Monday, April 21, 2014

"Up in Smoke" - The Marijuana Phenomenon....How is Dentistry Affected?

"Rocky Mountain High" has a new meaning...

As of January 1, 2014, the recreational use of marijuana became legal here in Colorado.  The "medicinal" use has been in place since 2002.  When Barack Obama became president, he openly said that he wouldn't make this a judicial priority. Pot shops started to "bud" up all over Colorado. They grew like "weeds".  It got a little out of hand.  Advertisements, crazy names and street sign shakers everywhere.  All vacant commercial real estate became pot shops.  To really put this into perspective, there are more pot shops in Denver than Starbucks.

(A video I took a few years ago of a guy toting a sign advertising $25 1/8th's on Colfax Avenue.  Sign toting has since become illegal for pot shops.)

Imagine, walking into a marijuana store and after perusing the dozens of strains, brands, edibles, etc - pulling out your cash and making a purchase. No need to look over your shoulder. You walk out, you go home and partake.  This is not a hallucination.  It is reality in Colorado.  (Buy stock in Frito-Lay now!)

Before it became legal for recreational use, I had been to many concerts at Red Rocks, an outdoor venue in Morrison, CO. At the start of every show, the rampant outbreak of "glaucoma" commenced and it seemed that the only cure had been to smoke dope.  These poor souls -all those years of suffering - buying tickets to their favorite artist and unable to see the stage due to their glaucoma.  No longer- with the legalization of medical and recreational marijuana, they can see clearly!

I say this with my tongue firmly in cheek.  I thought the medical "guise" was a sham as so few people truly had medical conditions that qualified.  If it was truly for medical use, why weren't pharmacists in charge of its distribution?  They are the only profession qualified to dispense legal drugs.

The recreational marijuana experiment is here to stay.  The State of Colorado is expected to generate over $100 million in tax revenues. If you are not from Colorado, take note, I predict that this phenomena is coming to your state soon.

Before I go any further - for full disclosure, my marijuana days are long over. Mind altering substances didn't agree with my preferred future. I voted against the legalization. Obviously, I was in the minority.  It is here to stay.  It is now as normal to smoke dope in Colorado as having a beer with friends.

I am not going to get into the social ramifications or discussions about the signs of the apocalypse.  I would like to open up the "doors of perception" in my profession and start the conversation.  

How does marijuana affect dentistry?

First of all, our patients use it.  Accept this fact.  A significant percentage always have. We need to ask them about their using habits.  This may seem strange and/or uncomfortable.  We need to know, so we can treat our patients appropriately. There are several risks and maybe even some benefits here. 

Potential Risks:

  • Smoking marijuana causes cancer.  I know, this is going to elicit all sorts of responses from the peanut gallery.  Bottom line, it has carcinogens in it that cause cancer.  When we do an oral cancer screening, we need to get over our fear and ask our patients.  We need to council and educate our patients with regards to the risks of use - Just as we do with alcohol.
  • Like tobacco, smoking marijuana is also a risk factor in periodontitis which is the leading cause for tooth loss these days.  I am sure that oral hygiene takes a back seat to vegging out on the couch listening to Pink Floyd. I also predict "higher" caries risk due to xerostomia, poor diet and lapses in oral hygiene. 
  • Very important point - just because it is legal, we dentists must practice dentistry SOBER!  This goes for the dentist and our staffs - all health care professionals included.  It has never been OK to go to lunch and knock back a few drinks then return for our afternoon patients. This is no different.  I know you say, "it helps with concentration" - Zero tolerance here! 
  • Marijuana use can lead to addiction.  We need to be skilled in communicating this fact to our patients as we do with alcohol and other drugs. There is a plethora of resources available to treat the disease of addiction. We need to be well versed in guiding those patients that need help towards recovery.

