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 (http://www.methproject.org/)

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 http://www.tcdodenver.com/ or like our facebook page, https://www.facebook.com/TCDOdenver.  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!

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......

Hmmmm.....


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 http://www.tcdodenver.com/ or like our facebook page, https://www.facebook.com/TCDOdenver.  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!

“Team of Rivals” - Reflections from my trip to Washington D.C. May 13-15, 2013

The Colorado Delegation in front of the Capitol

I am currently reading the book “Team of Rivals: The Political Genius of Abraham Lincoln, by Doris Kearns Goodwin.  The movie “Lincoln” was based, in part, on this book – although the movie only depicted a small segment of the story.

When “Lincoln” hit the theaters, I was enthralled by it.   I knew how it would end – happily, the slaves would be freed and tragically, he ultimately would meet his demise from an assassin’s bullet. 

The story illustrated his focus on doing what was right in his heart.  He faced tremendous challenges within himself, his wife/family and his political advisors.  Not to mention, the social norm at the time (slavery), the soldiers that were fighting in the Union Blues and the forgiveness that he exhibited toward the Confederates.  Lincoln, filled with guilt over the realities of war, always considered the southern states his countrymen and reinstated them to full citizenship upon the ending of the war. 

Lincoln was torn every minute of every day.  I could imagine the questions that he would be asking himself – “Am I doing the right thing?  Is it worth the war and all of its casualties? Why do the people I am leading, continue to follow?  Is all of this worth the personal sacrifice to me and my family?”  And the most important question,  “Why me? Couldn’t Seward or Chase be in charge?”

There was so much history in the movie that I was unaware if, I went and saw the movie again – and ultimately bought the book.  The book tells the back-story of how Lincoln arrived at becoming the leader that he was. 

 “Team of Rival’s” – Lincoln took his biggest political rivals – people he ran against for President and lesser political positions - and made them his cabinet.  He made them his closest, most trusted advisors.

This is the political equivalent of President Obama asking John McCain or Mitt Romney to fill the same roles. 

I have been in Washington DC this past week as part of a delegation of the Colorado Dental Association and the American Dental Association to try to improve the delivery of dental care to our communities.  During our time here we heard many politicians and pundits describing for us the current state of politics and the political process. 

As you already know, the climate isn’t pretty.  The government is spending much more than it has and nothing is getting done.  There is party posturing and political stalemates on every front. 

Our delegation met with all of our legislators or legislative staff.  We are looking to reform dental insurance - to break up the monopoly that they have.  With a monopoly, there is no competition.  With no competition, there is no innovation in the plans and the insured don’t always get the best benefits at the best price. 

A new medical device task is being implemented soon.  But there is no definition of what constitutes a “medical device”.  We asked to repeal the tax.  If they aren’t going to repeal the tax, at least define what is to be taxed.  As of now, no one has any idea!

I didn’t get a feeling like we were making an impression on any front.  I hope we planted a seed of change that we can nurture over time into definitive action.

Back to Abe Lincoln…As we were meeting with our legislators, searching for inspiration I began to think, what would a leader like Lincoln do in today’s Washington?

I would think he/she would act courageously, inspire us as a country and bring us together by forgiving the past to move us forward. 

I would hope that he/she would say, “We as a country are in trouble. If we continue along the path we are on, the country and all of it’s people will not be free.  Unfortunately, there is no easy solution.  Everyone must be willing to sacrifice and compromise your beliefs so we can once again be the country that we once were. We must not live in the past and pass along the blame that it was the democrats or republicans fault.  It does no good.  We must move forward with a unified vision of a thriving future -an America that courageously stands on the principles upon which it was founded.  We must change or suffer our demise.”

The only way to do this is for our president to look back in our history and create a “Team of Rivals”.  Get the political fighting done behind closed doors, come out with a unified front and unite us, inspire us and let’s move forward before it is too late.

The Spirituality of TEDMED 2013

My Badge

TEDMED ended this afternoon.  It has taken me a little time to unwind so I can make an attempt at articulating what I have experienced over these past few days.  I cannot lie, it is really difficult to illustrate.  I am hoping that some of the videos are available soon, so I can "wow" you like they "wowed" me.

Each talk that we witnessed resonated with us logically.  We sat in our chairs in the Kennedy Center and watched these amazing presentations and performances.  Some resonated more with me, some resonated more with my friends that I met here.

