A Take-Away From Hurricane Sandy

He was dejected and devastated.

It was possibly the worst day of his young life.

He stared at the alphabetical list over and over again and he still didn’t see his name.

He missed getting onto the High School Varsity Basketball team.

Sure, he goofed around a bit but as a sophomore was his career done?

He learned a crucial lesson.   Never again would he goof around on the court.   He would redouble his efforts and always bring his “A” game to everything related to basketball.  He spent hours practicing.   He woke up early and stayed late doing everything he could think of to excel.

Michael Jordan could have quit yet he persevered.   He learned the lesson from his mistake and went on to be the paradigm of a basketball superstar and more.

When people ask me why I’m different than other dentists, I didn’t know what to answer.

During Hurricane Sandy, with the power, internet and cable TV out, I had plenty of time to think.

I’m no Michael Jordan.  I do however bring my “A” game to everything I do in Dentistry.  I think my patients can tell.  I think you can tell when someone’s passionate about what they do.

Passionate people have a twinkle in their eye.   They are animated.   You can hear it in their voice.  You can read it in their words…if you know it’s theirs!

Look for passionate people to care for you.  Passion combined with knowledge and skill is the ideal.   By reading the book, you’ll be able to assess those too.

To your health,

Michael

T’is the Season

It’s football season.   I’m not a big fan.   I find it violent.

Yet, I appreciate that it’s our nation’s obsession.  Football has far surpassed baseball as America’s favorite sport.  I’m not including NASCAR as a sport, please forgive me.

The Heisman Trophy is arguably college’s premier award.   It’s awarded yearly to the best college football player.   The hype for this exceeds all other sporting awards combined.

Is this award or others predictive of future success?

The answer is a resounding NO.

Heisman Trophy winner Jason White of Oklahoma beat out Larry Fitzgerald and Eli Manning in 2003.

Fitzgerald and Manning are 2 of the highest salaried players in the NFL today.

No one’s heard about Jason White.  He didn’t even get signed and when he joined the Tennessee Titans, he didn’t last the season.

The point is that there are good predictors of success and poor ones.  It pays to look at the good one’s and ignore the ‘popular’ ones like the Heisman.

While it’s no secret that many believe the Heisman Trophy is a poor predictor of future football success, the same could be said about some of the “health predictors” people rely on to predict entry into the “nonagenarian or centenarian” club.

We have the capability to live well into our 90’s, 100’s and beyond.  Recently, I heard the statistic that our body’s life’s capacity is 120+ years.

The key, as we all know, is quality of life.  Living without medical assistance and with minimal medication.  Having minimal exposure to the “sick-care” system that we now have is a goal.  Living with our full mental capacity and living well is the goal too.

What if I could show you a list of predictors of health?

A list that, if followed can, not only extend your life but improve its quality.  A list that can help you avoid all sorts of inflammation-related problems such as heart disease, joint and muscle pain, dementia, wrinkles and yes, even erectile dysfunction?

This is a checklist of things you can do to materially improve your chances of aging unaffected by the usual afflictions.

Sounds too good to be true?

It’s all based on well-done studies published in reputable, refereed medical journals.   It’s a list I learned from Dr. Oz’s co-author and friend, Dr. Michael Roizen, the Chief Wellness officer at The Cleveland Clinic.

To get this list, just give our office a call at 212-928-1000 or email me directly: [email protected]

Our goal at Manhattan Dental Health is your total wellness.  We believe that as a part of your health care team, we have the obligation to disseminate, good and worthwhile information to you so we can help you achieve your goal of a healthier you.

To your health and wellness,

Michael

Thank You Orville Redenbacher!

The 2 things that have caused my patients the most grief and given me the most money are olive pits and unpopped popcorn kernels.  Thank you Orville Redenbacher!

Do yourself a BIG FAVOR.   Don’t believe that the olive is ‘pitted’ and don’t eat from the bottom of the popcorn bag.

It doesn’t matter if your teeth are filled, capped or not.   A pit or a hard popcorn kernel bit down upon just the wrong way will crack anything.

3 years ago my friend Steve was eating a salad with olives.   He assumed they were pitted.   WRONG!

3 years later, he has an implant and has spent thousands.  Don’t be like ‘Steve’, watch your pits.

To your health,

Michael

SLEEP is the new SEX, most of us don’t get enough.

And even if we do get enough, it may not be of the quality that it should be to maximize our health.

At The Cleveland Clinic this past summer, I heard Dr. Mike Roizen say that the 3 keys to health are:

Flossing, Red Wine and Sex

The point is that we need to reduce inflammation (like gum disease), eat antioxidants (like Resveratol in wine) and do things that make us feel good and release endorphins (like sex or exercise).

We also had 2 lecturers talk about sleep.   Sleep has been recognized as a key ingredient for good health.