Potential Benefits:

  • Pot may be a viable pain management alternative to opiates.  This is empirical.  But it does relieve pain. Chronic pain is a criteria to get access to a medical marijuana card.  I haven't seen any studies or if even these sort of studies are possible due to marijuana being a Schedule 1 drug. Opiate abuse/addiction is at an epidemic level.  There were three times more opiate deaths than drunk driving deaths in Colorado last year.  Pot is addictive but probably not as addictive or dangerous as opiates. I am not saying that pot is not dangerous.  I don't think it is as dangerous.
  • Pot may be a viable anti-anxiety alternative to benzodiazepams.  I will bet that our patients have been smoking pot prior to dental appointments for decades.  Again, I'm not sure if any studies have been done (see above). Another criteria for a medical marijuana card is anxiety.  
I do not proclaim myself to be an expert here.  These are just my observations and predictions as a practitioner and a citizen in the State of Colorado.  There is a wide open frontier of possible opportunities and pitfalls with the legalization of marijuana. Hopefully we can stay ahead of the curve and help our patients as always in the best possible manner.

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 contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Friday, April 11, 2014

Is Dentistry a Commodity?

From 1991 - 1995, I went to dental school to learn my craft.  I found out that early on, that the scientific based classes came very easy for me as I was a biomedical engineer prior to dental school.  What didn't come so easy, was the artistic training that was required to be a dentist.  We had to learn how to create teeth out of wax, plastic, amalgam, composite, gold, porcelain, etc.

Looking back to grade school, I was the kid that got sent to the principle's office from art class for being disruptive.  I would do anything to not do art.  I was quickly slapped with reality when I struggled in these early training exercises in dental school.  I had no artistic skills!

I struggled so much that I was required to go to what I call "wax camp" during the summer after the first year of dental school. (Does the movie"The Breakfast Club" comes to mind?)

The other "campers" and I huddled around bunsen burners flames and honed our skills with one-on-one instruction from some very talented instructors.  One day, I don't know when or why, the switch flipped and my right brain connected with my left brain and I was able to wax up teeth at a proficiently high level.  As time went on, I became better and better at it.   In fact, I taught this very same class at University of Colorado School of Dental Medicine for 7 years.

So back to the question, is dentistry a commodity?

Dentistry is an imperfect blend of art and science.  It is not mass produced on a conveyer belt in a factory.  It is provided uniquely and personally to our patients.

A mentor and master of dentistry, L.D. Pankey once said, "I've never had a tooth walk into my office. It was always attached to someone.  Get to know that person, and I may get the opportunity to treat that person's teeth."  Words which I live by in my practice philosophy.  We treat people holistically - mind, body, spirit. You are not a set of teeth, you are a "whole" person.

So is dentistry a commodity?

Can a person go to a dentist and say that he needs a size 12 upper molar and the dentist picks one off the shelf and glues it in?  NO

Can a person go to a shoe store and ask the salesman to fit him in a size 12 shoe? YES

Can that person buy a size 12 shoe for $30, and a size 12 shoe for $300?  YES

Is that shoe store being chastised by community organizations for "gouging" its clients?  NO 

Why then do dentists get chastised by insurance companies for charging a fair price for their services provided uniquely to an individual?  Usually people (insurance agents) placing unfair judgements on things they have no experience with.

If a dentist charges more for a service than a patient values, the patient will not buy that service. Simple economics - supply and demand.

If a person sees a value in either price point for the shoe, he/she will buy that shoe.

The same thing goes in dentistry.  There are different levels of service and challenges in treating patients.  A more difficult procedure may cost more as the dentist to takes more time, care, judgement and skill to perform that procedure to the level of care that the patient expects.

And any patient has the right to put value on things important to them.

Most third party entities (insurance companies, government agencies, etc.) have been masterful at creating a "dentistry is a commodity" mindset to the consumers.

I am emphatically saying that it is not a commodity.  Dentistry is a blend of art and science executed with proper judgement and skill that only comes from our highly specialized training and experience.

There may come a day that one can choose a size 12 upper molar off the shelf -

Then again, there may not...

All this could be a moot point as clean teeth do not decay - AND - 95% of dental problems are preventable!

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 contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Tuesday, April 8, 2014

25 Things About Me

As my 46th birthday approaches, I decided to take a different approach to my usual rants here on my blog.

This was a facebook thing several years ago.  I retrieved my list from 2008 and updated it. It was a good reflection exercise for me.

Here are 25 things about me in no particular order -

1. I used to alter my mind with substances but found that it didn’t agree with my present or future plans…

2. I am inspired by positive changes in people, places and things...

3. Someone from my high school told me once that I when I grow up, I wouldn’t listen to heavy metal anymore….”F@%k -you old friend, I still do!”