Everyone that I met was excited to be a part of the TEDMED community.  Everyone had their reasons for attending. I really wasn't sure what mine was - there were only 2 dentists out of the 1800 or so people. I have watched numerous TED talks and even attended a TEDx event in Boulder last summer.  I guess I was looking to be inspired by a different mindset of people.

Since the people here were some of the most intelligent that I have ever been around, I figured that science and logic would rule the roost.  The science and logic is all explainable.  We all shook our heads in agreement, thinking, "Why didn't I think of that?"

The inspiration for these "out of the box" thinkers and doers is also explainable.  Something happened to them, their communities, their patients, etc., to catalyze a change in their path.

Inspiration is one thing, but where did the passion come from?

What made these mensa club members drop everything and modify their trajectory?  How did they get the courage to step off their path and enter into the unknown?

It was mentioned that it is completely illogical to innovate - as there is no data that can be relied upon when you are innovating.  An innovator is forging a new frontier -  and trust me we saw new frontiers with every presentation.  These passionate innovators

Their innovation took courage, intelligence, and a never quitting passion.  There is no logic to explain this other than synchronicity - or devine intervention.

Carl Jung described four dimensions of consciousness.  Time, space, causation and synchronicity. Time and space are obviously defined.  Causation is a series of related events that explain a certain result.  Synchronicity is a series of unrelated events that are unexpectedly tied together to explain a certain result.

The only explanation that ties these events together is  - Spirituality, Karma, God, Yoda, The Great Pumpkin, etc.

It wasn't until the very end of the conference that the word spirituality was even mentioned.  There is no logic here.  Logic lies in the brain.  Spirituality lives in the heart. This is where the power source for the passion, the inspiration, and the courage is continuously fueled.  No logical explanation here, only synchronistical explanations.

The presenters that so graciously shared with us are changing the world.  They are changing the health of their communities.  Their passion is inspiring our passion. And now, our passion is being shared with our communities.

Everyone has unique gifts.  It is our obligation to share these unique gifts with the world - whatever they may be.  However small or big, it is our obligation.

Synchronicity will prevail and we will all be as "wowed" as I am now.

TEDMED - A synchronistic blend of art and science

More to follow!

(See www.TEDMED.com for more information)

First full day at TEDMED

My badge...

Dean and I!

Well, the day started out with a run with legendary ultra-marathoner Dean Karnazes.  There was a group of 20 or so of us.  Dean stated out bu causally mentioning that the last time he was in Washington dc, he ran here from california.  It took him 70 days of running 50 or so a day.  Had some nice conversation with him and other TEDMED delegates.  Interestingly enough his wife is a dentist in San Francisco. She practices in the same building as a friend of mine!  Small world.

I cleaned up and quickly got over to the Kennedy Center for the day.  There are  two main areas here.  The auditorium and the "hive". The hive is where all of the networking/connections are happening.  There are 50 mind blowing start-up companies that are looking to change the delivery of health care right now.

One in particular is called Emotiv. (www.emotiv.com) They measure brainwave activity and the ability to focus through EEG scanning.  I did a personality test with them through this EEG monitoring technology and m y dominant trait came up as an "Explorer". Never would have imagined that!

Another really cool company is called Neumitra. (www.neumitra.com) They have created a sensor that measures your stress, anxiety and focus etc.   When you become stressed or unfocused, the sensor gives you a reminder to take a walk,  listen to some music, talk to somebody. This has many uses and they are looking to applyq this technology in everyday life.  I can think of at least 5 different research projects that I would like to see done.  Wo knows, maybe I will?!?!

The speakers have been amazing.  This morning's theme was about big data.  The common theme was that we have the technology to analyze the zillions of data points in all aspects of health, why aren't we?  Several presenters gave their own personal experience transforming data into wisdom. A with any TED talk, we all were mind blown about the possibilities.

My favorite was a discussion about "what is cancer". It was a point counter point discussion.  When the video becomes available, i will pass it along.  It de-myths several concepts about cancer and the treatment of cancer.

