TEDMED 2014

For the second year in a row, I attended the TEDMED conference.  TEDMED is a corner of the infinite TED universe specifically focused on innovation in health care. 

Innovation is much too small of a word to describe what TEDMED is.

They try to introduce it on their website (www.tedmed.com): "TEDMED is a global community dedicated to unlocking imagination in service of health and medicine. Our goal is to seed the innovations of today, making possible the breakthroughs of tomorrow...for a healthier, more vibrant humanity." 

But even this is incomplete.  One must experience it to understand.

To attend, one must go through an application process.  TEDMED is always searching for the proper mix of delegates that will be allow for stimulating networking and friendships to be made.  This year the event was hosted in two cities, Washington D.C. and San Francisco.  I chose the latter.

There were 80 presenters, 2000+ delegates, 80 start up companies from various sectors of health.  This year's theme was "Unlocking Imagination".

240 page conference program

The presentations were thought provoking and expertly delivered in the classic TED style.  If you have ever seen a TED "talk", you know where I am coming from.

They shared how they were improving the design of hospitals to improve both the health of the patients and the communities they serve by leaving no footprint.  One was looking at diseases in different ways - for example, What role does childhood trauma play in all future diseases?

They challenged our paradigms at every turn. For example, legalization and government compensation for the harvesting of organs to reduce black market activity while saving lives.

They inspired us with virtual reality games to reduce pain in patients.  They gave us a glimpse of a new plastic that amorphically changes shape via electric manipulation to be used in cardiac catheterization.

One speaker was collecting voice samples to "donate" to people (kids and adults) who cannot talk - thereby giving them a voice and a personality.

Several bioethicists asked an uncomfortable audience on how messages to the public about drug use should be altered drastically.  One asked, should doctors be totally transparent? While another shared courageously about physician assisted death or discussed the ethics of genome mapping to tell our future propensity to disease.

My favorite speaker was Abraham Vergehese.  He is the author of several books including NY Times bestseller "Cutting For Stone".  I had the opportunity to meet him afterwards and have him sign a book that I read in 1999 titled, "The Tennis Partner".  I told him how important that book was to me and charged me with the impetus to live each day to the fullest.

After sharing life stories for a bit, he signed my book with the last line from the narrative, "...Get the ball back over the net just one more time."  (never give up!).  He gave me a hug and told me that I made his day (how cool!?!?!?!).  http://abrahamverghese.com/

Abraham Verghese and I at TEDMED 2014

     

The "convention floor" is known as the hive.  The hive is always buzzing with activities.  The start up companies are all there on display with things to play with.  Of course, I had to go to the obligatory brainwave activity detector to verify that the old neurons are still sparking once in while.  And, like last year, contrary to most people's opinion, I do indeed have a brain that is functional....I will leave it at that.

Verifying that I do indeed have a brain.

The hive is where it all happened.  The space was designed very deliberately to maximize our experiences. There were several areas for lounging, networking, working, watching presentations, eating, etc.  There were speaker meet-ups where you can have very in depth conversations with the speaker and other curious fellow delegates.

Another area was called the campfire where they served gourmet smores and had a vast array of topics to talk about about current and future trends in health care.

The attendees were medical students, PhD. students, biomedical engineers, heads of various prominent medical school departments, angel investors, artists, employees of tech, medical devices and marketing firms.  I was "wowed"by practically everyone I met. I was humbled my the creativity and intelligence of my fellow delegates.  I was inspired for their zest and zeal to change the world from their specific niche.  I met people from all over the world - US, Israel, Canada, UK, Australia, South America, Hong Kong, etc.

I WAS THE ONLY DENTIST.....too bad....I would encourage some of my fellow colleagues, (especially the thought leaders) to consider coming in the future.  I wasn't lonely, but I was the only dentist!

The over arching theme:  No matter what new technology is becoming available to better treat the patient's physical maladies, nothing can help a patient's psyche more than a healthcare professional (Physician, Nurse, Dentist, etc) that genuinely cares and connects with his/her patients on a human level.

Thanks to all the TEDMED-er's involved in putting on such an amazing experience and allowing me to attend once again!

Peace.

