Brush with Fame

As a college student in New York City, celebrity sightings were practically an everyday occurrence. Having your morning route blocked off by a camera crew or being forced to wait until a director got a satisfactory shot of an Olsen twin strolling across campus was a perfectly valid reason for being late to class. It was totally normal to share a subway car with late night hosts, TV stars, and popular musicians. One time, in order to drop off an assignment before my TA’s deadline, I begged a production assistant to grant me access to a building that had been closed off for filming and wound up getting to watch the entire cast of “Mona Lisa Smile” file out of the classroom where I attended lecture twice a week.

Although I was fully cognizant that celebrities are just plain human at the end of the day, I guess I never gave too much thought to the idea that they, too, have to go to the dentist. Not that there’s been any shortage of reminders. In school, our first esthetics lecture contained headshots of famous actors and actresses whose dental work we would later analyze ad nauseum, discussing all the things we would have done differently and what improvements we’d make to them if given the chance. (I’m looking at you, Tom Cruise.)

These days, when a celebrity goes for a checkup, it’s not uncommon to have the mundane minutiae of the visit documented on a camera phone and then shared with millions of people online. I even received a text message alert when one of the Kardashians left her most recent dental appointment and was reportedly—brace yourself—STILL feeling numb. Why her dentist’s ability to achieve profound local anesthesia was considered breaking news is beyond me.

Yet, for someone who loves pop culture as much as I do, the concept of having a famous person in my office, let alone my dental chair, had never crossed my mind. In my universe, dentistry and celebrity were two totally separate entities whose intersection I had not ever considered. Sure, I’ve marveled at how Kate Beckinsale manages to keep her skin so youthful and radiant, but wondering what teeth whitening products she uses and whether she’s got smooth or stippled gingiva doesn’t keep me up at night.

I suppose that I should have expected to come into contact with some celebrity patients eventually after moving to southern California, where the rich and famous come to work and play. Shortly after joining my current practice, I was slowly introduced to some of our more high-profile clientele. I had the opportunity to meet a local news anchor and some professional athletes whom I’d probably be more excited about if I followed any sports at all. And although San Diego doesn’t see nearly as much celebrity activity as New York or Los Angeles, I’ve come across plenty of Californians willing to shell out big bucks for a Hollywood smile.

A few weeks ago, I got to see and experience what having a bona fide celebrity in the office is like when Michelle Phan came in for her appointment. For those who may not be aware, Michelle is a former waitress turned YouTube sensation turned beauty products mogul who has successfully parlayed her passion for cosmetics into a burgeoning makeup empire. She now has millions of loyal fans around the globe who follow and celebrate her every move through countless social media outlets. In other words—as we say in San Diego—she’s kind of a big deal. People know her.

As someone whose formal instruction in the application of lip gloss started and ended two decades ago in the girl’s bathroom at West Brook Middle School, I was not at all familiar with her career or her celebrity status when I first joined the practice. In preparation for her arrival, I typed her name into an online search engine; within seconds, I found results that even the NSA might deem excessively intrusive.

On the day of her appointment, the sight of THE Michelle Phan standing in our reception area was equal parts startling and surreal. No matter how many times I’ve stumbled across famous people, seeing them in the flesh is something I have yet to grow fully accustomed to. When you’ve witnessed their lives play out on television and all over the Internet, it almost doesn’t seem real that they’re right there in front of you, and even more unreal that they’ve come for dental treatment. I mean, I’ve never seen a Minotaur before, but if one was waiting for me in my operatory, I’d probably be just as surprised to see it and just as disoriented by its presence.

Just to be clear, I am in no way implying that Michelle Phan bears any resemblance to a Minotaur.

But once the initial oh-my-gosh-she’s-just-as-pretty-in-person-as-she-is-on-TV shock wore off, it was back to business as usual. There really was no difference in how she was being received in our office compared to any of our other patients. The front desk greeted her just as warmly as the patient whose appointment was right before hers. Our assistants made the same efforts that they make with every patient we see to ensure that she was as comfortable as possible throughout her stay. We treated her the same way we treat all of our clients: like members of our family.

Perhaps that’s the secret to keeping everybody on our patient roster happy. Treat every person like a star, and every star like family. While it may never be the official slogan of our office, I hope that every patient in our care understands that that’s what we’re striving for.