A close second was Mayor Mick Cornett from Oklahoma City, OK. He shared his own struggle with obesity and then how he helped his city lose over a million pounds collectively.  He created infrastructure to promote more walking, running and cycling - less driving.  He asked all of the restaurants to offer healthy choice options.  It was also promoted through church groups, work, schools, etc. A whole new attitude transformed the health of the city.  On a side note, OK City is now on the fittest city list, has one of the lowest unemployment rates, a solid economy and a growing population.  It reminds me of Mayor Hickenlooper's "one book, one city" campaign.  It would be great to see other cities follow suit.

Then Richard Simmons showed up.   I was surprised at how much fun he was.  There is rumors of me being on the stage dancing with him and several other men from the audience...They are true.  I hope that section wasn't taped!

Last night, they outfitted us with "fitbit's". They are little pedometers that measure your steps, calories burned, etc.  Since this is supposed to be about health, they gave us the goal of 10,000 steps per day.  I was at 11,000 by noon (i took it running with me....). The food that they have been giving us is also very healthy, organic and fresh.

I have a physical scheduled for later this afternoon.  All done via smart phone technology.  The results will be available digitally-although not necesarrily on my phone.  This technology could seamlessly provide access to remote areas where health care is sparse.

Then lastly, I have to talk about the people that are here.  I am surrounded by the most innovative thinkers and leaders that I have ever been around.  There aren't too many dentists here.  I am trying to illustrate that we are still practicing a free-market driven health care system that works.  When I describe how I practice, the common comment is "I wish that the practice of medicine was more like that."

I don't see why it isn't...with this group of people, anything is possible!

More to come!

Who Are Our Role Models?

I recently gave a leadership lecture at the Rocky Mountain Dental Convention.  In one key part, I ask the audience to identify who inspires them. Who are your role models?

For me, it had been Lance Armstrong for many years.  I am an avid cyclist and I never missed a stage of the Tour de France - either live stream on the internet or on tv.  In fact, I remember watching late night recaps on ESPN during the Greg LeMond era - before it was really popular.  When Lance came along, I was hooked onto the entire phenomena.

I also have contributed to LIVESTRONG both through donations as well as spirit.

For years I have been defending Lance Armstrong.  He claimed to ride clean, and more importantly, he gave inspiration to the many afflicted with cancer.

I heard him speak once.  He was challenged by his oncologist after his cancer surgery/treatment that when he left the hospital, he could take one of two paths forward: 1. He can go on with his life and keep his cancer experience privately behind him, or 2. he could accept the challenge of the "obligation of the cured" - a mission to help those who are directly or indirectly suffering from the disease.

He obviously chose the second path.

That is what was most inspiring to me about Lance.

So now he comes out about his performance enhancing drug use.  The rumors were true.  I watched the Oprah interview. I felt let down by him.  He admitted his wrongdoings, but his body language showed very little remorse.  To live with that lie for so long must have been killing him spiritually.  He believed the lie, he believed the media hype.  He has a long road to redemption.

He has hurt a lot of people.  He has a lifetime of amends to make.  Hopefully he will dedicate the rest of his time here trying to right his wrongs.

But he is human!  We all make mistakes, no one is perfect.  I know I made my fair share, and I am sure I will make more as time goes forward.

Charles Barkley said in the 80's, "I am not a role model!"  It was very controversial at the time, but how true his words were. Here is a video from that era.

"I am not a role model"

He then goes on to say, "Parents should be role models" - Amen to that!  We shouldn't listen to the media on who should be our role models.  Our role models (whether we know it our not) have been with us all along the way.  They are our parents, our families, our teachers, our coaches, our friends, our colleagues, etc.

Take the time to identify them and thank them.  Then pay it forward!

I forgive Lance Armstrong for his transgressions.  At this point, I don't trust him - but I forgive him.  Consistent action towards change and amends will be the determining factor for trust from me.

That's what I am rooting for....

Here is a video from the late George Carlin on Lance Armstrong/role models that drives home my point. Warning: It contains some pretty foul language

George Carlin on Lance Armstrong

Easy on that Bite!

I practice comprehensive dentistry.  In my process, I have a three-pronged approach to address all things that could affect the oral health.  The first is health related - where we evaluate the health of the teeth, gums and oral tissues.  The second is functional - all things relating to the bite and jaw joints.  And finally, Esthetics. - anything related to the smile.  When all three are addressed, the dentistry becomes predictable.

About 70% of my patients have issues with their bite. Some knowingly, most are unaware.  Through a discovery process, my patients who were unaware, become aware of bite (occlusal) issues. This leads to discussions about how function can affect both the health and the esthetics of the teeth.

