“Check Your Six” at Gas Stations!

check your six“Check your six” is an axiomatic phrase to live by for fighter pilots.  It means be aware of what’s behind you.  If you use a clock to refer to what’s around you, 12 o’clock is in front of you, and six o’clock is behind you.

If you study surveillance video of robberies, muggings, or other violent crimes, you’ll notice that the victim is often completely unaware of the approaching bad guys.  This is the case in the video below.

A lot of people go about their day in a bubble of distraction.  Today, distraction often involves cell phones, electronic games, and music delivered by headphones.  It can also be as simple as a conversation, kids demanding attention, or just the task at hand (such as fueling up your car or loading groceries).

Being AWARE of your surroundings, and the PEOPLE lurking around you can be your BEST defense.  Continue reading

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Posted in Personal Security & Safety | Tagged , , | 6 Comments

New PMS! No… Not That Kind!

open dental--6We all have a long “to do” list, both at home and the office.  One item that’s been on my list at the office has been to upgrade the computer and Practice Management Software (PMS).

I’ve delayed doing it for a few reasons.  First, my computer and PMS have been working just fine.  If it ain’t broke, why fix it, eh?  But, here’s the thing…  I knew I was working with a ticking time bomb of a computer.  Believe it or not, my front desk computer is a Windows 98 machine.  I’m not kidding.  It’s at least 12 years old, and it’s still running!  It moans and groans on start-up.

Windows 98!  Really!

Windows 98! Really!

The power supply fan is rather loud (bearings are probably shot).  But, it works!  Laugh at me all you want!  Windows 98 is still regarded as the most stable version of Windows.  My old computer never crashed.  Not once in all those years.

open dental--5

For the PMS, I’ve been running Softdent version 9.1b.  That’s many, many generations old.  It WORKED!  It served me well.  But, this old version didn’t even have a field in the patient chart for an email address or cell phone.

But, I’ve become increasingly worried that one day, I’d hear a “pop” and see a puff of smoke around the old computer.  The next puff of smoke would be coming out of my ears.  Sure, we backed it up every day.  But, it’s so old, what am I going to RESTORE it to?? Continue reading

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Posted in Dental Product Reviews, What Happened Today | Tagged , , , , , | 7 Comments

What The Dental Warrior Is Reading

books-6832I tend to read in fits and starts.  Recently, I decided to get back on the treadmill at home to get some exercise.  I get bored very quickly on the treadmill, so I need something to distract me.  And, it may as well be something that enlightens me.  I’ve got a large stack of unread books.  But, over the past few weeks, I’ve made a dent in my reading project.

Without further ado, here’s what I’ve read or am currently reading:

books-6831

Reviews of each book after the jump! Continue reading

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Posted in Must Read Books! | Tagged , | 3 Comments

Do You Have an Evil Plan?

If everyone is zigging, should you be zagging?

A Vector Cute Cartoon Devil Smiling FaceI just finished reading a book, Evil Plans: Having Fun on the Road to World Domination,” by Hugh Macleod.  It reminded me of a thought that occasionally percolates in my brain.  What can I do (in my career and life) that is different?  Really different.  I ponder the question, and then…. “Look!  Squirrel!”  Life gets in the way. 

Routine is comfortable.  Homeostasis is comforting.  Conformity is easy.  Stretching is painful.

Just boo it.

One thing I’ve learned as I cross the threshold of middle age is that if an idea is hated by some people… even many people…. it’s probably a good idea.  If many tell you it can’t be done, then you should probably do it.  Dentists are particularly anxious to shoot down (boo) any colleague who strays from the straight and narrow.

Just screw it.

How could you micro-niche your dental practice?  How could you transform your practice in a way that would stand out?  What could you do that is “impossible?”  What would you like to do that would piss off a lot of dentists? Continue reading

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Posted in Editorial, Must Read Books!, Practice Management | Tagged | 20 Comments

I’m a Bad Businessman – Bridge Repair

We’ve fallen and can’t get up!

A new patient was referred to me by a local periodontist.  She’s in her 70s.  Her husband fell down, and in the process of helping him, she fell on her face and fractured porcelain on teeth #9 and #10.  They are part of a larger bridge, #6 – #14.  Teeth #s 8, 10, and 12 are pontics.  Teeth #s 7 and 9 aren’t so hot, as you can see.

bridge-repair-x-rays

The patient and her husband were due to return home (up north) for the summer.  Her husband is still in the hospital.

bridge repair-6763

Porcelain fractured down to the metal on the incisal.

bridge repair-6764

Metal is just visible at the incisal edge.

bridge repair-6762

Metal is visible on the incisal edge and lingual.  Apologies for the poor quality photo (scratched mirror).