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

Thanks for reading!  BK

Life's Platitudes

“Life’s” Platitudes

Don't you hate those wise, thought provoking quotes? I usually do too, but in recent events, a few of these rang true for me.  This blog entry is dedicated to my friend Mike.

Platitude #1 - Life is Short….

My friend Mike passed away a few weeks ago.  He died of complications of the flu.  This aggressive strain quickly moved into pneumonia, which led to acute respiratory distress. This forced the doctors to insert a breathing tube to help him get oxygen into his blood stream and he was placed into a medical coma.  After ten days, his heart went into full cardiac arrest and he was unable to be revived. He was 49 years old. 

“Crazy,” I thought. “Healthy people don’t die of the flu!  How could this happen?  Why!?!?!”

The night before he died I gave a presentation on leadership.  This talk was to alumni of a drug and alcohol treatment center.  I spoke about concepts that I am passionate about help me to live my life with some level of significance.  The concepts include: Love my family and friends unconditionally; help others; live courageously, humbly and with integrity. I do a lot of prayer and meditation - especially when I exercise.  And my mindset is usually pretty good. Sometimes I'm better at it than others.  But for the most part, these daily affirmations really help me stay focus so I can be effective.

I knew my friend was in a coma but I didn’t think he was going to die.  I shared my worries with the audience, “You never know when your time will be up.  Better live every day to the fullest extent without regret.”  I know - platitudes....But they aren't relevant, until something like this happens.  

I proceeded to tell the group that my friend was in the hospital and his circumstances were grim.

He died too soon for my liking.   It is human nature to ask why did this happen.  With any of life’s challenges, there is a lesson. (another platitude...)

After a lot of praying, meditating and consulting with friends, I have learned that life is short - get my affairs in order, love my family, friends and work, live each day to the fullest.  

Platitude #2 - Life’s a Bitch….

Initially I was sad.  He isn’t here anymore.  He was a friend that, although I didn’t see him that often, when we got together we could talk heart to heart. 

He had a great dental practice. He was universally loved.  He really knew me, I really knew him – so I thought. 

A few days after he passed, I went to his office to help finish some work on a few of his patients that needed follow up care.  After spending time with his office staff about the tragedy, I was given a glimpse into his life over the past few months.  He had been struggling.  My interpretation was that he was lonely, he was stuck in a rut – possibly even depressed.  His practice was struggling financially.  He might have been struggling financially as well. 

Even under this stress, he still marched forward -helping friends, patients, etc.  Maybe he helped so he wouldn’t have to face his challenges.  Perhaps he was stuck and the only way he knew how to get out of his rut was to help others. 

On his desk was a photograph of Mike, myself and another mutual friend.  The picture was at his open house for his business.  The office space was unique, bold and comfortable.  At the time the picture was taken, life for him was so full of possibilities. 

What changed?   What happened?  Why didn’t he ask for help?  Any of his friends would have dropped whatever they were doing to help.  All he had to do was ask.

Lesson – Outside appearances are not always reflective of what is going on in the inside.  Ask for help when struggling.

Platitude #3 - Life is Beautiful…..

I received many phone calls from disbelieving friends and colleagues. I recited the facts of the situation that I knew.  I gave out the info on his funeral. 

At his funeral, hundreds of people showed up. It was a beautiful celebration.  Friends and family from different parts of his life all shared stories.  We laughed, we cried, we consoled each other.

I shared a story on how I met him.

He was an alcoholic.  Almost 11 years ago, I organized an intervention to help him get his life turned around.  At the time, he didn’t want my help.  He was obstinate, stubborn and arrogant. He was in denial and he thought he could beat the problem on his own. 

I too am a recovering alcoholic.  My trajectory turned around in 1998 when life got really bad.  For whatever reason,  I was graced with the willingness to do whatever it took to treat my problem.  A responsibility that helps me maintain my recovery is to share my story. Another key component of my recovery is helping other lost souls like my friend.

A few days after the intervention, he surrendered his will and reluctantly went to treatment for his problem.  He returned a few months later a changed man.  I had been involved in many of these interventions.  When they return from treatment, some want to thank me and some want to hit me.

Fortunately, he thanked me.  In fact, he credits me for saving his life.  I never felt comfortable with that fact.  I was just giving to him what was freely given to me - The gift of hope.  Someone was there for me when I was ready. I owed it to that person (and myself) to pay it forward.