Here is an explanation that I give my patients as a take home read to further explain the goals and my process of bite therapy.  Note that the therapy is a process - it is not "here is a piece of plastic for you to chew on..."  It is a process that sometimes takes several months to properly address.  

Occlusal (Bite) Therapy

Occlusion is a dental term for how your top and bottom teeth come together—as when you bite.  Biting serves one purpose: to break up your food so it can more easily be digested. When you have a healthy bite all of your top and bottom teeth hit each other evenly with the jaw in it’s most comfortable (or orthopedically correct) position.  When the bite is idealized, you will potentially need very little dental work over the course of your life.

Occlusal (bite) therapy is usually indicated if you present with symptoms (If you find that your teeth look worn, or you are constantly touching, clenching or grinding your teeth together when you are not chewing food) or if the doctor sees signs of over-function (fractures, worn teeth or fillings, advancing gum problems, mobile teeth, etc.)  You may “over-functioning” on your teeth. This will cause problems that may need attention either now or down the road.

If your bite is not balanced, (or if you clench or grind your teeth, chew gum excessively, or bite your nails, etc.) your teeth are prone to poor performance. You can experience cracking, fracturing or excessive wear. Dental work may need to be replaced prematurely. You are more prone to gum recession or advancing gum disease, sensitive or loose teeth. Finally, your smile can be affected with ground down or chipped teeth, especially your front teeth.

An unbalanced bite can also affect the jaw joints (known as the TMJ) and associated muscles that open and close the jaw.  Depending on the problem(s), over-functioning can lead to sore jaw and neck muscles, headaches (even migraines), clicking and popping of the jaw joints during opening and closing, severe pain and limited range of motion of the jaw.

Recognizing bite problems as early as possible increases the probability that you will have good looking and functioning teeth at an elderly age. Much of the dental work in an adult’s mouth might have been avoided if the signs of occlusal (bite) disease had been recognized and addressed in the early stages.

Lucia Jig

The Lucia Jig is the usually the start of occlusal or bite therapy.  It is indicated for a number of reasons.  The first is to help you stop clenching and grinding of the teeth together.  If you are unaware of these habits, hopefully it will make you more aware.  The second indication is to relieve pain in the jaw/jaw muscles, and/or headaches. By stopping the clenching it will shut off the muscles are overworking, dis-coordinated or are in spasm. Most people find relief within a few days to a few weeks.  The more that the Lucia jig is worn, the quicker it will start to work.

This is not a permanent solution.  Once the muscles have been deprogrammed, the jaw joints (TMJ’s) slide into their orthopedically correct position.  It is to be used as indicated by the doctor.  Please if you have any questions, don’t hesitate to ask

Occlusal splint (nightguard, bite splint, etc.)

This hard acrylic appliance is custom-made to fit snugly over either your upper or lower teeth. It becomes a temporary perfect bite for you. It is a process of determining what a perfect bite is and may include several adjustments until it is idealized. The doctor will encourage feedback from you on how things are feeling when you are wearing the splint as well as when you are not wearing the splint. When it is properly adjusted and worn as prescribed, many of the signs and symptoms of bite problems often disappear as long as you wear the splint. 

The properly adjusted bite splint can then be used as a guide to idealize your bite.  In most cases if your bite is idealized, you won’t have to wear the splint anymore, and your teeth have the best chance of working for you over the course of your lifetime.

Idealizing your bite

There are several options when looking to idealize your bite.  These options will be determined once you are stable with the occlusal splint. 

Occlusal analysis: The doctor will mount models of your teeth on a mechanical jaw that can mimic all of your jaw movements.  He will then be able to determine what kind of adjustments/dental work will be needed to idealize your bite.

Options include:

Equilibration:  A focused reshaping of your teeth so that they bite together simultaneously with even pressure.  The doctor reshapes the areas that are interfering and most likely causing you to clench and/or grind your teeth.  This is usually accomplished in 1 to 3 appointments, is usually pain free during and after the procedure. 

Equilibration combined with restoration: Equilibration as above, with the combination of some teeth that need fillings, crowns, veneers, etc.

Orthodontics:  If the teeth are severely malpositioned, orthodontics may be recommended to improve their position so that the bite then be idealized with equilibration possibly combined with restorative.

