome. But no one is doing it.
I think it is the responsibility of the lecturer to say, "this is great, but you may not find anyone doing this in your community" or "this thing is just getting off the ground so it may take a couple of years before you start seeing this in mainstream orthodontics."
But to say it is here and not use a caveat is where they lead you astray.

If you are an avid reader you know I have had this problem in the past. I don't know where to go with this. I don't know how to take a course and not get misled.
So, I can do a couple of things. I can buy into Crahnam's ideas and never see another lecturer.
Or Spear or Kois. You like a guy and spend $75,000 doing all their courses and never stray from your one guy. Or, you can hide in your office and do all your CE online (not that this is bad, it is just a way of not being misled)
But I am starting to get a little disenfranchised with the whole thing.
I don't have an answer. I guess this might just be the way it is. I don't think Crahnam was trying to sell anything. I don't think he was trying to do what he did. Maybe in his world AOO is very blowing up but...
I don't know what else to say.
I didn't mean to bring you down before the weekend.
Are you having this problem?
Did you know about AOO/Wilckodontics?
Is it something that is going to take off?
Let me know what you think.

Have a great weekend,

Tuesday, September 22, 2009

NO, you can't have those Skittles

Hey all,
I had a pretty good weekend.
I was able to finish my 20 mile run and not be admitted to the hospital.
In the past I have had some trouble cramping in my legs after the 16 mile mark.
I sweat a lot, and everyone was giving me advice on what to do. Get more potassium, so eat bananas and oranges.
Drink this and take this.
So after trying almost everything in every combination I think I have got it.
I ate before the run, which I never do. Not much but a half of a cliff bar.
Then I tried these electrolyte pills. One before the run and one every hour of running.
I took the GU products during the run as well (man they are disgusting) and voila
no cramping.
Then after the run I used a Hammer product called Rejuvinate. I tell you, I felt like a million bucks.

We watched a movie called Unknown. It was pretty good.
Six guys wake up in a locked down warehouse. They all have temporary amnesia. They know
something went down, but they don't know what. They don't know who the good guys are and who the bad guys are.
So they are trying to get out, but they don't know whose side they are on.
They find a newspaper article in the bathroom that said what WENT down, but they don't know who is who.
They keep trying to figure out who they are themselves and who the other guys are.

The Florida Dental Association just sent a magazine about nutrition that dentists are supposed to put out in our reception area.
I thumbed through it and it struck me funny.
First, I want to tell you about this kid I know. I saw him at the baseball field.
He is a really nice kid and he has some really nice parents.
This kid is overweight. Okay, I am being kind, he is huge. He has got to be about 150-175 pounds, maybe more. Now let's put this into perspective, my son, who is the same age, is 72 pounds. My son is not breaking any height records but...
I am sitting at the baseball field, and I am feeling sorry for this kid.
I see his parents there and they are both heavy. Now they are not nearly as heavy as their kid, relatively.
Now you all know how much I love my kids. But I (think) I know what is best for them.
I know that saying NO to them sometimes is good for them.
I don't know what is going on with this family and whether there are a bunch of emotional issues going on but...
I have to think that in order for this kid to get this heavy he has to eat and eat often. Not only is he eating often he is eat so much crap it is not even funny.
My kids understand at the Gammichia house crap food is a "once in a while" treat. I mean there is still a basket in our pantry that is filled with last year's Halloween candy.
If the kids behave at the dinner table or they have a good day we use it as a reward.
It is not, "Hey Billy, welcome home from school, can I get you a twinkie or something. And, when you are done with that, there is a bag of Skittles waiting for you." (As a dentist my hair on the back of my neck stands up when I hear the word Skittles. When my kids come home from a birthday party and they have eaten Skittles, I have to really hold myself back from screamming NNNOOOOOOOOOOOOOOOOO!!!)
In everything we do there is some thought (I am talking about now, not in college). We understand that milk is good for our kids. There was some kick back to milk, but never a problem with chocolate milk. So, we buy the 1/2 sugar chocolate syrup.
This is the thing, at our house we are not ogres or anything. Our kids get their fair share of sweets. We have root beer floats as a family at least 2 times a week.
We have sweets. So, I am wondering how this kid gets so large.
I was sitting next to the parents at the baseball game, and they were talking about the brownies they were going to get this kid when he gets home (as I write this I am thinking to myself, brownies are not bad). But when they say it, it makes me cringe.
Try this, lay off the brownies for a couple of months, and see how it goes. I am not just talking about the other kids making fun of him, I am talking about this kid's overall health--high cholesterol, heart stress on his heart. Then it is like, "Oh no, I can't believe Billy has Diabetes." But let's not change his diet, let's just give him shots so he can continue to eat crappy.
I am mad at the parents.

Now back to the FDA magazine. As I thumb through it, and it has chapters on things like "Sodas are bad" and "Veggies are good" and one you probably haven't heard before "Candy and sweets have a negative effect on teeth."
The question begs why do we have to have this magazine.
Do parents really NOT know? How about we have a magazine about how driving with your eyes closed is bad? Or that school and a good education are good.
Then these are the parents that come into my office and are shocked when the kid has 6 cavities. Well what do they drink? Well, in the morning it is chocolate milk and I send them to school with a Capri-Sun. They come home and I give them a Sunny Delight, and then for dinner we drink some Coke. Hmmmm?
And who brushes your 5-year-old's teeth? Well, they do? Hmmmmm?
Don't get me wrong, I know it is hard raising kids. And you are talking to a lazy parent, but I know when I am lazy I try to be lazy in areas that won't physically hurt my kids. Maybe emotionally, like, "No, I won't go bike riding with you, can't you see I am watching the game?"
or "No, I don't want to help you with your homework, I am talking to my friends on the phone."
My kids are going to be so screwed up....But at least they will be physically fit and have nice teeth.
I know I sound like an ass today (no comments on this) and I am being too hard on these parents . But, have to tell you I think as far as that kid on the baseball field, to me I think it is a form of child abuse. It might be a stretch, but the parents may have forgotten about how hard it is for a kid to be in middle school. They have forgotten how mean kids can be, and I don't care if it is at a Christian school or not.
I am going to step down from my soapbox now as long as you parents say, "NO" every once in awhile.
Maybe, NO to brownies.
NO, to unsupervised Internet use (if you don't know, your kids are finding porn sites while you are making dinner and watching the game).
NO, to Mountain Dew.
NO, to (I don't even like writing it) Skittles.
NO, to making fun of other kids.
NO, to driving with your eyes closed.