This is why we had such a unique friendship.  We both had suffered greatly and we had overcome our struggles.

As I got over the anger of his death, I entered into the mindset of gratitude.  I am grateful that we had marched together in recovery for almost 11 years of our lives.

I recall a personal story from the book “Alcoholics Anonymous”.  The story tells of a lady’s personal struggles and how she overcame her struggles while building a new life.  The end of the story says, “In exchange for a bottle and a hangover, I have been given the Keys to the Kingdom.”

My friend and I both have been given the “Keys to the Kingdom." 

When I first met my friend, he was close to death from alcohol poisoning.  Jaundice overtook his body as his liver was failing.  After treatment, Grace offered him a second chance at life.  He took advantage of this opportunity and made a life for himself filled with significant relationships and events.  He helped hundreds of other people in the same manner that he claims I helped him. 

He struggled too – but that is life.  I still feel cheated that he was taken away from this world way too soon.  It was his time to turn in his set of “Keys”.

I don’t think he would have traded his life for anything.  Neither would I....

Lesson learned – You never know who is listening, what they hear that touched them with significance, or when they hear it  - so share my experience with the world. 

Be grateful for what I have. 

Find a lesson in every challenge that life throws at me.

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!  BK

Grand Canyon - R2R2R

"The journey of a thousand miles starts with a single step" Lao Tzu - Tao Te Ching

The "before" shot - denial firmly set in...."This is crazy!"

While I'm convalescing on the couch, I decided to pass my time by recounting my recently completed run.

Last September, a group of friends and I went to the Grand Canyon to attempt a Rim to Rim to Rim run.  (R2R2R).  We started on the North Rim and bailed out at the South Rim.  A number of excuses - It was too hot, we had stomach issues, got too far behind our time goal, etc.  Even though we didn't accomplish our goal, I considered it the most amazing run - until now

We set out with a new plan, with some new players and armed with the experience of knowing the trail landmarks. We decided to do it in November - when the weather would be much cooler.  The heat really got to us last year.  We decided to start at the South Rim this time.  The North Rim lodging was closed and there were no support opportunities there.

I liken this strategy to when the explorer Cortez burned his ships upon arrival in the new world. No turning back! We are fully in or do not attempt.  

My partners were Gary Benson, John Stevens, Steven Griffith and Dave Lindeman. John had a few friends join us from Michigan to do the run (Jeff and Jerry) as well.  Dave wanted to experience the canyon and had no interest in running the entire thing.  His goal was to run to the bottom, turn around and run back up to the South Rim.  The equivalent of doing a Rim-to-Rim.  A huge accomplishment in its own right. Originally, there were several others that had planned to come but were unable to make it.

We arrived at the South Rim around 8 pm.  We met for dinner and discussed the plan/strategy for the run.  I have been doing crazy endurance events with Gary for over 20 years and was looking forward to accomplishing this with him.  I've been running with John for about 13 years - he is much faster than Gary and I.  Steven has done several ultra's and offers hours of unsolicited entertainment. Steven also is much faster than Gary and I.

At dinner, I said to John - "We should stick together for the first half - then do whatever feels right."  He quickly responded with "I think everyone should do their own pace for the entire run."

So it seemed that John had a time goal...

This is a 46+ mile run.  I had no idea how my body, legs and brain would respond to the stress of the run.  Gary is really good at keeping me moving at a sustainable pace.  Steven and John both think I am much faster than I really am.  I keep telling them that I am tall, not fast!  My goal was to finish - period.  I have a history of starting out too fast.  I was not going get sucked into my interpretation of John's challenge.

So Gary and I would pair off - Dave would join us as well.  John would pair up with Steven. Hopefully whatever John was thinking for time, doesn't hurt him in the long run.

Jeff and Jerry from Michigan would pair off as well.

We predicted that this would take anywhere from 16-20 hours to complete.  We took our obligatory group photos in the dark that, of course,  didn't come out.  With no announcer to get us revved up, unceremoniously we were off.  We hit the trail Friday morning at 4:15am.  John, Steven, Jeff and Jerry were gone pretty quickly.  I hoped we would catch up at one of the campgrounds ahead.