           

Surgery:  For the most severe alignment issues, the bite may need to be re-set with a surgical procedure. If it is indicated we work hand in hand with some of the finest surgeons in Colorado. You will be referred for an evaluation by an Oral and Maxillofacial Surgeon.


Copyrighted material (2013) Brett H. Kessler, DDS.  

What's the Goal?

What's the goal?

It's that time of the year again.  Every December, I sit down and look at the past year and set up the plan for the next.  I do this both personally professionally.

Time to keep score - How did I do?  I definitely fell short in some areas.  And, I definitely over-achieved in others.

I look at personal accomplishments, family accomplishments, professional accomplishments, etc.

In 2012, (Tangibles)
What worked?
What didn't?
What was missing?

How do I feel about all this? (Intangibles)

Review of my Mission Statement, Vision Statement, and Core values

What are my goals for next year?
What are my priorities?

I highly recommend taking a little time to look at these things.  Living with intention is much better than blowing in the wind.

How about you...What is the goal?

Carpe Diem

This is a reprint of an article that I penned for the Journal of the Colorado Dental Association, Summer 2012 (Vol. 91, No. 3). I currently serve as Vice President.

Carpe Diem…

“If you live each day as if it is your last, one day you most certainly will be right.”  Steve Jobs, in his commencement speech to the 2005 graduating class at Stanford University. (Quote attributed to H.H. “Breaker” Morant)

Quite the statement, I must say.  Especially since cancer recently took him away from our world and into the realm of the unknown.  

Now, after reading Steve Jobs’ biography by Walter Isaacson, it was very clear to me Steve Jobs was a visionary.  He was not, however, a saint.  In fact, the book showed an accurate and honest depiction of a man that knew what he wanted and would do almost anything to get his way.  Often, he was selfish, self-centered, mean, inconsiderate, and eccentric. Hardly the traits of a saint…

But he was a visionary.  One thing that is certain, he stayed true to his vision and his vision changed the world.  The computer industry (Apple), the music industry (iPods, iTunes), movie animation (Pixar), the retail experience (Apple store), and the smart phone (iPhone) all have been re-invented through his innovation and subsequently changed our lives.

In his commencement speech he continued, “It (quote) made an impression on me. And since then, for the past thirty-three years, I’ve looked in the mirror every morning and asked myself, ‘If today were the last day of my life, would I want to do what I am about to do today?’  If the answer is no for too many days in a row, I know I need to change something.”

I know of many dentists that are not happy in their current situations.  In my life, there have been times that I, too, have been unhappy with my situation.  Like my colleagues, I felt trapped, the walls caving in on me.  One day, something inside me gave me the courage to make changes.   I made a call for help.  

That call was instrumental in me turning my life around in ways beyond what I could have ever imagined.  There have been many mentors in my life that I have called upon. I am grateful for their guidance. I would not be the man I am today without them. The key point is I called and asked for help. Help did not find me, I sought it out.

Dentistry is stressful.  A mentor, Jerry Gropper, DDS, once said of our profession, “Dentists must have the eye of a sculptor, the hands of a surgeon, the insight of a therapist, the knowledge of a scientist, and the financial acumen of a businessman.” It is no wonder so many of us have struggles. This is a tall order indeed.

How then can we get out of our proverbial “ruts”?

Thoreau said, “I know of no more encouraging fact than the unquestionable ability of man to elevate his life by conscious endeavor.”  Uh-oh....He is saying that it is going to take some work.

First we must seek out who we are and what makes us truly happy.  It could be our family life, our practice model, our friends that we surround ourselves with.  It could be small changes or big changes.  One thing that is certain - Nothing changes if nothing changes.

Stephen Covey’s book, The7 Habits of Highly Successful People, describes this necessary change eloquently in the first habit, “Be Proactive”.  He talks of courage being the most important attribute.  Courage is not the absence of fear.  It is recognizing the fear that is within you and with a leap of faith - taking action. In this case, being proactive means to make the decision to make positive changes in your life.

Next, he encourages us to “Begin With the End in Mind” (Habit 2).  In this habit we are to create a vision of a better future. Covey writes,  “To begin with the end in mind means to start with a clear understanding of your destination.  It means to know where you are going so that you better understand where you are now and so that the steps you take are always in the right direction”.  

Our happiness is determined by how well we live within our core values and to what extent we discipline ourselves to our vision.