Before she left, Michelle graciously posed for pictures with our staff and even recorded a video testimonial to share her thoughts on being seen in our office (spoiler alert: she’ll be back). I’ll admit, I’ve always thought it was kind of cheesy when I saw dentists plastering photos of famous people all over their offices and websites to market themselves as a “Celebrity Doctor,” as if evidence of treating a star is supposed to be indicative of a higher level of skill or credibility. Then again, I suppose it wouldn’t matter all that much to me if a patient came to my office and specifically requested to be put in my care just because I had a history of treating well-known public figures.

What I’ve come to realize is that the most successful doctors are the ones who can provide their patients with such remarkable service that they’re eager to come back and willing to go out and tell the world what a great experience they’ve had. The highest compliment my patients can give me is the referral of their friends and family. I know that if I never see another famous person’s name on the schedule again, it won’t be a reflection of my abilities as a clinician or businesswoman. What I really hope to see are the same familiar names and happy, smiling faces returning again and again because they trust me to provide them with the best dentistry I can.

Diana Nguyen, DDS

A Senior Moment

Your “senior moment” as a dentist can come at anytime. I stood at the podium addressing my colleagues at the House of Delegates during the Arizona Dental Association meeting on September 21, 2013, in Sedona.

It hit me, and the words just fell out of my mouth. “This is not my profession, this is not my association.” At the age of 61, I am able to start wrapping my arms around the fact that the profession and the association belong to the younger dentists now. My role, as I am in my senior years, is to try to facilitate their transition in while Debbie and I transition into another purpose.

I think the thing that hit me first is that Errol (51) and Karl (65) were not there. This was the first meeting of the HOD where Errol Kahn and Karl Zimmerman, two very involved dentists, were only with us in spirit.

And then the real irony of this meeting hit. As the clock moved closer to 11:00, everyone in the room knew that long-time AzDA supporter and past presidential candidate for ADA, Charley Siroky (76), was about to be buried just two hours way in Phoenix. Charley had been a pillar of the association. He was involved in so many ways. And yet, God made it happen that many who would attend his funeral were not going to be present. His friends and colleagues from all over the state would not be there to say their final goodbyes.

I could not help but see the lesson crystallize as it was evident that, no matter how important a dentist was, the reason for their importance was our profession. No one person is bigger than the association or the profession. Understanding that there will be no more Dental Association meetings for Errol, Karl or Charley has changed my view of the world and, more specifically, my view of my place in organized dentistry.

Realizing that Charley was only 15 years older than me has helped me understand that I have much I want to do with the remaining years of my profession and life. I'd like to remind all of my younger colleagues who sit and worry about their future and the future of the profession that we all did at your age. You should be involved and thinking about how you will spend your career in dentistry.

My great hope is that you will think and worry and become passionate about your profession and life as a dentist. More importantly, I hope the time flies by as it has for Debbie and I, and that you will have that senior moment and realize it is never was about you. The best in dentistry is yet to come!

Enjoy being a dentist,

Bob Oro, DMD, MAGD

P.S. This is my final blog for AGD; it belongs to the next generation.

Control Freak

How and when do I stop being a control freak?

I was raised in a family of control freaks. Everyone thinks they know best, and they probably do know best. On top of that, no one has the patience to teach anyone else, and therefore end up doing everything themselves. Naturally, I grew up to be exactly the same. Now, as a new business owner, I realize that the family trait I have is actually a curse.

I started my own practice a little short of a year ago, and I did everything myself at first. Although I started fully staffed, at times I was my own receptionist, treatment coordinator, biller, assistant, hygienist, marketer, manager, designer, HR, etc. I’m sure that sounds very familiar. I used to think that I had to take on these roles regardless of the staff being present. They were new and they did not have the proper training yet. It never even occurred to me that it may just be my handicap of not being able to let go.

Now that my staff is fully trained and fully capable of doing all they were hired to do, I still find myself immersing into their tasks and taking over their responsibilities. This results in my being very tired and feeling hopeless that as the practice grows, my load will keep getting heavier, for no good reason. I have realized that my inability to delegate is the source of my problems. I’ve also that heard many other practitioners go through the same phase, but eventually learn to adapt. I’m doing my best to adapt, but keep finding myself taking over pretty much everyone. I think I can do it best, though that probably isn’t true anymore.

How do I stop? Should I stop at all? Will I stop naturally as the practice keeps growing and I just don’t have the time? Should I even worry about it now? I don’t know how to handle this and I find it to be one of the most challenging issues I’ve encountered in this quest to have my prefect practice.

Mona Goodarzi, DDS

They Like Me. They Really Like Me!