We started our journey at 7,000 feet on the Bright Angel Trail.  The steep trail descends quickly along the south rim wall through many switchbacks.  I have never been on this trail in the light and cannot comment on the views other than from the top.

Elevation Profile

I spent the first hour or so trying to arrange and distribute the weight of my pack so it was as comfortable as it could be.  I chose to use the same pack as last year: a Go-Light Rush pack that held a 3 liter hydration bladder with an add on Salomon front pack for easy access to food, camera and other necessities.  I used super-light hiking poles to help assuage both the the uphill pulls and the downhill crashes on my knees and hips.

One thing that I have experienced with these long events, is that I also must manage the distribution of gas, liquid and solids in terms of bodily functions both upward and downward. Mis-management of any of the aforementioned factors can make for a really great or a really bad day!  This includes transit times of both liquid and solid fuel (by fuel, I mean food).  The goal with the gasses is to minimize the production of them at all costs as they can lead to problems with the other 2.  Some of us do better with this than others.

I tried to super hydrate on the drive from Denver and not get caught eating food that I know would come back to haunt me the next day during the run. The best laid plans....

All I can say is thank goodness there were several bathrooms the first 5 miles.  I think I visited at least half of them.  Still not satisfied.  My stomach wasn't unbearable, but it wasn't fully comfortable either. It didn't stop me from running so I marched onward with the hope that time would resolve my issues.

The sun started to come up at around 6 am.  The contrasting views illustrated by the changing light, shadows and textures of the landscape throughout the day were spectacular.

Sunrise at the bottom of Devil's Corkscrew

Downhill is the evil seduction of false hope. We were cruising along happy and steady.  My mind was feeling confident that today would be no problem.  As we approached the Colorado River, I ran ahead to get some pictures of Gary and Dave and the river as the light of the morning sun spilled over the canyon.

We entered Phantom Ranch at around 7:00 am. This is about the 10 mile marker and the end of the wonderful downhill. My stomach was feeling better, but I wasn't hungry and had to really force the food and the water.  I distributed some cargo from the back pack to the front pack for easy access to food.  I was cursing that I brought pants and a jacket as it was perfect weather for running in shorts.  I try to be prepared for anything, and I was worried about it being really cold on the North Rim.  We filled up our water bladders and re-packed our packs.

Off we went onto the North Kaibab trail.  Next stop was the Pumphouse Ranger Station, approximately 10 miles of gradual uphill.

Dave was doing great.  I thought he might be tempted to go the distance with us but after about another hour of running with us, he turned around to head back.  He probably did 25 miles. A spectacular run Dave!

We entered into a slot canyon for the next 5 miles or so.  The trail follows Bright Angel Creek and has amazing views, several bridges to cross and a completely different light profile in the slot canyon.  This part of the trail is called the "Vishnu Schist".

Gary and Dave crossing one of the many bridges

Throughout this section and the next, we started to encounter other R2R2R's.  There were maybe 10 others on the trail that day with the same goal in mind.

Waterfall at Bright Angel Creek

As we exited the Vishnu, the trail started to increase its steepness grade.  We made it to the Pumphouse Ranger Station ahead of the time that Gary predicted.  We were moving fairly comfortably.  I visited the outhouse once again, and this time I left very satisfied as I dropped some serious solid waste out of my bowels - Finally!

This was the last opportunity for water until we get to the North Rim - a steep 5.4 mile climb from 4,600' to 8,241' and back.  All of the services were closed on the North Rim for the winter. While we were refueling, I decided to keep my pants and jacket just in case the weather is bad on top.  I decided to leave one of my food bags at the campground so I didn't have to carry the extra weight on the climb.  This proved to be a good calculation as I did not need all that food for this section.  I took what I needed and we pressed on.

We started to wonder when the others would pass us coming down.  I figured it would be soon.

This next section was a bear.  It was steep and technical.  It was hard to run any but a few sections of this section.  As a bonus and something to take our minds off of the slow trudge, a completely different set of views unfolded in front of us.

Exiting out of the Pumphouse Ranger Station

Half way up!