Everyone has a bright future, if we choose to have one.  

The last book I will reference is from John Ortberg When the Game is Over, It all Goes back into the Box.  He gives the analogy of life as a calendar.  Each square in the calendar is a frame for one episode of our lives.  Nobody knows how many squares one gets, but each of us must choose how we fill them.

When we think of our day, is it filled with meaningful events with our families, patients, colleagues, etc.? Or, are we stuck in our rut, allowing the world and its pressures to create unhappiness in our lives. 

You get to choose…Carpe Diem.

Is Orthodontics Enough?

Sometimes yes, sometimes no.

Many times adults inquire about getting their smile fixed with veneers or orthodontics.  To maximize the aesthetic result, sometimes they need both.

This patient was recommended orthodontics to correct her upper and lower crowding. Due to the position of her teeth, they have worn down though function - both chewing and grinding of her teeth. She was also recommended veneers to restore the ideal and aesthetic tooth form.

Figure 1: Pre-op smile

Figure 2 illustrates what the teeth look like after the completion of orthodontics.  Her teeth are now in the correct position, but due to the wear on teeth edges, they just don't "look right."

As we were getting close to finishing her orthodontics, we had a discussion about veneers and how they can help create an amazing smile for her. 

Figure 2: Orthodontics complete

The day we removed her braces, we began the veneer process and created a more aesthetic smile with provisional veneers made of a hard plastic.  No one knew that she had any work done, except that she got her braces off.

Figure 3 illustrates the smile with the new veneers in place.  We chose to do simple teeth whitening and place veneers on only her front 4 teeth. Because we were able to idealize the position of her teeth, we could create a perfect bite and be super-conservative with the dentistry. This is the ultimate benefit of true comprehensive care.  Her smile will look amazing for years to come.  Needless to say, she is very happy!

Figure 3: Post veneer placement and teeth whitening

We love to create natural looking smiles.  A smile is a window to the soul - we do everything we can to help our patient's souls shine though! 

We offer complimentary consultations for anyone with questions about the best ways to improve their smile. To set up a free consultation, please call 303-321-4445, visit our website www.TCDOdenver.com, or our facebook site www.facebook.com/TCDOdenver

Fig 1: Pre-op

Figure 2:  Post - orthodontics, pre-veneers

Figure 3: Veneer delivery, whitening.

Grand Canyon Run. August 31st - September 1st 2012

I am going to start out by saying that this was, by far, the best run I have ever done.  We didn't do the full rim to rim to rim, but under the circumstances it was a wise decision. More on that later.   

The idea to do this was hatched around Christmas 2011 at Gary Benson’s house.   We have been doing these crazy adventures together for the last 20 years. As usual, he enthusiastically agreed to the idea.  My good friend and neighbor, John Stevens was on board early as well.  The three of us have had many adventures together including a mountain bike ride from Telluride, CO to Moab, UT, a few 50K’s and countless trail runs/mountain bike rides. 

 As we started to plan it, other than the mileage, the heat seemed to be the biggest challenge.  We weren't too worried about the elevation changes.  We decided that this was definitely doable at night.  To add to the adventure, we picked a full moon night to maximize the light on the trail and beauty of the scenery.  September 1st was our chosen date.

We spent most of the year doing long runs on weekends that involved big elevation changes.  We ran a few 14'ers at night to get used to using our headlights, and hand-held flashlights.  The biggest run I did was Echo Lake (10,600’) to Chicago Lakes en route to Mount Spaulding (13,858’) over night.  It was an eight-hour adventure.  After doing this I felt that I was ready for the Grand Canyon.  The others did various other excursions, including the Leadville 50 mile mountain bike race, runs up and down Argentine Pass out of Silver Plume, CO, century rides, crazy cross-training work-outs at Red Rocks amphitheater, and of course, ton’s of trail runs/snowshoe runs. 

Enter Conrad Laporte.  He began joining us on our winter snowshoe adventures in February.  He is a great athlete and friend with the same sense for adventure and zest for life that we have.  He is 20 years younger than us.  We mentioned the Grand Canyon idea and he was sold. (Not sure if it was naïveté or bravado, but he was full on board!)  We had several others of our friends that we trained with all year, but were not able to make it.  Conrad stuck around with us on our weekend adventures.  He had never run more than 6 miles before he met us.   He is such a good athlete; we all thought he would be able to pull this off, even without any experience.  Turned out, he did the best of all of us!