I love you, now go say NO to your kids.

I'm glad we had this talk.
Have a good Wednesday,

Monday, September 21, 2009

Youth is wasted on the young

How did you spend your weekend?

I spent mine at a few U-11 girl's soccer games, and I was amazed at the parental conduct at each of them. Now, I must tell you, I am not a novice at these games. My oldest daughter plays very competitive soccer and has so for years; so I am accustomed to seeing the depths to which parents can sink. However, this weekend, for some reason, really stood out to me.

I am the dad that definitely lives his sports vicariously through his kids. I don't think it is a bad thing - they are more athletically gifted that I was. I love watching them play and play hard and I love to cheer for them. What I don't do is cheer against the other team. Listening to the parents on a variety of teams this weekend basically asking their daughters to "take out" other players - seriously?? Are we going to turn youth sports into our gladiatorial battles? I felt like I was in bizzaro world. If we put even a fraction of that parental passion into encouraging our kids in school we would not be lagging in the worldwide education standards.

What is happening with our society that we push our kids farther and farther and harder and harder. What is childhood anymore? Will our kids remember their childhood as a series of sporting events and activities where adults around them are yelling and behaving like fools? How will they deal with conflict? How will they deal with adversity? Life doesn't give you a referee to blame. How will my kids relay their memories of childhood to their grandkids as they sit on the lanai at Del Boca Vista (phase III)?

On the dental front, what is a good (g-rated) term for the hyper-picky patient.

I'm not talking about the patient that is spending thousands on anterior work to give them that "Julia Roberts" smile. I'm talking about the 40-something smoker with severe maxillary and mandibular malocclusion that wants a small incisal nick repaired and then proceeds to spend 2 follow-up appointments pointing out "imperfections" in the restoration that, quite honestly, don't exist. The restored tooth looks better than any other tooth in the mouth. Unrealistic expectations can just make you dread entering the treatment room.

Yeah, an incisal restoration is the part of your smile that is missing. Let's focus on that, not brushing and flossing or getting orthodontics.
And while we are at it, there are not many bloggers that can incorporate a reference to "Pretty Woman" and a reference to Public Enemy in the same paragraph! (FLAVOR-FLAAAAAAAAV).

Finally, in the spirit of Kanye West, I will probably rudely interrupt John during one of his posts this week to complain that Justin Timberlake's SNL version of "Single Ladies" didn't win a grammy.

What a world we live in. Well I better go make my daughter run sprints because they only tied their game today (serious sarcasm). Putting the voices to bed now, have a great week.

Friday, September 18, 2009

Daddy, are we rich?

Hey all,

I don't know about you but work has picked up a bit.
It feels pretty good right now. We are not breaking any records but...
I run with a real estate attorney, and he said work has picked up for him as well. He says it is not huge deals or anything but it is things.

No movies this week because something weird happened. I put my Netflix movies into the sleeve but not into the envelope. I put them by my wallet and phone for the next morning. I usually mail them from work. I get to work, and I only have the envelopes. Hmmm, that is weird. I must have left them on the table where I picked up my wallet and phone. I got home and they weren't there. I went back to my car thinking the movies might have slipped through a crack in the seats or something. Long story short, I have lost both movies. I think between leaving my house and getting in my car I threw the trash. I must have inadvertently thrown them away.
This whole week I have looked for these movies. They are not around.
I have to call Netflix and ask for their mercy.

I am still reading The Power of One. I have to admit the book is dragging but it is partially my fault. I have no time to read lately. I am now falling asleep on the couch before 10:30 every night. It is weird. I have always been a 11:30-12 kind of guy but...I am telling you, I am getting old. I am going to be that grandpa who is passed out on the couch at 2pm with my dentures hanging out of my mouth.

Big weekend this weekend.
Going to a fancy steak dinner tonight.
Running 20 miles at 4:30am tomorrow. Soccer game at noon (great time for a soccer game in an open field. I think the weather is really turning in central Florida, it will only be 93).
Then birthday party and football watching the rest of the day. Gator football at 3:30 and then who cares after that.

I was at a 10 year old birthday party a month or so ago and I was talking to another mother. She was complaining that her daughter is the only girl in the neighborhood that goes to private school. And she says her daughter is always complaining that the kids in the neighborhood give her a hard time because she is rich. You know, "Whatever rich girl, just go back to your private school, I think you just missed your tea time." Or something like that.
Now this woman was complaining because she doesn't consider herself and her family to be rich.
Before we go on I want to put things into perspective. Perspective is a good word when it comes to money.
First I want you to take a minute and think in your mind what RICH is. Don't read on. Is it how much you have in the bank? Is it how much you make? Is it the people you see on TV?
Did you think about it?
Okay let's think about this a minute.
The United States of America is the richest country in the world by far (if you go by resources and labor force but if you go by GDP we are 6th or 7th. We are trying so hard to catch up to Liechtenstein....shout out to Lindsey for pointing that out).
According to the Washington Post in 2006 (which was a much better economy than now) 50% of Americans made less than 48,000.
Only 10% households earn more than $100,000 and only 1% earned more than $350,000.