Since the time Sally Field received her Oscar for Best Actress for her role in 1984’s “Places in the Heart,” her acceptance speech has been misquoted more times than it has been properly repeated. In keeping with the misquoters, I have taken liberties with her speech to talk about a problem I have.

“They like me. They really like me.” For the past 24 years as a business owner, this has been my modus operandi. I’ve committed to these words as a personal philosophy, of sorts. It chants in the back of my head when I deal with difficult patients and it taunts me during those challenging moments with team members. Recently, I have started to ask myself if this mantra has brought value to my business life or if, in fact, it has created additional and unnecessary stress.

I’m a people-pleaser. I’ve always been a people-pleaser. I could write a whole paper on why first-borns struggle with the need to make people happy but, I’ll save that for another time. Suffice it to say, people pleasing is kind of “ma thang.” Inherent in the need to please people, of course, is getting that warm fuzzy feeling when your mission was accomplished. That people are pleased and, maybe they really like you (an added bonus), is success!

Well, that has been MY measure of success. It turns out that maybe, after all of these years, my success barometer has been a bit corrupt. Because, while I have been working my tail off my entire career — my entire life, actually — I am exhausted. And, I have little to show for trying to make them like me.

Oh, lots of people like me. That’s what I’m good at. But have I earned their respect? Do my patients and team take me seriously? Am I a good leader and effective manager? Is getting people to like me an effective business strategy? I’m not so sure.

My practice is growing, and quickly. That’s the good news. With growth, the drama and conflict have increased. That’s the bad news. And, in my constant analysis of the situation, the common denominator turns out to be me. “Nice” does not generate effective business methodologies. What to do?

Perhaps, the wisdom that comes of age can serve me here (and make me feel better about the whole age thing). I need to remind myself about the people who bring value to my life and to my career. I don’t really have to accumulate a boatload of insincere likes anymore. Maybe the respect that I show others will allow them the freedom to make their own choices about me. And, ultimately, straightforward communication can ensue. No more pressure to make people happy when I need to make difficult decisions and then follow through with them. What a concept!

There will be no more killing them with kindness. At the end of the day, it’s really killing my effectiveness. Keeping more team members and more patients in a growing practice all happy and liking me will kill me, metaphorically. Don’t panic. I’m not going to become an “owner-zilla”. It’s not in me. But I am going to try to be more mindful of the health of both my business and my psyche as I try to hone better leadership and management skills. These are skills that I was able to elude when my practice was smaller.

Thank you, Sally Field, for allowing me to parse and ponder your famous misquote!

In case you were wondering what Sally Field really DID say in her acceptance speech on March 25, 1985, here is the actual quote:

“I haven't had an orthodox career, and I've wanted more than anything to have your respect. The first time I didn't feel it, but this time I feel it—and I can't deny the fact that you like me, right now, you like me!”

Claudia Anderson, DDS

Freshman Operative Practical

Remember the freshman practical, a strictly timed test that decided your fate?

Alphabetically seated in the operative lab in 1975, I studied beside Ms. Oleander Jacobs. She was later paired with me for clinical exercises that she couldn’t perform without seriously hurting me. She lacked the didactic skills for good—or even acceptable—dentistry. But on one particular day when the test involved waxing a crown in the lab; I felt safe.

Nervous students watched the clock slowly tick toward 9 a.m. Tension filled the air as the instructor announced, “Now.” Matches were struck and a room of Bunsen burners whooshed to life—at least, most of them did.

“Mine’s not working. Whaddo I do?”

“You should’ve checked it earlier, Mr. Brown. That’s the sign of a good clinician. See if you can share your neighbor’s.”

“I can’t find my wax instrument,” another student desperately announced. “Does anyone have an extra?” No one came to his rescue; he had to make do with a discoid-cleoid.

“I need a match. Can I borrow a match or a lighter?”

“A lighter? No one smokes, you nimrod. Use this,” he said, while tilting his burner to pass the flame.

Habitually dirty, Oleander was more grimy-gross than usual. Her pungent body odor mingled with the scent of cheap candles and the heat of several dozen miniature campfires. The mix began to weigh ponderously in the air, which didn’t help my nerves.

But wait! Something else is afire—some familiar stench. Several nearby students raised their heads to sniff the air like Basset hounds. Then it came to me: burning hair! Instinctively looking left, I stammered, “Oleander, you … you … your hair is on fire!”