As we were making progress, we still hadn't seen the rest of the group.  Both Gary and I thought that something went wrong and they were planning to bail on the North Rim.  I was thinking, I could bail with them, but I left my food bag down at the Pumphouse Ranger Station - I wouldn't want to leave that!  I felt tired and ready for the climb to be over.  I knew that for the return trip, I would have to dig deep to see what I had left inside physically and emotionally.

We finally ran into them at one quarter mile from the top.  They looked strong, regardless of how they were feeling, they looked really strong.  It turns out that both Steven and John ran out of water and went looking for a refill on the top. This diversion cost them about 30 minutes.

Steven tried to talk us into turning around with them and joining up for the rest of the run. We declined as we have yet to make it to the top and didn't want to have any doubt that we did the entire thing.  Also, I needed a break!

2 switchbacks later, we made it to the North Rim at 12:45.  8.5 hours into the run.  

North Kaibab Trailhead sign.

It was beautiful weather on top - I was happy, but mad that I had to drag my jacket and wind pants up that climb for nothing...We sat, ate and got busy back down before we talked ourselves out of continuing forward.  We stopped for 15 minutes.

Selfie at Supai Tunnel

Supai Tunnel

As we descended, it was very steep and technical.  This was the most dangerous section of the day. We were tired and didn't want to trip, fall, stub a toe, etc.  So we descended carefully and purposely.  As the afternoon wore on, the sun laid new shadows and contrasts that were stunning.

Me at the Coconino point overlook

Gary at the Coconino point overlook

A view, I never want to forget...

We made it back down to the Pumphouse Ranger Station in about the same amount of time that it took us to climb to the top.  I spent more time taking it easy and documenting the landscape with my camera phone. Gary ran out of water on the way down so we shared what I had left until we could refill.

I proceeded to visit the outhouse again at the Pumphouse - I promise you that it earned its name pumphouse for a reason!  Again feeling very refreshed as my GI issues were gone, we laid out all of our food on a picnic table, and started eating and eating and eating.  

Up walked a runner dressed in a kilt and a rainbow hat with a propeller attached to it.  He looked pretty out of it.  I urged him to take some food from me.  After he initially refused, he finally took some.  I didn't want to carry the extra food anymore anyway.  We bid him good wishes and we pushed forward.

In my mind, it was a quick run to Phantom Ranch.  I forgot it was nearly 9 miles.  Gary led the way alternating running and speed walking.  (in fact, Gary led the way the entire day).  It was a perfect pace.  I mentioned to him how good I felt but didn't want to jinx anything...2 hours later I wasn't feeling so good! 

As were running through the Cottonwood campground, we were talking about if we were going to call this run our first 50.  I thought it was a great idea, but I'm not sure that I want to ever do another....A group of campers overheard our conversation and asked us if we were going to the "Tonto".  I stopped and asked what that was.  He explained that it was a two mile run between the Bright Angel and the South Kaibab trailheads on the South Rim.  That would give us the four miles that we needed to make it an official 50 mile run.   I said out loud that that wasn't going to happen.  The entire campsite erupted in laughter as we pressed on through.

The wheels are starting to come off....

The same waterfall at Bright Angel Creek

We were losing sunlight as we passed through Vishnu's and then into Phantom Ranch.  I was struggling to keep pace. The wheels were about to come off for me and Gary knew it.  As we entered the campground, Gary wouldn't let me sit down and made me eat and drink to refuel.  It was a good move on his part.  If I sat down, it would have been very hard to get going again.  

As we repacked our bags, the realization that we have about 10 miles to go - mostly uphill in the dark.  I got my headlight back on and started to move on.  Running with headlamps is an interesting phenomenon for me.  

It allows me to focus on just the spot of light in my focus.  When we were climbing the North Rim, it was mentally exhausting because I could see the top and it never seemed to get any closer. With the light, I am able to focus on just keeping moving forward.  (Dori from the movie Finding Nemo comes to mind - "Just keep swimming, just keep swimming...")  I can't see the top or anything else.

Eventually, I will get there.  Gary predicted 5 more hours and we would be done. I thought that sounded longer than what it would take.  I kept that thought to myself as he is usually right on the money with his predictions.  I was feeling much better after refueling.  I had the remainder of my food in my front pack for easy access and I had enough water to get to the Indian Garden's campground.  About 5 miles.  