So are you rich? I think by these numbers if you are making over a $100k you are in the top 10%...you are rich.
The problem is that we compare ourselves to Warren Buffett , Sam Walton, and JayZ. But that is not reality. We read People magazine and see Tiger Woods on his 300 foot yacht and think that is rich. We drive by the gated communities on the lake and see the tops of the mansions and think that is rich. We see the Aston Martin coupes and say now that is rich.
I used to ask my father if we were rich. He would say NO, kind of strongly. Now we lived in a big house, we had nice cars, I had me and four brothers and sisters all in private school, we had a boat.
I mean, come on dad.
Now to someone who has a lot of their money going out, it doesn't seem like enough is coming in, so your perspective is different. But this does not mean you are not earning in the top 4%. You are just spending more than the top 3%.
So, back to this woman. They live in a nice house. Her kids go to private school.
She has a very nice ring on her finger and a Rolex, and she drives a Cadillac.
Come on...you are rich.
I talked to a guy that has kids that go to our school and asked him what he thought rich was. And he said some crazy number, he said something like, "if you make over 1 million dollars a year."
To me that isn't rich, that is mega rich. According to The Post only the top 1% make over a million dollars a year.

I am not saying being rich is a bad thing. I am part of the upper 10%. My wife wears a Rolex (which I bought for her before I had a clue about anything) and has a nice ring (please see last parentheses) , we live in a nice house and our kids go to private school.
Just so we are all clear, just because you have stuff doesn't make you rich.

So what does it mean to be rich? Well I can tell you that there are about 1600-2500 verses about money in the Bible. There are more verses about money in the Bible than there are about Faith. Jesus told something like 39 parables, more than half were about money.
So what does that tell you. God wasn't lying when He said that it is harder for a rich man to get into heaven than a camel to get through the eye of a needle.
Or when He says, "No one can serve two masters (interesting how he calls money a master. We all can identify that...chasing after money.) Either you hate the one and love the other, or he will be devoted to the one and despise the other. You cannot serve both God and money."

Understanding what rich really is and recognizing how much we have has comes with some responsibility.
Responsibility to use this talent (we all have a skill that God gave us) and use it for good. For me it is teeth. For you it might be law or teaching or administration.
But we have a skill and we have money. That is not it. It is what we do with it that takes responsibility.
I have to tell you that I love stuff and my comfort, I have told you that.
But it surely can be an idol of mine. But I am finding that this stuff (as the Bible would say) gets eaten by moths or rusts.
I am loving stuff that fades away.

So when my kids ask me if we are rich I tell them yes. But I tell him the above. I tell them it is hard not to love money. It is hard to save, it is hard to tithe, it is hard to make the decision to pay a gajillion dollars for your Christian education. It is tough giving your money away to the poor (ask Joe Biden). It is tough making a bunch of money and choosing to give it away than hoard it.
But that is what the Gammichia's choose to do.
I have to tell you the truth, when I give it away I love money less. I love the Creator of the money more. I am rich by the standards of the Washington Post, but I can tell you I am so much richer than that.
I have been richly blessed in so many more ways than money, and I am truly thankful for that.
And I don't have any problems telling my kids that (and hopefully the neighborhood kids will talk about us).

Have a great weekend,

Go Gators

Tuesday, September 15, 2009


Hi all,

Florida vs Tennessee week. If you are from Tennessee, presently live in Tennessee, have family that live in Tennessee...I am not talking to you. Imagine me with a scowl on my face. That is my game face. I want to beat you so bad that you will pray you had Phillip Fulmer back.
This is where being a man of God and a football fan conflict. I am not suppose to hate, but I don't think there was college football in Jesus' time. If there was there certainly would be an 11th commandment.

Lots of comments on the Implant vs Bridge blog. I don't think I will comment on it so much any more until it is more of a rivalry. It was an unanimous vote. A landslide to say the least.
Everyone would do an implant. They would do an implant on themselves and their patients.
If you want to see the comments go back to that blog and scroll down and you will see all the comments. Remember, if you comment, to check the box that reads "email me with follow-up comments" so you can see all of the comments after yours.

I went to the Florida Academy of Cosmetic Dentists annual meeting this weekend, Thursday afternoon, all day Friday and Saturday. Thursday was a digital photography lecture, I saw John Kois on Friday and John Cranham (this is a guy who practices in Virginia Beach but is a big-wig at the Dawson Institute).
Man, my head is spinning. I have to tell you I so enjoy being with other dentists that are passionate about teeth and getting better but I am not a fan of feeling like "I suck and I don't know how to begin to stop sucking" after a weekend.

I will probably start putting my thoughts on my laptop soon. Maybe Friday.
I saw the movie Jacket. Weird but pretty good. I was an hour and a half into the movie and I said to myself, I think I have seen this before. I told you I am getting old.
I finished Mr. Destiny. Pretty good for a late 80's movie.
As you know I am off on Mondays. My wife and I hang just about every Monday. We have some friends that are also off on Mondays so sometimes we hang out. His wife wanted to see Julie and Julia. I was like, "Come on, are you kidding me?" But friendship takes sacrifice so I went, kicking and scratching. Making fun of the movie even as we are watching the previews. Oh by the way, there was no one in the theater except us. This also opened it up for more jokes. But I have to say, I loved this movie. It dragged just a little at the end and I think it finished weak but during the movie was saying out loud (remember no one is there), "this movie is great".