Benefits of adequate sleep found in the latest research include:

*  Live Longer

*  Increased Cardiovascular (Heart) health and function

*  Helps reduce inflammation and chronic illness

*  Decreases stress

*  Increases memory and creativity

*  Promotes weight loss

*  Fights depression

*  Reduces Migraines

*  Increases stamina and performance

*  Fights Diabetes

Can your Dentist help?

YES, YES and YES, if they have the experience and training.

It starts with a thorough examination to see how jaw structures and soft tissues might contribute to the problem.   It might also, after a sleep study, include an appliance that is custom made to open the airways.   Just think, how do you get most of your oxygen?   Through your nose and mouth!   Both have to be in working order.

Want to fight Somnus interruptus (inadequate sleep)?   Speak to your Dentist.

To your health,

Michael

The Dangers of Insurance-Driven Care

Again, this week I saw a patient who succumbed to inadequate dental care through no fault of her own.   She went to the Dentist.   She complained of her problems and she followed advice.   Yet, her problems became worse and frustrated, she just stopped going to the Dentist.   After all, it just wasn’t getting better.

Why did her problems go untreated?

Our healthcare system is directed by people who don’t care about your health.   Is that crazy?  You bet it is.  It’s the ‘fox guarding the hen house’.

Insurance company and Government bureaucracies direct much of our healthcare much to the frustration of the Doctors who care for you.   Just ask your Doctor.  Is insurance a help or a hindrance?  I know what they’ll say.   They love the access and they hate the control.

So, many of my physician colleagues are opting out of accepting insurance and Medicare.   Why?  Because they feel it’s compromising the quality of their care.  They’re right.

This isn’t political; it’s the honest, hard truth.   If you have a Doctor who truly cares, he or she wants what’s best for you.   They went into the profession to be ‘of service’.   Watching people not get the care they deserve is abhorrent to them.  No one wants to see their efforts fail and yet we’re failing to keep people healthy.  According to the World Health Organization, we’re #37, just behind Costa Rica!

Yet, people still come here from all over the World for Dental and Medical care because we still have the best schools and our experienced Doctors are the best.

The problem is actually worse than it appears.  Some may say, well, we’ll just go to these experienced, good Doctors and pay out-of-pocket.  That might work for a few more years.

What’s happening now is that our Nation’s young doctors are being trained in Hospitals, Medical and Dental Schools all over the Country in this insurance-driven health care.   Faculties are being decreased because of decreases in reimbursement just as tuition to schools have gone through the roof and class sizes increase, diluting resources even further.

Graduating healthcare students are facing such incredible debt that they have no choice other than to accept jobs with large, insurance-driven clinics that also practice the ‘insurance-driven’ style of care.

In Dentistry, it means that even if a Dentist wants to practice the “ideal” care he or she was trained to do (if they were), they can’t.   When care is guided by the meager yearly maximums that insurance companies pay, the only option is to do “patch-up” care.   That works for some but for my patient this week, it was severely damaging.

What happened to Jane (not her real name)?  She started noticing when she was pregnant that “my teeth seemed to be loosening”.  What Jane was experiencing was gum disease that often is exacerbated by the hormonal changes of pregnancy.  But the problem went undiagnosed.

After the pregnancy, the acute part of the disease subsided.   The underlying effect, the loss of bone and support of the teeth continued.   That loss of support, together with nighttime clenching then caused her teeth to shift.

Jane came to see me because her smile had changed.   She now had spaces between her teeth, spaces that only recently appeared.   Also, the gaps between her back teeth were getting more annoying.   Everything she ate got caught.   She has to floss after every meal just to be comfortable.

Worse, while all this was happening, she had 2 caps done.   Guess what?   They have gaps between them now too.

Did she go to a “bad” dentist?   I wouldn’t go that far.    What I do know is that no one ever took the time to really get down to the causes of her problems.   WHY NOT?  Because insurance companies pay a premium for treatment and not diagnostics.   Yet, you need a proper diagnosis before you have any treatment!

Insurance companies have it backwards.  They should pay maximum fees for preventive and diagnostic care.   Doctors should be rewarded for keeping people healthy and not by doing procedures when they get sick.   That’s part of what’s wrong with the system.

Back to poor Jane, who is now undergoing gum treatment.   She’ll need Invisalign to move her teeth back to where they should be and close some of the gaps.   Some, that can’t be closed, will require restorations and caps to be redone.   Moreover, she’ll need porcelain veneers to fix her smile and compensate for the loss of gum and bone from the gum disease that started the whole mess and resolve the ‘black triangles’ that make her smile look aged.

Will insurance cover this?   It will cover up to the yearly maximum and Jane has a superior plan that covers $2,000 a year.   It will not cover anything they deem as ‘cosmetic’.  So over the 2 years it will take to treat Jane, she’ll probably get $4,000 of benefit.   Her out-of-pocket expense?  Nearly $20,000!!

Wow, $24,000 to treat problems that could have been prevented with relative ease while she was pregnant.