We power hiked the climb and ran any downhills and flats that we encountered.  Gary would get ahead and I would just keep pace.  My mind started to get into a meditative state.  I was reflecting on how much fun it would be to take a few days to do this with Gina and the kids - when the kids are older.  We could do it like most of the people that experience the Canyon - on Mules.  It would be an amazing experience.  I hope we can.  

I became very grateful that Gina allows me to explore this part of me and continues to support my peculiarities ( a big word for 'craziness').  I am so lucky to have such an amazing supportive family.  I was thinking how grateful I was to experience this day with such amazing friends in Gary, John, Steve and Dave.  I was thinking how great it was to be alive and living each day to the fullest extent.  I was thinking about how blessed I am with all of the gifts in my life.  

As I pressed on with full of emotion, the climb didn't seem so bad.  We entered Indian Garden at about 2 hours.  We refilled enough water to get us through the final push. 4.7 miles to go.  

The final climb was steep!  It was broken up into 3 mile and 1.5 mile rest areas.  We set our sights for these sections.  We started to see a few headlights in the distance up the side of the cliff.  Gary figured it out to be John and Steven.  We started communicating through yelling.   I couldn't believe that they were so close! It gave us both bursts of energy.  I was emptying the reservoir of what I had left - which was dwindling fast.  

Ominous Warning which I failed to heed....

There seemed to be hundreds of switchbacks.  Gary was about a full switchback ahead of me and as we passed each other, he explained that each switchback was a victory.  So as we passed we acknowledged each other with a victory salutation.  Every few switches, I stopped to stretch and rest.  The trudge ends with a long relatively flat section to the trailhead.  I always get emotional at the end of a challenge such as this.  I passed those last 100 yards wiping my eyes. Thank God it was over.  Steven was at the finish to catch us up with his experience and to walk us to our rooms.  They were just 15 minutes ahead of us. Final stats - 46 miles, 17 hours 45 minutes

Everyone finished strong.  I'm looking forward to talking with John yet to hear how his day and his buddy's day went. 

We had an Epic Day!  I need a massage....

I enjoyed my trip and I didn't get bit!

Veneers, Veneers and More Veneers

A smile is the window to the soul.  

As a dentist, I do everything I can to help my patient's soul shine through.  

BK Mission Statement

Smiles communicate happiness, pleasure and confidence.  Many of my patients who come to me for smile improvements, are happy people but self conscious and may not project their inner happiness as effectively as they would like.  This could affect any relationship that they are in whether it be personal or professional.

93% of all communications are non-verbal - of which body language including facial expressions are a large part of that.

A new improved smile is life-changing!

I'd like to share an example with you:

One of my patients moved to a new neighborhood.. She was slow to make new friends/acquaintances with her new neighbors.  She was perplexed by this as she had never had difficulty with making friends in the past. She had some dental issues that allowed us to have a conversation about her smile.  Once we improved her smile, she mentioned to me that people seemed more friendly to her.  A close friend told her that she didn't smile very much before and perhaps her new neighbors judged her as unfriendly. This brought tears to her eyes as she explained this to me.  She had no idea that she was hiding her smile.  Her new smile outwardly projects her inner beauty, happiness and confidence.

Here are some examples of  what can be done to improve smiles with veneers.

 Case 1: Before: Stained old restorations

After- Veneers and teethwhitening.

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Case 2: Before - Worn front teeth from grinding

After - Four veneers, teeth whitening, and bite therapy to protect her new smile

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Case 3: Before - stained, yellow teeth

After - Four veneers, whitening

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Case 4: Before - Old restorations, improve smile

After: Four veneers, teeth whitening

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Each case is carefully crafted to match the patient's facial structures, personality and function.  Before we start we have a discussion dedicated to help the patient identify their goals with their smiles.  The better we can identify these goals, the better we can create the smiles that he/she desires.

For more examples of smiles that we have created and lives that have changed, click on the link - Smiles

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!  BK

Case study - Addressing Jaw (TMJ) Problems to a Wonderful New Smile with Veneers and Crowns.

I haven't blogged in a while....My patient care coordinator Monique asked why?

"I haven't been inspired to write lately!"

She said, "Why don't you share some of the smiles that we have improved?  They are life changing!"

I thought about it for a moment...""Not a bad idea!"

So here it goes.....