We started our drive at about 5:30 on Thursday morning.  On the drive, we listened, “Born to Run: A Hidden Tribe, Superathletes and the Greatest Race the World Has Never Seen” by Christopher Mcdougall on Audiobook.  It was the perfect preview to the run we were about to embark upon.  It is an amazing story with a side bar diatribe about running in barefoot shoes.  Both Gary and I ran with barefoot shoes, as we have been for the past 2 plus years.   Conrad and John wore their trail shoes. 

We arrived at the GC at noon on Friday.  John and his wife Tracy, had secured a room at the North Rim Lodge. While they were checking in at the hotel we got to see the “big hole” for the first time.

When I get nervous, I joke around a lot.  I exclaimed that the canyon wasn’t so “grand”, it was definitely great, but not “grand”.  Denial!!! Standing at the North Rim, the view is indescribable.  Pictures do not do it justice!

The plan was to start at 4pm, run through the night starting form the North Rim.  I figured it would take about 6 hours to run across from North to South, then immediately turn back to the North Rim.  I figured about 10 hours for the return trip.  We timed it so it would be cool at the bottom of the canyon.  Daytime temps go well over 100 degrees at this time of year.  The forecast at the North Rim was a high of 72, low of 49.  At Phantom Ranch (the low elevation point of the trek) the forecast was a high of 99 and low of 72.  The temp never got below 80.

We were taking the North Kaibab trail to the Bright Angel Trail.  A total of 23 miles each way with a significant descent of over 6000’ then an ascent of about 5000’ to the South Rim.

While we were preparing/resting at the North Rim Lodge, I thought that John and Conrad would go together and Gary and I would pair off due to similar abilities.  We each went over our nutrition plans and agreed to be open to the potential changes. Sometimes, for whatever reason, it just doesn’t work.  We all had a ton of food.  The trail descriptions told of several water sources along the route.  That was encouraging, but we agreed to fill our water bladders full every time – in case we miss a water station.  It will be dark and none of us had ever done this.  There was too much at stake to risk running out of water. 

4pm – we were off.  Tracy joined us on the hike down.  It started raining, thunder and lightening too.  Tracy turned back after about 30 minutes.  We put on our rain gear.  Had Tracy hiked with us for 5 more minutes, she would have seen an amazing view at the “cocnino overlook”.

The rain was cold.  I began to worry since all my warm gear was now on me and I was getting cold.  If the rain continues, it would have been a long, wet and cold night.   Got to keep moving…JFR….

The rain stopped after about 15 minutes and it got really hot and humid.  Again, worry set in.  I started to up the water intake and salt pills as I didn’t want to dehydrate or stat to cramp. 

My nutrition plan was to eat as much solid food early while supplementing with power gels, then switch to power gels only as my stomach stopped tolerating the solids.  My philosophy was to keep “topping off the tank” instead of depleting all of my energy stores and trying to catch up.  I had PB and J sandwiches, Kind and Lara bars, beef jerky, granola, cookies, gum drops, and power gels. 

The trail was very dusty and steep.  The rain wet the top layer and settled down the dust.  It made it easer to run/breathe. There were a lot of switchbacks early on and we descended quickly.  Within an hour, the trail turned rocky and technical.  The scenery was unbelievable, but it was had to run the technical trail and take in the views.  I stopped to take several pictures along the way.  I knew that once the sun went down, the scenery would be barely visible, and my camera doesn’t work well in the dark. 

We made it to the Cottonwood campground in 2 hours.  We seemed to be on track for my predicted time.  We all stuck together. John was having stomach issues early and was working himself through them.  He ALWAYS has trouble at 3 hours into a workout and this was no exception.  He changed some things up and recovered well. 

We then made it to the Phantom Ranch (PR) in 4 hours.  It was now completely dark.  No sign of the moon yet.  At Phantom Ranch we met with some campers.  There were several picnic tables set up and people were huddled around conversing.  The PR general store opened soon after we arrived and all of the campers went inside for food and beers.  I purchased a PR tee shirt for a souvenir. 

Gary and Conrad were also starting to experience stomach issues.  We filled up our water, hit the bathrooms and started back on our trek.

