Sunday, September 29, 2013

Breaking Bad (teeth) - What Walter White and Other Meth Dealers Don't Tell You.

The popular and compelling television show "Breaking Bad" is coming to a close.  Since there is so much talk of the show and its main focus - the drug methamphetamine, I figured the timing was right to discuss the other side of the story.

Methamphetamine is a highly addictive stimulant drug similar to cocaine.  It's effect on the brain is instant and profound.  Addiction rates are high to those that use it.  Many users claim they became addicted the first time they tried the drug.

It destroys the lives of the user, the families, the communities, the environment, and the properties (houses, apartments and hotel rooms) where the users partake.

Advocacy entities such as the Meth Project have developed broad reaching prevention plans that have been extremely successful.  Their tagline "Not Even Once", their penetration into the communities, their television and radio ads send powerful messages that have worked in preventing a potential user from making the choice to use.  Please support this amazing organization.  Meth Project (

Addiction (to any drug, including methamphetamine) is a treatable disease.  There are many local resources.  If you are struggling with addiction or know someone that is, please take action.

The end result of untreated addiction is death.  

A great treatment resource is SAMSHA.  This is a government organization whose mission is to reduce the impact of substance abuse and mental illness on America's communities. (Samsha)

As a dentist, I have seen my fair share of "meth mouth".  It is a phenomena that is illustrated by massive destruction of teeth.  It is usually caused by the smoking of the drug.  The ingredients that are used in the manufacturing of the drug (muriatic acid, battery acid, drano, psuedophedrine, phosphorous, lye, drano, etc.) literally melt the teeth away when they come into contact with the smoke.  It happens quickly (usually within a few months) and the damage is irreversible.

Figure 1- Close up of "meth mouth"

It is very difficult to do traditional cosmetic dentistry (such as veneers) on teeth that present in this way.  Usually full mouth extraction and dentures are required to give these patients the ability to function and to look presentable once again.

In my experience, dentists can really make a difference in the lives of these patients.  Once sober and motivated, re-creating the smile is very impactful to early recovery, self esteem, and the integration back into being productive members of our communities.

Figure 2- Before and after of the same patient who had meth mouth  Full mouth extraction and dentures were fabricated.
Walter White and the entire cast of "Breaking Bad" have made for engaging television, but the brutal reality of meth addiction is virtually invisible on the show.  Fans of the show have a connection to Walter, Jesse, their families and those close to them.  When I take a moment to reflect on the other (real) side of this drama, it is hard not to think of those patients and their families I've treated in the past.  

Meth is a Bad Drug...

If you are someone with a history of substance abuse, I have a great deal of experience treating dental patients with this problem once the addiction is treated and arrested.  I congratulate you on your recovery. Please take note that I am not a free clinic and do not have resources to give away free dentistry to you. I love the impact that cosmetic dentistry has on the lives of my patients.  This type of work is very difficult and it comes with a cost to maintain the viability of my business. If you are interested in becoming part of our community of patients, I would be happy to treat you as a regular paying client.  

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website or like our facebook page,  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!

Sunday, September 8, 2013

The Most Influential Person in the History of Dentistry - was not a dentist!

I found out about this in the most surprising way.  I was reading the book The Power of Habit, by Charles Duhigg and I was introduced to Claude Hopkins.  He is considered the most influential man in dentistry.  Ironically, he was a marketer, not a dentist.  He was considered one of the most influential marketing experts of his time as well.

How was he the most influential person in the history of dentistry?  His marketing campaign helped to create the habit of daily toothbrushing.

In the early 1900's, tooth decay was rampant in America.  It was so bad that it had become an issue of national security.  There were so many WWI recruits with oral infections that they were hampered in pain and could not perform on the battlefield.

Claude Hopkins was approached by an old friend about a new dentifrice (toothpaste) called Pepsodent.  At the time, tooth powders were peddled door to door by traveling salesmen.  Hopkins quickly declined the offer to promote this toothpaste.  It was a losing battle as less than 7% of the population in the United States had an actual toothbrush in their medicine cabinets.

It was not part of our daily routine at the time.  Why would people use toothpaste, if they didn't even use a toothbrush?

The Pepsodent people, quite confident in their product, were persistent with Hopkins and eventually he agreed to take on the marketing campaign.

As Hopkins dove into the (boring) dental scientific literature of the time, he stumbled upon a description of the "mucinous plaque" that forms on teeth.  This film, he found out was the root of all dental troubles.  This is where the bacteria was that caused the tooth decay and gum disease.

Ironically, it was easily removed through normal toothbrushing without the use of any toothpaste. He ignored this fact and exploited the horrible "film" that destroyed teeth and ruined smiles.

Figure 1 - Pepsodent ad from 1929 describing the call to action 

Actual Pepsodent Advertisements

His marketing campaign was brilliant.  He created a cue, "Rub your tongue across your teeth and you will feel this film."  He then went on to say that this film must be removed each day.

He also appealed to the self esteem of the population - He implied that having a nice smile is a crucial part in being beautiful and attractive.

By creating a daily cue (rub tongue across teeth), encouraging repetition (the film must be removed daily) and establishing a reward (beautiful smile) - he helped create a national habit of daily oral hygiene using toothbrushes and pepsodent.

Through this marketing campaign, the people in the US that had toothbrushes and actually used them soared to 65% within 10 years.

If he was still alive, I wonder how he could create an ad campaign for flossing everyday too.

The dental profession hasn't figured out how to appeal to the emotions around flossing.  We all know the logic behind it, but to create this habit, we need to appeal to the emotional side of the communities that we serve.

On a side note, I just have to say:
clean teeth do not decay.....

Another side note that I learned at TEDMED last spring:

 More people in the world have smart phones than have toothbrushes......


If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website or like our facebook page,  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!