To your health..and Jane’s

Michael

Leviticus 19:18, Luke: 6:31 and Health Care?

These Biblical verses say, “Love your neighbor as yourself” and “Do unto others as you would have them do to you” respectively.

What do these concepts, which are found in various forms in most religions, have to do with Healthcare?

These proverbs are the foundation of what we now call the “Golden Rule”.  It guides the moral compass and ethics we are urged to follow in regards to our interactions with others.  It is the same for healthcare providers.

Here is the question that I always ask myself when recommending care for patients.  “Knowing what I know, what would I do if this were me?”   The answer to that question guides me.  As a consumer of healthcare also, I would ask that of my healthcare provider just as I ask it of myself when I am that provider.

Yet, there are pitfalls with this question.  First is: what is “knowing”.   With over 35 years experience, I know more now than I ever did.   Does that change my treatment recommendations?   Yes it does.  I know what works and just as important, I know what doesn’t work.

With the half-life of medical knowledge estimated at 5 years or less, keeping up on up-to-date knowledge is increasingly difficult.  Current “knowledge” is the key.

So, another key question I ask myself constantly is; “Is the knowledge I have the most current or is there something more I need to know before making a recommendation?”  Sometimes, the answer to this question is “I don’t know”.  What do I do then?

I rely on a group of highly passionate specialists for consultation.   I can’t keep up with everything there is to know about the increasing complexity of just Dentistry not to mention Medicine.

That’s why I may ask a patient to see a specialist.   It’s as much for my edification as it is for theirs.

That’s why I ask for all your Physicians names and phone numbers.   I may need to contact them to get me up to date on a specific medication, treatment or illness.

How can you, as a health care consumer appreciate the level of your healthcare provider’s “Knowledge”?

One way is membership in specific organizations that require reaching a level of expertise or maintenance of continuing education.   For instance, I belong to the American Dental Association.   That means nothing to you as consumer as it relates to my knowledge of dentistry other than it means I graduated a Dental School.

However I also belong to a several organizations that are selective.   You can’t just apply; you have to be voted in based on exacting criteria.   The International Academy of Dental-Facial Esthetics, The New York Academy of Dentistry and the American College of Dentists are 3 such organizations.   There are several others.

It is incumbent on you, the consumer, to look at your Healthcare provider’s credentials and scrutinize them to determine what they mean and how relevant they are to your needs.

To your health,

Michael

Integrative Medicine

After attending the symposium on Oral-Systemic health at The Cleveland Clinic last month I have a new appreciation for the field of integrative medicine.  The term Holistic has gotten a bad rap.  It implies non-scientific, non-traditional and even unproven therapy, especially to those of us in the traditional medical community.  That’s unfortunate because alternative medicine, also known as integrative medicine has a great deal to offer and many of its more effective advocates make a lot of sense.  Acupuncture, for instance, was once mocked as “voodoo medicine” and is now an integral part of accepted therapy.

Personally, I subscribe to several health newsletters.  They are short, concise and packed with useful information.  The Cleveland Clinic’s and Dr. Andrew Weil’s are two of my favorite.  They’re free too.

Our current system can best be described as a “sick-care” system.  We treat disease with medication, surgery or other therapies.   This is the model that insurance and pharmaceutical companies promote.

This type of care is expensive and not on the public’s best interest.  It’s certainly not in your personal best interest either.

How can the system change?

It can only change if we demand it of our healthcare practitioners, government and employers.

I’ve written 2 letters to a President of the USA.  Both were to President Obama and both were on healthcare reform.  I outlined a comprehensive restructuring plan.

While I’m not a policy expert, I am in the system as both a practitioner and a patient.  I’m also a citizen who, I believe has an obligation to exercise my right by letting politicians know my mind.

You can write too.   You can exercise your rights to express your opinion.   Do you like our system?  If not, let the people who are crafting it know.

To your health,

Michael

Do you find your dentist from a stranger on the phone or an advertisement?

Sadly, many people do this and worse.

“Do you take my insurance?” should not be the first question you ask when looking for any health care provider.

“Where can I get the best care?” should be the question asked.

Will you be able to know this from a stranger or a website whose aim it is to get patients for doctors or an advertisement aimed at luring you with offers and come-ons?

Ultimately, you have to take some responsibility.   Learn about your needs.   Learn about your potential new dentist’s strengths.   Do they match up?

You wouldn’t go to a surgeon to have cosmetic bonding and you wouldn’t go to a Pediatric Dentist if you were an adult.

If you’re a person with Diabetes, or pre-Diabetes or have a family history of Diabetes, wouldn’t you want to go to someone who understands the complexity of the disease and the interaction that occurs in your mouth?

Do you know that not all Dentists have such an in-depth, medically based approach?

Educate yourself.  Read The Book.   Don’t let your teeth fall into the hands of The Tooth Fairy.

 

To your health,

Michael