She swatted the top of her head, as one might do with an annoying fly they have no hope of hitting. Irritated at the interruption, she briefly glared at me before bending back over the lab bench. She pressed her chin firmly against her chest and studied the die with her Coke-bottle glasses. Her flailing had not only failed to extinguish the blaze, but had further fanned the flames, which shot ever higher from atop her oily mop.

Floyd, seated to the left of Oleander, sprang into action. He jumped up, jostling his steel lab stool, and made a mad dash to the sink. Grabbing a stack of paper towels, he ran them under the faucet and smacked the top of Oleander’s headwith the wet wad. This merely encouraged the fire, which reached further heavenward. Maybe it was my imagination, but I thought I saw a hint of blue at the tip. Was the conflagration going critical?

Maybe that guy who couldn’t find his burner could use Oleander’s head.

Throughout it all, Ms. Jacobs continued to diligently carve her wax, which she had transformed from a block to a marble. Her detached countenance contrasted sharply with the flaming emergency, which Floyd and I had to deal with. Water wasn’t the answer, and the lard lurking in the depths might spread the fire. Baking soda wasn’t readily available, but the fire extinguisher seemed inappropriate. Then again, that might be fun...

Water seemed to be the only option. I jumped up and completely knocked over my stool, which crashed to the floor with a loud, metallic clank that caught the attention of an ever-widening circle ofstudents. Several turned to gaze wide-eyed on the pyrotechnic glory that was “Oleander the Human Torch.”

I filled a green mixing bowl with water and dumped it on her head. Miraculously, the flames were snuffed out before the grease fire could spread. Floyd whacked her head with wet paper towels one last time, just to make sure. All was well, but Oleander was drenched.

I thought she would have been grateful, thanking me and Floyd for our heroic efforts. Conversely, she could have gone ballistic. But, she simply kept on working, never again lifting her chin off her chest.

When my metal stool had reverberated against the floor, the clueless instructor glanced up briefly, but quickly went back to his cheap paperback. Students around our little bonfire seemed to enjoy the comic relief, while those seated further from the epicenter diligently carved their crowns without pausing to see where the awful stench was coming from.

With the misplaced flames duly extinguished, Oleander and the entire class were safe. However, those seated near the fiasco found it hard to concentrate and quietly chuckled through half-smiles. From time to time, the proctor put his book down and strolled around to inspect our progress. But he never suspected the close call in Section J. Everyone passed that test, including Ms. Jacobs and her two-man fire brigade.

The following day, Oleander arrived at school, as slithery-slimy as ever, her hair still unwashed. I discreetly searched for a burnt spot on her scalp but couldn’t find one. She turned, caught me staring and actually smiled. I weakly smiled back, hoping I wasn’t sending her the wrong signals. Somehow, the scorched field had blended in with her disheveled mop.

Oleander somehow made it through all four years. I found it hard to imagine her responding appropriately to a patient’s angst, and hoped she went into research. But I never knew. Afraid that she had misinterpreted my stare, I never stayed in touch.

Jim Rhea, DMD

Generation Gap

Do you accommodate patients differently because of their age? In my practice, we have a relatively narrow age range, with the majority of patients in the 25 to 40 range. This accounts for the fact that our office just celebrated a two-year anniversary. Every now and then, I do get an older patient. I notice some big differences in their wants and needs, as well as the type of interaction they seem to crave from their dental practitioner. There are definitely positives and negatives on both sides.

My main struggle with patients that are my age or younger is the fact that they do not make their oral health a priority. They are too busy dealing with their careers, starting families, and just living their lives. Coming to the dentist to redo those old crowns or even for regular six month checkups is not at the top of the priority list. I find that this is not a financial or even a lack of insurance issue. I have good friends who have great dental insurance from their jobs but have not been to the dentist in years. Every year, it goes untouched because coming in for a cleaning and a checkup is just not in their immediate realm of interest. No matter how much oral hygiene instruction I give, flossing is a constant challenge to many young adults that have gotten through years of graduate school and are successfully earning a living in a major city. They have jobs in law, finance and even healthcare (doctors and nurses, I am talking about you!). At some point, I just have to be happy with the fact that I try to review all their needs and give them good guidelines during their exams; the rest is out of my hands.

As patients get older, they are ready to become more invested in their oral health. They may have neglected their teeth as young adults, but now that they are more established with their careers and have older children that do not need as much attention, they are more ready to focus on themselves. Many typically have a mouth full of dentistry that needs to be replaced and they are excited to learn about what their options are.