Topic du jour
I wanted to talk about tattoos. Okay before I start, I want to tell you I know this is going to be a real touchy subject. There are going to be readers that feel like tattoos are taboo and some readers think they are creative and they can't wait for another one.
I get that. I will try to be as fair as possible.
And lets get this out of the way right now. I have a tattoo. I got it when I was in dental school. In college I wanted a tattoo and I wanted to get Yosemite Sam tattooed on my ankle. Well, luckily someone said, "that is stupid, why don't you get something that means something to you."
That got me thinking, maybe a cartoon character might not be such a great idea.
I decided to go with a peace sign. I had my brother, an artist, draw my hand holding up a piece sign. I think it is cool (my kids ask me what it means and I tell them it means I love two kids. They say, "Dad, you have three kids." Then I say, "You better hope you are one of the two." Ahhh, that is parenting at its best isn't it.)
My sisters have tattoos at the base of their backs. My mom has one on her ankle.
I don't mind tattoos. Let me rephrase that, I don't mind tattoos in places that can be hidden when you feel like hiding them.
It is these tattoos that got me thinking...the tattoos that you can't hide.
I think I am a pretty with it kind of guy. In as much as my conservative self can be I think I am pretty liberal. I think I can see the good in this new generation.
I think I see each generation doing things that are kind of stupid but I see where they are coming from.
I did my share of law fracturing (don't tell my dad).
But the tattooing has kind of gone to a new level. Tattooing has gone from the occasional tattoo on the deltoid muscle to where it is now. That is tattooing on necks, forearms, hands, heads.
I am not even talking about the piercing stuff because most of that stuff can come off for a job interview or something important.
I go about my daily life and I see tattoos everywhere. I look around and think to myself all these people can not be NBA players. They all can't be X-games athletes. They all can't be in bands. Lets say a 20 years old wants to get a tattoo on their neck. Not the back of the neck under your hair, but a real nice one, say some Chinese symbols (to me they look like a Chinese menu...like Beef and Broccoli) right down from the ear.
Do they think they are ever going to want a job in the future? So I assuming they are they know they are never going to get a white collar job. So at 20 years old they have written off an office job for the rest of their life.
I saw in newspaper a dude, who was tattooed all over. He had LOVE written on his fingers on one hand and HATE on his other hand. He had a tattoo of a spider web on his neck. The reason he was in the newspaper is that he was having a tough time getting a job. He felt that he was discriminated against because of his tattoos. YAH THINK?
"Yes this is my new front desk person, her name is Sam. Please excuse the tattoo of SCREW OFF on her forearm. You know these kids now-a-days."
This guy in the newspaper was trying to form a coalition. Something like, Tattooed but employable, and fight the establishment.
Well, the article goes on to talk to an employment attorney and the attorney goes on to say, "Sorry sucka."
I mean he used words that were much more gracious but basically the employer, as long as it is not discriminatory/racial, has the right to choose who he or she employs.
But as more and more "kids" get tattooed now a days, the trends have to change.
Either the employers are going to have to realize that everyone is tattooed and they are going to have to change OR the kids are going to have to realize this might affect my chances of getting a job.
I was in TJ Maxx last week and one of the employees had the big hole earrings and tattoos on his neck and arms and such. I was shocked. And he looked like someone of importance there, not just a stock boy or something.
But I don't think this is an overwhelming trend.
I know what you parents of teen agers are thinking. John, you don't have a clue about teens now a days.
I was talking to the 16 year old across the street last week and he asked if I wanted to see his new tattoo. About a 6 inch cross on his deltoid muscles, down his arm.
His mom went with him. GREAT.
16 years old. A 16 year old doesn't have a clue about what his/her future holds. This is the role of the parent. Parents actually parenting. Hmm? What a concept.
I don't know. I like a lot of people with tattoos. I have a lot of successful patients and friends that have tattoos. But I think the vast majority of the ones that have them in revealing spots wish they never got them.
I know its all about the generation and kids staking a claim or something. But do they have to stake such a claim. Can't they just listen to crappy music?
Can't they just wear weird clothes?
Why do they have to let everyone know that ADRIANNA was their first love by writing it in the inside of their lip?

Am I making sense?
Do you have an opinion?

Monday, September 14, 2009

You've been warned

"Fool me once, shame on you. Fool me twice, shame on me."

Well you are back so, shame on you. I tried to warn you once before so now I will just assume you have accepted the risk of brainwarpage by reading again.

I love reading John's posts. They are so logical and organized and seem to stick to one point. If you have ever talked to me you will know that I do not operate in the same way. I tend to wander all over the place at times and love to do lots of different things. My blog posts will, probably, go the same way.

So much time and so little things to talk about - wait a minute, reverse that.

A friend of mine, when he heard that I was doing this blog, asked if I was actually doing it or if my hygienist was doing it and I just came in at the end to say hi. That one made me laugh even though it does present an interesting quandry as a dentist. The healthier I keep my patients the less they see what I do and the less they are aware of me. Any thoughts? What perception to people have of the dentist, I mean we are not "real doctors" anyway - right.

I showed that video to my 8 year old over the weekend and he just laughed and laughed. I love that sound.

So I finished my Leo Tolstoy biography on Friday. If you don't know, Tolstoy was a Russian writer, thinker, theologian, quasi-anarchist nut-job from the late 19th century. His most famous work is War and Peace (or as it was originally entitled, 'War - what is it good for') I was struck by how neurotic he was and I must admit it made me feel better about myself. He was a brilliant mind and yet a horrible parent and husband. He is now widely thought of as the greatest novelist of all time - what would you rather be: anonymous and happy or famous and miserable. I like my anonymity (as I write on the AGD blog - I also like my irony).

The voices are pretty quiet this morning. Probably because I was in for 2 emergency procedures over the weekend. I can go months without even a phone call over the weekend then hit one like this past weekend where I am in the office on Saturday and Sunday. So you know, I live 3 blocks from my office. I love it, I get to be a neighborhood dentist and see my patients at the grocery store, church, on the bike trails. But it also makes it hard to say no or put off a procedure until Monday.

Not that I am bitter but you do realize that I am both a KC Royals fan and a KC Chiefs fan. The fact that I am still alive on Monday should be impressive by itself.

As I mentioned above, I am a FB junkie. That said, I am careful in who I allow as a FB friend. I do not friend patients or staff. I figure there are some things that I just don't want others to see or know about me and I know there are things that I don't want to know about them. I know some dentists who don't have that same restriction - if you do FB or Myspace (which is so 2006) how do you handle that issue? As we become more and more digital we lose more and more privacy. What amazes me is that we are so willing to give this up. I see people all the time posting that they are going on a 2 week vacation or that their husband/wife/parents are out of town. Why do I think people care?? Moreover, why do I want to let people know when I am out of town?