4. My kids are exactly like my wife and I, and it is scary! We are raising our children Jewish…however, sometimes Sunday school interferes with our ski weekends and my mountain running “problem”…Sorry Rabbi Mo!

5. I love to run, bike, triathlon, snowshoe etc.… my favorite running partners over the years have been Gina, my Dad, my brothers and sisters, Gary Benson, Charlie Perez, Maggie Close, Liza Gualandi, John Stevens, Conrad LaPorte, Steven Griffith, Dave Lindeman, Brian Reick, all my Team-in-Training groups, my dog Kida and now Crosby.  Thinking back, Gary Benson has been sharing adventures with me for close to 25 years.

6. I love to run/play in the mountains. In fact, last fall I ran the Grand Canyon, South Rim to North Rim and back to the South Rim in less than 18 hours.  Other notable athletic accomplishments – Leadville 50 mile mountain bike race, mountain biked from Telluride to Moab, multiple marathons, trail marathons, and snowshoe marathons. (yes you read that right SNOWSHOE marathons)

Which segues nicely into….

7. My life is an adventure, just ask anyone!

8. I am a deeply spiritual person. I try to improve my faith every day. Sometimes I falter and my intentions don't align with my actions. I am human and there are lessons to be learned everyday….There is spirituality in imperfection.

9. I am excited to see so many friends that are on similar paths as I. I am proud to walk this path with all of you! You give me strength and hope when I cannot see it for myself.

10. I have an awesome dental practice, and an amazing team of people that I work with. (employees, patients, consultants, referring doctors, specialists, etc). I am proud of the lives that we impact through our dentistry. . I love being a dentist. I believe that the smile is the window to the soul. I do everything that I can to help my patients’ soul shine through.

11. Progressive music genre: “Complicated music for complicated people” – I think that Geoff Tate of Queensryche was speaking to me when he said that!

12. I would play guitar for a living if I thought it would support my lifestyle.

13. Two friends (Mike Ford and Pat Gibbons) died recently from complications of the flu.  Their lives were cut short, but their impact on the world was huge and their spirits carry on in so many lives that they touched.

14. My wife is a saint to put up with me on a daily basis!

15. I am glad to have reconnected with so many friends from the past on social media.  I am so happy for all of you who choose to share about your lives.  I hope to reconnect in person with you in our various travels.

16. The economy may not have a bright immediate future. However, our attitudes do, if we choose accordingly.

17. In October, 2007, I testified before the United States Congress on behalf of the American Dental Association. I was to explain to them about the ravages of methamphetamines on oral health. My true message was that there is a solution to the disease of addiction. Treatment works. Sometimes it may take a few times but it is the best solution going. And, it saves lives!

18. I am about to become the President of the Colorado Dental Association – I am nervous, excited, and amazed that any group of people would choose me to lead an organization.   I hope to leave the organization better than when I took it over.  I work with an amazing board and CDA staff that keep this train rolling in the right direction!

19. The best thing about being a father is that I get to live my childhood again through them. I am blessed to have a loving family to share their experience on how to do this thing! It is easy to father a child, it is an accomplishment to be a father.

20. Religious people are afraid to go to hell in the afterlife. Spiritual people have been to hell (here on earth) and don’t want to go back!

21. I have had many mentors in my life to which I am most grateful. They saw things in me that I couldn’t see in myself and then encouraged me to grow those gifts.  I try to pay it forward by mentoring others. Thanks to all of you, especially mom and dad....

22. My wife thinks that social media is weird but she is starting to warm up.

23. My dream house is in the mountains near a rolling, open meadow strewn with wildflowers and a stream running through it.

24. I played basketball in high school.  As a rebellious teenager, I began to hate it at the time. Looking back regretfully, I could have played at a higher level if I put the effort in.  Basketball has so many life lessons in it.  I took my son Max to the Coach K basketball camp two of the past three years.  Last spring, I reached out to my old basketball coach from high school (Ken Sartini). Over dinner we caught up on what had been going on in our lives the past 20 plus years.  I thanked him for being a great teacher and mentor to me.  I still talk to him often, what a gift!

25. One more….Chicago Cub’s, next year is now! Come on already!

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!  BK