I am almost 31 years old. Over the last decade (most of my adulthood), I have grown accustomed to communicating with those around me via email and social media. That’s just how things evolved with my generation. I see this mentality in many of my patients that are in my age range. For the older generations, it’s a bit of a different story. For the majority of their lives, they have dealt with technology-free human interactions and see value in this when visiting their health care provider. When I am doing a new patient exam or even a hygiene recall, I would say I easily average an extra 10-15 minutes more on older patients, simply because of their desire to talk about things other than dentistry. They have grown accustomed to this type of interaction, which I have seen is very common with older dentists. Schmoozing your patients is something they seem to be quite good at, though it can be debated whether this is essential to being a good practitioner.

When I was in school, one of the facts that many instructors shared was that most patients will never know if you are a good dentist or not in terms of your technical skills. What they will remember and appreciate is how they are treated; that is the number one thing you can offer in terms of customer service and growing your practice. I still have issues with this statement because it implies that, in the long run, your clinical skills are less important that your people skills. But I can definitely see how it could have been the case in past generations. Patients established a human connection with their dentist, and if they were treated well and felt good, they kept going back, no matter how “good” the actual work was. These days, younger patients have more choices and more importantly, more access to content. They can go on your office Facebook page, blog or website and peruse before and after photos. They can filter through patient reviews on websites like Yelp or post their smile photos and get responses from doctors on Realself.com. That first impression of you is established way before the patient meets you and you have a chance to impress them with a friendly greeting and some witty banter. A 28-year-old patient will be impressed by a nice website and some clever posts on Facebook. Some fancy high-quality before and after pictures would not hurt either. A 58-year-old year old patient, however, may be more impressed by the way he is treated on the phone when he actually calls the office, as well as the amount of individual attention he receives from the doctor when he comes for his appointment.

What do you guys think? Am I totally stereotyping age groups, or have you found similar things to be true from your experiences?

Have a great rest of the week. I hope the weather is treating you better than it currently is in the NYC region, where the East River is literally starting to freeze over.

Lilya Horowitz, DDS

What a Pain!

What a PAIN! Literally.

Originally I had a different topic in mind for today’s blog, but my current week shifted my focus. Actually, it shifted my entire physical being. On Monday morning, as I was preparing to leave for the day, I wanted to do one more thing. I bent down and twisted, and it happened. I absolutely, positively torqued something in my lower back. Of course I have had periodic tightness and soreness in my lower back—I’ve been practicing full time dentistry for 10 years now—but I have never in my life had breathtaking pain.

Being the eternal optimist I believed that once I got moving and working, I would feel fine. Alas, no such luck. In fact, the more I moved, the worse I felt. I didn’t even attempt to sit to perform dentistry. Luckily for me, my schedule was 8-2 straight through and all operative was with UR quad or anterior. It was no small miracle that I wasn’t doing a double prep on #14 and #15 on the patient that can’t lean back or open more than 2cm.

By midday there was still no improvement. I began arguing with myself. Should I bail on the very important meeting I have set for 5 p.m. tonight and go to the chiropractor? Or do I wait and see? I mean, after all, it has worked so well for all those patients who believe their small cavities can wait, right?

Looking forward to the week ahead, I could see that my schedule was set to be busy and productive (a positive). I also saw that my schedule didn’t allow much time for me to sneak to the chiropractor until Friday afternoon (a negative). I hesitated to make a decision until the office manager explained it to me “You understand this isn’t going to get better on its own and you are not useful in the shape you are in. Get into the chiropractor and I will reset the 5 p.m. meeting.” I, stubbornly, didn’t want to be the reason that this meeting was put off once again. But the increasing pain in my back dictated she was right, as usual…

I discussed it with my partner, and he agreed as we joked about the physical demands of dentistry. (We also laughed that we should both being working on our core muscles regularly.) I had fallen victim to the notion that I would not be slowed by a physical limitation. I couldn’t have been more wrong in my life.

At home after the adjustment, I iced and loaded up on NSAIDs. I was certain this torture would get better soon. It had to. Unfortunately, it wasn’t until midday Wednesday that I felt semi-human, the smile that I was sporting was genuine again, I felt like a laugh was tolerable. Have you realized that your back is involved when you have a hearty belly laugh? It is! Though time will tell if I will be a habitual offender, my hope is that it will be another decade before I feel this pain again. I fear, though, that the frequency and intensity will be sooner and greater than I desire. For now, I am making it through.

Outside of regaining needed core strength, what else should I do to make certain I am not a victim to the L5S1 pain I have been enduring this week?

Colleen DeLacy, DDS, FAGD
Michigan