One upside of FB is that I can stay in contact with some dentists around the country and not feel so alone. If you are not a dentist and reading this blog, it can be a lonely profession. I am in solo private practice, it is nice to be able to vent/commiserate with a peer. To try to eliminate the post - please don't tell me about how Dentaltown can do the same thing. I am aware of Dentaltown and the Jonesian devotion it inspires in its members. I am not talking about a study club, I am talking about just letting off steam with some friends. That is what FB lets this husband, father of 3 solo-practitioner, small business owner do in his "spare" time.

Well I have crosswords to do, bills to pay and, if I have time, some patients to say hi to after their hygiene appointments so I better put the voices to bed. Have a great week.


Friday, September 11, 2009

9-11, I will never forget

I was driving in the car this morning and realized it was September 11th, 9-11-09

I usually have my car tuned to sports radio in the morning, and when I saw a sign that said, “9-11, We will never forget.” I kind of got the chills.

I turned my radio to the news radio show, and of course that is what they were talking about.
I heard them talking and my mind kind of went back to that day. I remember exactly what was going on when I heard about the first plane hitting the world trade center. I remember the patient I was working on.

Shortly after, I went to the TV in the staff lounge and remember my knees almost buckling when I saw the second tower coming down.

I will never forget that.

I drove in my car for the next 20 minutes thinking about our country and everything that it means to live in this country. I well up with so much pride that I am an American.

This is the best country in the world. We help our neighbors.

Say what you will about the war or being in the Middle East, but I think we are just trying to make this world better and safer.

This is a country that was down, and then the tsunami hits and we give more money than all the other countries put together.

We are free. That means so much to me. Free to elect a president. Free to critique that president. Free to do whatever we want in the confines of the law.

Not many people can say that.

I was in Europe a couple of years ago (now I have been to Europe one time, so don’t think I am this world traveler) and a young couple from Denmark (you know we all want to live in Denmark) was sitting next to me. They felt so free to talk about my country and my president. They had no problem telling me what they thought.

I didn’t say anything. To this day I regret giving this little punk a piece of my mind.
I vowed to never be quiet when someone is talking about my country. I guess it was fear that I didn’t know enough. Fear that this guy knew more about politics than I did.

Next time I won’t care.

It wasn’t that he was talking about a Republican president who I have a lot in common with. I vowed that if someone talks about my president. The president of my country, I will not be quiet.

Someone talks bad about the president now, and I remind them that he is our president. It is okay to disagree with him (because remember we are free) but I’m not a big fan of disrespecting him or talking evil about him.

I did get to go to Ground Zero about a year after 9-11 and there was still black on the adjacent building from the smoke. The whole area was so somber. And to know now that they have started to rebuild this area makes my heart pound.

My head is kind of spinning right now. I am a proud American. I am still a little pissed at the terrorists. But I know in my religion I am supposed to love them.

I want to tell my kids to be proud but to be aware that people want to take this away.
That we must guard ourselves from the enemy.

So you see how I am confused. You see why this blog is a little “all over the place”.
Why would people want to hurt us? I don’t know.

Why should we love someone that is our enemy? I don’t know (I know but it is a little too heavy for this blog right now).

Have a great weekend.

Do not forget the sacrifice of our first responders and the innocent victims on that day 8 years ago.

Think about them today…in fact think about them for the whole weekend. And if you are like me, think about them every time you see an American flag.


Thank you

Tuesday, September 8, 2009

Bridge vs Implant

Hey all,

Did you see Ric's post on Monday. It was like I was reading my own thoughts.
It was weird. I guess it was the same except for the fact that his was about 400 words and mine are 4000 (I don't want any comments on that). I think he is going to be very funny.

Hope everyone had a good weekend. Friday night my son was playing football and broke his pinkie finger on his left hand.
I keep telling Luke he is like a porcelain figurine.
It can't be because he is going through a growth spurt because he is short.
He does play hard though.

I am going to get right to it today. No fluff.
I was sitting in my office writing up charts, and my father was seeing a patient in the next room.
He came back into the office (we share office space) and showed me an x-ray of central incisal (non-dental people...tooth right in the front) that had internal resorption, and he had it bad.

The tooth could not be fixed. He put up the x-ray on the computer screen we have in the office, and we both knew what needed to happen to this tooth.
So I kind of listened in as he spoke to his patient. And then he recommended that this gentleman get a BRIDGE. I almost fell off my chair.
I would in almost every instance do an implant in this case.
I thought everyone felt the same way I did. At least everyone IN OUR OFFICE.
There would not be a single question on what I would do. I am trying to think of anyway if I lost
one tooth a reason why I wouldn't get an implant, and I can't think of one.
So my dad came back into our office and I said, "If you lost #8 you would tell me that you would want a bridge?"
He said, "Yes."
I was shocked. I said, "Why?"
He said a couple of reasons. He has just finished a case where the patient was trying to replace #8 and two implants failed in that spot. He eventually just went and did a bridge. So this jaded him.
Then he said he wouldn't want to wear a flipper for 6-8 months.
(I guess I have to preface all this by saying that we don't do immediate loading implants.
We don't trust them. Our periodontists don't trust them. I am not saying that immediate loading
implants are bad or wrong. I am just saying we don't do them. )
So these two thing, the flipper and past failures in this one patient, would be enough to have my dad prep #7, 9 and, 10.
I was speechless. I have always looked at the end result of NOT having to prep his virgin teeth and the ability to floss and the long standing success of implants as an overwhelming reason to go with the implant option. I have always looked past the misery of the first 6-9 months.