This particular patient of mine presented with jaw pain after a car accident.  He had many broken bones and chipped teeth. He went through many surgeries and has healed up nicely.

I treat a lot of patients with jaw pain.  I enjoy it - When I was in dental school, we were taught to do bite splint therapy. If they don't get better, send them to their psychiatrist as they are crazy.  I didn't buy that as I had a history of jaw problems and I wasn't crazy...

I spent many years after dental school taking classes on how to treat patients comprehensively -and this included the orthopedic treatment of the jaw and how it relates to the bite. By following some of these protocols, I am now able to treat a wide variety of dental issues predictably.

So we started with bite therapy that included various types of splints over two years to allow the jaw to heal. As his jaw healed and then stabilized, we started discussions on idealizing his bite.  He didn't present with esthetic concerns, but as we got to know each other through his treatment, he revealed to me that his front teeth chipped during the accident.

Adding length to the front teeth without addressing the function could be a very risky procedure.  The length of the front teeth could affect how one chew's food, how one grinds their teeth and also could affect how one speaks.

If the increased length interferes with the normal jaw movements or grinding patterns, the restorations are at high risk to break. It could affect the jaw muscles or one could develop headaches.  Teeth that are too long will compromise the 's', 'f', and 'v' sounds - giving the patient speech impediments.  They must also fit the features of the face to look as natural possible.

If any of these factors are not addressed, the results could be devastating.

Fig. 1 - Multiple short and chipped teeth

As part of idealizing his bite, we were able to add length and repair the smile within the harmony of his function.

Here is the after photo.

Fig. 2 -Restored smile with veneers and crowns

Happy patient.  He admits to me that he was very self conscious with his smile prior to the restorations.  Now he smiles confidently and most important, he is comfortable!

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!

Discovery

"I never had a tooth walk into my office.  It was always attached to a person." L.D. Pankey

When I first heard Dr. Pankey's quote, I really took it to heart.  Treat the person, you may get the opportunity to treat their teeth. In dental school, we had requirements.  I needed to do 'x' amount of crowns, 'y' amount of fillings, cleanings, etc. All my efforts were to fulfill my requirements.

Once in private practice, the 'teeth requirements' became people that chose to be patients of mine.  I consider it an honor to be able to provide the best care that I can to my patients.  They choose me from personal referrals or a direct result of a marketing piece.  They stay because they trust me and my team.  In my heart, I have always wanted to get to know my patients.

In my practice, I spend a great deal of time with my new patients in consultation before we enter the clinical area.  I call this the discovery meeting.  It is an opportunity for us to get to know each other in a relaxed atmosphere.

It usually starts with some simple, "get-to-know-you" type questions - e.g. (What brings you in today? Do you live in the area? What do you do for work? What are your hobbies? etc.)

The conversation usually shifts into an exchange of values.  I describe who I am and how I practice.

I then have a series of questions for my patient to answer regarding their dental history, their perceived state of their oral health, and what their goals are for their teeth.

Now most people don't obsess over their teeth (of course, some do!).  The questions I ask are designed for the patient to start to think about potential problems- especially around the health, function and esthetics.

This leads to a discovery what the true status of their oral health.  It is key that the patient begins to "discover" this themselves as we guide them along the path.

If the questions are asked correctly, the patient does most or all of the talking, I just sit there and take notes.

I am very consultative in nature and I continue to ask questions. During the exam I continue to ask relevant questions and show patients areas I have concerns with.  This allows them to remain engaged in the process and they start to discover things at a deeper level.

I find that my job is to educate and offer solutions to potential or active dental problems.  The patient is usually armed with enough information that they can move forward with treatment at their pace.

Occasionally (this happened recently!), from the discovery interview, we decide that it is probably not a good fit to move forward with the exam.  Which is fine -  If we have different values and we discover this up front, it will save all sorts of problems and animosity down the road for both of us!

I have identified the demographic that I wish to serve.  I treat people that are truly concerned with their oral health and are willing to take an active role in optimizing it - Optimal dentistry specific to their goals.  Sometimes this is a full mouth reconstruction, sometimes it is twice a year cleanings and check ups -Whatever is appropriate.

This has led to a satisfying practice, knowing that we are partnering with our clients helping them along the path!