As we left the Phantom Ranch, we could see movement in the brush off the trail.  Our headlights lit up glowing eyes of deer literally 10 feet off the trail.  Very surreal.  I kept hoping there were no mountain lions behind the deer.  Any of these animals could have posed a serious challenge had they decided to come at us…we quietly pressed onward, and they thankfully stayed put.

We were about to cross the Colorado River.  That meant it was now all uphill until we reach the South Rim.  We power hiked from here.  No one was feeling all that great, the heat/humidity really sapped our energy.  The full moon became visible as we crossed the bridge over the Colorado River.  It was beautiful.  We tried to leave our headlamps off, but the trail was too technical.  It seemed like a long sandy hike as we came out of the direct river valley.  There were several stream crossings on the Bright Angel trail. 

We entered a steep area of switchbacks called the Devil’s Corkscrew.  Gary and I were sharing my water at this point.  His energy drink was not agreeing with his stomach at all.  We were both getting dehydrated.  Conrad and John decided to leave Gary and I at this point.  We agreed to keep in touch via walkie-talkie every hour.  Gary and I slogged up through the corkscrew.  The advantage of hiking at night is that you only focus on what you can see with your light source. 

But…we could now see the South Rim Village lit up clearly.  It looked close….but it wasn’t!

An hour went by and we contacted the other group.  They were at the Indian Garden Campground attending to the blisters on their feet.  They were waiting for us.  We all filled up to get ready for the hardest climb.  From the Indian Garden to the top is only 4.7 miles, but there was 3000 feet of climbing in front of us – and the teasing lights of the South Rim Village around every turn giving us false hope that we were close. 

There were rest/water stops at 3 miles and 1.5 miles before the Rim.  We were travelling very slowly at this point.  Arriving at each rest stop at 45 minute intervals.  That is 30 minutes to travel 1 mile.  A turtle’s pace! 

We finally reached the top at 9 hours, 11 minutes.  No one felt all that great.  My kidneys and left knee were bothering me.  After taking inventory of everyone, we decided that if it took us 9 plus hours going the easier way, it would have taken us over 12 hours to get back.  It was now 1 am.  We also would have been at the base of the canyon in the heat of the next day and it would have been quite dangerous. 

The south rim was 20 degrees colder with a stiff wind. It was probably high 40’s low 50’s   I became chilled pretty quickly.  I was not disappointed in our decision to stay the night.  We secured a room at the El Tovar Hotel.  It was very nice.  We all showered and crashed hard. 

We awoke early to try to figure out how to get back to the North Rim.  The Shuttles were $85 per person – cash.  Thankfully John’s wife Tracy agreed to drive the 4 plus hour trip around the canyon to save us.  We must have been quite a sight to see!

Tracy drove us to the North Rim and we ate at Jacob Lake Inn, a great little restaurant one hour north of the North Rim. We then went back to Kanab to sleep the night, get packed and headed back to Denver.  John and Tracy were planning to stay a few days longer to vacation together.  Although they ended up going home early Sunday Morning too.

We drove through Zion National Park and took in the views.  Equally amazing scenery as the Grand Canyon.  As we progressed home, Gary, Conrad and I were trying to think if there was any better run that we had ever done.  Gary mentioned the Porcupine Rim Trail in Moab as one of his favorites.  I agreed it was awesome but paled in comparison to what we had just done.  NOTHING COMPARED TO WHAT WE HAD JUST DONE!  Even though we didn’t complete the quest, we were alive to tell about it!

Long story short, we detoured into Moab and ran an hour on the Porcupine Rim trail before lightening strikes scared us back to our car.

Adventure complete with plans to return to the Grand Canyon in the near future to complete our quest.  We also posed the idea to do a marathon next month in Colorado Springs.

It was really nice to sleep in my own bed last night!  The perfect end to an amazing weekend!

Thanks for all the support and well wishes from our families and friends.  Your good vibes were with us every step of the way.

It seems that when I commune with nature, especially during adventures like these, I get to know myself more with every step I take. And with every step I take, I recognize what a gift my life is and how much I cherish it. I know God has a plan for me and this meditation brought me closer than ever to recognize his greatness. I feel very blessed.

Even though I was away from my family, I hope someday that we can experience portions of this with them.   I am especially grateful to have shared this with such great friends.  I am sure it was a defining moment for all of us.

Peace!

Brett