So my father told this patient the pros and cons of both. But most of the time they ultimately will ask, "Well, what do you think?"
Or in the way we present the pros and cons will sway the patient to your opinion (you know you do it). So basically it is going to be our decision.
This is kind of a harsh reality for me. I didn't think I ever thought much different than the majority. I make most of my decisions thinking that if 10 dentists were doing this 8 of them would agree with me. I know, I know, this is crazy thinking, but maybe it just makes me feel better.
The reality is for me that I have to educate myself. I have to know everything. I have to be armed with the knowledge of everything out there to better treat the person that says, "Well, what do you think?"
I have to think that I have. I have to think that I know most of the things going on out there.
I am not talking about doing all things that you know about.
I am not about hearing about a new thing and jumping in with both feet. I am about knowing about it, reading about it, and listening to the pulse of the dental community about it. That is what I am talking about.
Never has it been so clear.
We have a tendency to get in ruts.
You know you just go through the day practicing dentistry and the next thing you know you haven't been to a CE class in two years. Then you realize you have been using the same products for 5 years and don't even know what is out there.
I don't do this, but I can see how I could. I am using a product that really works. I hate changing. I hate using the "new" stuff and it not working. So I don't even want to know what is out there.

Okay back on track...
So my father's patient said, "Well, this has to be done so let's just schedule that extraction and bridge."
As he came back to the office, we talked about this point. The point that a patient is usually going to do what we think is best.
(My father said that he has recommended a bridge before and the patient still went with an implant. This brings up a whole other blog. What do you do if a patient wants to do something you don't recommend?)
I told him he should call his friends and see what they say.
I think I am in the majority on this one.
So I would like to hear what you would do. #8 internal resorption and the tooth can't be saved.
What would you do? Implant or bridge.

Let's end it here. If I get enough responses then we will talk about it.
But just don't say IMPLANT. Tell me your thoughts.
If you are a non-dental person, tell me what you would want and tell me your reasoning.

Have a great Wednesday,

ps Along the CE lines. I am going to the Florida Academy of Cosmetic Dentistry annual meeting
this weekend. Thursday is a photography lecture. Friday is John Kois all day. I am really jazzed about seeing him. I have probably seen him 4 times. One thing I hate is the first hour of this is the peridontium, to bring everyone up to speed. Then on Saturday, John Cranham all day. He is very good, also.

Monday, September 7, 2009

The voices in my head

Start the clock now cuz I'm betting by October somebody at AGD headquarters is going to have to explain how I was allowed to post on a public AGD forum with little censoring. That's right boys and girls of the The Daily Grind blog you will, apparently, be subjected to the ramblings in my mind every Monday (at least for a week).

As we enter this journey I figure you should know what voices you will be hearing from (and yes I know the proper "east coast" grammar is 'voices from whom you will be hearing' but I'm not from the east coast, here in the midwest we end our sentences with prepositions). This isn't some demon possessed Exorcist. Instead, it is the collection of voices of my parents, wife, kids, id, ego, manic, depressive, dentist, lawyer, lover, fighter, Seinfeld watching, Bible-thumping midwestern dental practicing ragmuffin just-a-trudging along in this world. If you can't take a joke, don't understand sarcasm, have never been lonely or frustrated or felt inadequate or been convinced that you put the "man" in manic-depressive then my weekly rave may not be your cup of tea.

If, however, you can enjoy Tommy Boy and Pride and Prejudice, love to read books ranging from a biography of Leo Tolstoy to Old Hat/New Hat, laugh a-lot because life is fun, love helping people, care more about others than yourself and try to find the weekly reference to Seinfeld (my little Superman in each episode) - then you're in luck.

I am married to a Veterinarian who limits her practice to dentistry (oh you can bet you will hear more on this in the coming weeks), have 3 kids ages 10, 8 & 4. I started my own dental practice from scratch 9/11/2006 (no huge celebrations on that day). I am enjoying the challenge of growing a business in the Great Recession (there should really be a sarcasm font).

I do the New York Times and LA Times Crossword puzzles everyday - I tell you that not to impress you but to encourage you to also read Rex Parker's NYT blog and the LA Crossword Confidential blog (and may I also give a shout-out to Todd, Orange and Puzzlegirl who along with Rex Parker are my blog jedi-masters). I would rather be home with my family than at the office but I absolutely love my job. I love being an employer and have a great staff. I love to run (insert Run, Fatboy, Run movie reference here) and have completed the Disney Goofy Challenge (13.1 miles on Saturday and 26.2 miles on Sunday) all while continuing to gain weight - I was impressed myself.

Well, I better put the voices to bed for now. Thanks for letting me into your life a little bit, I hope it is fun for you - I figure it is saving me a couple hundred dollars a week in therapy.

Have a great day,


Friday, September 4, 2009

Selling Dentistry

Hey all,

Well it has officially started. FOOTBALL SEASON. And it started with a punch/bang. All is well.

I am about 100 pages into The Power of One and it is very good.
The author writes like he talks and he talks with a drawl and it is hard to figure out. So it is taking me a while to get going.
I am just finishing up King Arthur and the Knights of the Round Table with the kids. 400 pages and I read every one of them out loud. That is hard because they use words like smote (which is the past tense of smite) and thither.

My wife and I watched a movie called Doubt. It was average. It is about a nun.

I started watching a movie called Mr. Destiny. This is an old film (1990) about a guy that is down on himself. See if he just would of hit a home run in the state finals in high school, instead of being the goat and striking out, things would have been different. So classic, ghost of Christmas past, movie. So the movie is about what his wife would of been like if he was the hero.

That is it for the other stuff so let's get right to it.

I wanted to talk about selling dentistry. Now I know this is going to be a HOT topic for some of you. Let me say that this is my opinion and if we disagree it is not because I am a jerk or I am hateful. It just means I have a different way of doing things than you. I don't want you to be mad at me. If you disagree with me I would want you to comment but I don't want you to say nasty things about my mother.

Selling dentistry. Hmmm? Where do I begin?

Let's start by talking about a car salesman.

I mean they take selling and make it an art. But you know most of us don't have great experiences at the car dealer.

"I have to tell you ma'am if you leave today you are going to miss out on this deal."

"I mean, who knows, that car might not be here. We have had a rush on that color lately."

"I know your car is only three years old but you never know what is going to happen out there on the road. Do you really want to be driving your precious kids in a three-year-old car on that crazy highway?"

"I am going to have to talk to my manager."

"Let's just take if for a test drive and see, you are going to love it."

I know a couple of things.

The salesman is thinking, "They are here and the iron is never going to get as hot as it is right now. If they leave there is a very low chance they will be back."

I also know that I don't know too many people that like pressure sales. I don't know too many people that like the run around that they get at a car dealership.

Now consumers who understand what they are going to get when they go there, are better prepared. That is if they know the game and they think they have the upper hand.

(Now, all things are different at the luxury car dealerships. I have heard things are very different there. I have friends that have very expensive cars and they invite their car "consultants" over for BBQs.)

I don't think many people feel great leaving a dealership. I have heard so many stories from patients. The newspaper has written articles about it.

Now that is all that surrounds an industry that SELLS its products.

Let's bring it back home.

Let me tell you how I do it and I will tell you about what I have heard about other offices.

There are two things going on here. The stuff that will make them healthier and things that will make them prettier.

Let's start with getting them healthier. They have a mouth problem. I know what is best for the patient. I have been through the Pankey Continuums. I have taken all the Spear courses, anterior esthetics courses ... blah, blah, blah (what I am trying to say is that I have try to educate myself to know what is best). Let me rephrase that, I think I know what is best for my patient.

You do a new patient exam. And you find some problems.

There are two kinds of patients with problems. One that knows they have problems and they come to you for solutions. The worse of the two is the one that has problems but doesn't know it.

Now the million dollar question (more like ten million). How do you get these people to see what you see?

Some dentists say, "This is your problem, this is what it is going to cost to fix it. Now I am going to introduce you to Mary who is going to discuss with you how you are going to pay for it."

I get this approach. I get that someone has spent 25 years trying to explain to their patients their problem but they don't want to know it. They get mad at the dentist and the patient kills the messenger. So they figure on this technique because it is the least stressful.

Some dentists might be shy about telling someone that doesn't know they have a problem that they have a problem. They don't want to ruffle any one's feathers so they just fill some cavities.

Now I am kind of a mixture of both. I spend a lot of time in the new patient exam on building a relationship. I find that if my patients like me and trust me that they can hear me when I tell them there is a problem.

I spend a lot of time on education.

"This is what periodontal disease looks like. Here is a picture of periodontal disease looks like. This is what the exam looks like so when we get into the clinical room and we start probing your gums you are going to know what I am doing and you are going to know 1-3 mm's are good and anything above 5 mm is something to worry about." They have to own their problem.

That is why I do a lot of intraoral photos. See this big black thing in your tooth? This is bad. Black is bad.

This is not selling. This is educating. And I think you have more than a patient. You have a relationship with someone and they trust you.

And I always, always, always hear, "No one has ever taken this much time with me" (granted some people get pissed when they are used to a 10-minute exam and cleaning and we give them the full monty ... you can't win).

My issue with telling people their problems is when it is a BBBBIIIIIIIGGGGGGG problem.

They are 45 years old. They have a terrible bite. Maybe some crossbite, maybe some crowding. Maybe some group function. Patient is a bruxer.

Chipping of the maxillary anteriors and wearing down of the lower anterior. Flat occlusal plain the back. Scalloped tongue. This person needs an overhaul.

This is too much education for someone to grasp in a 90-minute appointment. If I tell them all their problems and try to educate them on all I know ... I will lose them. They will leave my office with their head spinning and never come back.

I can justify this by saying to myself, "They needed to know" or "I planted the seed."

Or I guess I could tell them the treatment plan and introduce them to Mary.

You know what I mean.

This is a tough one.

So how do I handle it? It depends. If they know their problem, I give them what I think is the solution.

For instance, this week, new patient exam. The patient was 34 and had an impacted upper canine. He has tooth #C (baby tooth). He was a class II and a grinder. He knew his problem. He has been told by the last three dentists.

He did not want to do anything. What was I going to do change his mind?

I said, "You know you have a problem. You know what it would take to fix your problem ... ortho, oral surgery, possibly an implant. I am here for you when you perceive the problem needs to be fixed."

I recommended a occlusal splint and some fillings.

So this guy is in my practice, likes me, trusts me, but doesn't want to do it.

Now could I have told him if he doesn't do it he is going to have to find another dentist?

Or could I have made the problem seem like a 99% clogged cardiac artery?

To make him feel that if he doesn't do it he is making a dire mistake, I guess I could.

And would I fault a dentist who did? No (because if he was my brother I would want him to fix it).

Then I look at my patient pool as a whole. I think I have seen a great number of 85-year-olds that have all their teeth and have crappy bites.

Now do I see more older people with great occlusion with all their teeth? Yes.

Now this is what I tell my 40-year-old patients. I can only tell you what I know. More elderly people have healthier teeth at 85 when they have this (fill in the blank).

Do I get mad at the 40-year-old that has never heard this before, has three kids in private school, is in over his head with his new car payment, work is very stressful, who understands what you are saying and just can't do it? NO.

Am I babbling? Probably, because I have battled this to myself for a long time.

I am not done with this but I think I might come back to it.

But before this gets too long I wanted to talk about selling stuff.

As a young dentist, I knew this dentist that would put veneers on 90-year-olds. Not spry, I want to look more beautiful 90-year-olds. People who needed to be helped into the chair 90-year-olds. This jaded me so bad as a young dentist. I thought this dentist was putting his gain above the patients. And I think this is really the key here. If the dentist is selling for his/her gain instead of what is best for the patient, they have stepped over the line. Now granted this is a slippery slope to be trodding. Some dentist may think that veneers on a 90-year-old is what is best for them.

I started writing this blog, today, with the intention of talking about hygienists who are on a production bonus. Meaning they get a cut of everything they sell. We don't do this. Do I want my hygienist to talk about what the patient desires? Yes. Do I want my patient to leave the practice because they were getting the hard sell everytime they came in? NO!

We have this questionnaire before the new patient exam. One of the questions is, "Is there something that you would like to do to improve your smile?" They inevitable say that they would like to whiten their teeth.

During our exam I at least address this by saying, "I am not a seller, but I want to at least address this question. We can do so many things to make your smile brighter. I just want you to know that we will never push anything on you. BUT I want you to know it is all available. Take-home whitening, in-office whitening, bonding, veneers. So if that is something you would be interested in please ask someone about it."

I think the hygienists are most valuable when they listen to the patient. Have a discussion about procedures, not selling. Then I come in and my hygienist might say, "Mr. Stud was asking me about the spaces between his front teeth."

Very casual.

Maybe I will come back to this but this is now definitely getting too long.

Just remember I had no intention of putting anyone down. If you give someone a treatment plan and then hand this patient off to Mary then I would like you to comment. Not about my mother but tell our readers why you do this.

If your hygienist is on a production bonus tell us how this works. Your mindset behind it.

Have a great Labor Day weekend.


P.S. Don't forget ... New blogger Dr. Ric Crowder on Monday.

Wednesday, September 2, 2009

Ramblings about football and of course Tim Tebow

Hey all,

Can you smell that? Ahh the sweet sweet aroma of college football.

Oh my gosh are you guys sick of hearing about the Gators and Tim Tebow yet? Because I am not.

Football has a way of taking all these issues of your life and making them better...at least for me (and basketball, too). But now that EVERY paper and television network and every internet site is talking about the GATORS everyday and all day. I can see how it can get too much.

But you have to admit Tim Tebow is a special individual. I mean half of the articles on Tim Tebow are not about football. They are about a man who is living right.

A man getting up 2 hours before practice and running through drills with his wide receivers. A man working hard to win the prize.

A man that goes on mission trips on his spring break. A man that goes to prisons during the summer and brings his friends.

And I am not talking about him spreading the Gospel but I am talking about a dude that has a platform and he is using it to spread good.

Look at all the things you see in the media about meathead football players... Pacman Jones, Plaxico Burress, Leonard Little, Donte Stallworth...just to name a few.

I know there are a lot of good things going on behind the scenes in NFL players lives that is exceptional but the media doesn't report it.

I know a lot of NFL players are spending a lot of time and money and there is no coverage at all about it.

To their credit ESPN does do feel-good stories. I will digress, I have to tell you about this one. A kid, when he was 10 years old lost both his legs by slipping on a railroad track and the train ran over them. So the story was about how he and his best friend grew up in the projects of some Midwest town. Now after he lost his legs his best friend carried him where ever he needed to go. I mean the kid used a wheelchair but everywhere it was hard to get the chair his friend would carry him. One small problem, even without his legs he was still a little over 175 pounds. And, oh yeah, his friend that was carrying him all around was legally BLIND. Now how it got onto ESPN is that they both were high school wrestlers. And the story goes on to show about deep friendship, overcoming hardships and personal success. Then the article ends with this guy using his new legs to walk his graduation. OMgosh was I bawling watching the clip on the computer. I looked it up...you gotta see it.


Where was I? Oh yeah, no coverage for the good things that go on in sports figures lives. But for the bad....God forbid someone takes steroids. New flash, athletes takes steroids. Now let’s talk about it for a week. News flash....actors are crazy, people are crazy.

I don't know why the media has to play 24 hours of Cassie Anthony and Anna Nicole Smith. I can't stand stuff like this. Like the real news stops so we can cover the crazy "stars".

Don't even get me started on Britney Spears, Madonna and John and Kate.

So when a guy like Tebow comes around and get us talking about doing good in this world, kind of like paying it forward, and the media jumps all over this...I say great, I say finally.

I am not excited because he is a Gator (but it is nice) and it is not because he has the possibility of winning 2 Heisman's and 3 National Championships (are you getting goose bumps, too?), it is because football is not the only thing this young man is about.

With football and all the sh#!#%%^t he does, and he is still graduating early for crying out loud. I got to think he had a lot more to do outside of the classroom than I did and I didn't even graduate on time.

I think it is kind of funny how much is written about this guy. I mean between the Tebowisms and the GQ articles.

But in a world that loves to hate people that succeed (just like I hate Charlie Ward and Nick Saban), I think people have a really hard time not respecting Tim (oh yeah we are on a first name basis). People hate Tim Tebow for the coverage but they have to respect the guy that loves his enemies, feeds the poor, visits the prisoners, and heals the sick.

Because we all know this is what success looks like. It is not the money and the fame (if you don't believe watch ESPN when they do a series on athletes living under bridges) it is about what you do with your stage.

We all get pissed when we hear things like athletes "holding out". For you nonsports people, this is when a team drafts an individual and they sign a contract for a ridiculous amount of money. Well three years later he is no longer the highest paid player at his position. Now he will not play if the team doesn't pay him more. Or a kid like Michael Crabtree that was drafted out of college and has never played a down in the NFL and won't play until he gets paid a ridiculous amount of money.

Okay sometimes it is about money but what are you going to do with all that money? What are you going to do once you are out of football or out of the NBA?

I am sorry to get all sappy but success is how you use the "talents" God gave you.

I am talking athletic ability. I am talking teeth skills. I am talking about if you are a lawn mower, a plumber, an electrician, a lawyer, a radiologist (shout out to Connie), a teacher, a youth director, a school administrator, a mom...

Are you successful? Are you using your talents?

Are you making this world better?

I think I am. I think I am the Tim Tebow of dentistry.

Man can you smell it? Yeah that is football.

Have a great Wednesday,


P.S. The AGD has found a dentist to help out blogging. You all know I have been really struggling with the time it takes to blog. I love doing it but I don't want to do it on my day off, because this is family time. So I asked the staff at the AGD to help me on Mondays and I think they have found a dentist that fits really well.

His name is Dr. Ric Crowder. His first blog is going to be on Monday, so let us all try to read it and try to be real nice to him (at least at the beginning). I am looking forward to reading someone else's perspective on things. Welcome aboard Ric!


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

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