Plan A, Plan B, Plan C

Treatment options discussed included: Continue reading

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Posted in Case Presentation | Tagged , , | 19 Comments

Slam-Dunk Anesthesia for Lower Molars!

PDL-blog-6770And, painless, too!  Promise!

I’ve learned a lot of tricks over the years, and the internet has been my go-to source.  For at least 20 years, I’ve been an active participant in online forums.  The ability to access the minds of hundreds and even thousands of my colleagues has proved invaluable throughout my career.

A friend of mine, Dr. Michael Nugent (aka the “Shooting Dentist“) from the Great State of Texas, has been cajoling me about writing this particular article for at least a year.  He finally and unabashedly resorted to bribery by sending me a 40-round AR-15 Magpul magazine.

magpul-40-rd

And, it worked.  So… all my readers… take note!  ;)

I’m still feeling it!

One frustrating aspect of daily dental practice for many dentists is consistent and profound anesthesia for lower molars.  We were taught to administer an inferior alveolar nerve block… aka “IANB.”  And, many of us have run into situations where the patient exhibits the classic signs of anesthesia, yet they still feel pain.  So, we give them another block.  And, wait.  And, then HOPE that we got it that time.

Mind you, administering a “painless” IANB is quite the challenge.  It’s not a fun injection to receive.

There are other techniques such as Gow Gates and Akinosi techniques, sworn by some to be very effective.  And, in their hands, I’m sure they are.  I’ve never felt comfortable with either.

Years ago, I briefly tried the intra-osseous technique branded as the “X-tip.”  With this gizmo, you actually punch a hole through the gingiva and cortical plate with the needle mounted on a slow-speed handpiece.  It works, but it can be a bit scary / traumatic to both the patient and the dentist!  You’ve got to make sure your aim is good and not running into a root.  I had a couple of cases that ended up sloughing some tissue and bone post-operatively.   I abandoned the technique shortly thereafter.  I consider it more an issue of my own shortcomings, not the product or technique.

Another fall-back technique, after all else has failed, is the PDL (periodontal ligament) injection.  For some reason, this has been long held as the technique of last resort.  And, by the time you get to it (after trying multiple blocks), the patient is pretty weary and probably losing confidence.  And, chances are that many dentists are not doing the PDL injection correctly.

Make your life easier and patients’ experience better with PDL (intraligamentary) injections.

Why not make it the PDL technique of FIRST resort?  If it can work when all else fails, why not use it routinely… first?  OMG!  FIRST?   Well, yeah… sorta.  Read on. Continue reading

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Posted in Clinical Technique, Editor's Picks, Tips & Tricks | Tagged , , | 38 Comments

“I wish I had a gun.” Not!

juan-williamsI just came across an article about auto theft with the victim being the wife of a Fox News commentator, Juan Williams.

And another article.

Williams is known for his beliefs that Americans should not be able to keep and bear arms.  He’s “anti-gun.”  And, that’s fine.  He’s free to believe that, as wrong as he is.

A liberal is a conservative who hasn’t been mugged, yet.

car-keys

Don’t leave your key’s in the car while fueling up at the gas station!

Well, his wife was at a gas station and while putting her credit card into the pump, a thief jumped into her car and drove away.  Presumably, she foolishly left the key in the ignition.  DUH!

But, according to an interview with Juan Williams, he said that his wife remarked, “I wish I had a gun.”  Oh, really?  Never mind that she could not have legally used a gun in this scenario.  The use of lethal force is limited to protecting / defending LIFE (not a car) in most states.

Having a gun is not a talisman that wards off all crime / criminals.  Nor does it Continue reading

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Posted in Guns & Knives, Personal Security & Safety | Tagged , , , | 10 Comments

The Media & Gun Mythology

It seems today that the media gets things wrong more than they get them right.  This applies to nearly every type of story, too.  If they’re caught in their “mistakes,” they make a token apology and move on.  Accuracy and truth are no longer tenets of journalism.  Don’t get me started on the abject deterioration of spelling and grammar in the media!

 It just went off!

Choosing a gun-1

Smith & Wesson 642 Airweight (.38-Special)

One topic that the news media consistently gets wrong is anything involving guns.  Guns reportedly “go off.”  No.  They don’t.  They’re inanimate objects.  They no more “go off” than cars “drive themselves off.”  (Yet, there’s another such story you’ll see below.)

Guns have to be fired, just as cars have to be driven… by humans.  But, the media doesn’t like to place the blame where it belongs.  They specifically confer animating qualities to guns making them seemingly autonomous rather than even suggesting that firing a gun requires human manipulation.  Hollywood movies are also responsible for misinformation about how guns work (and don’t work).

I’m was just cleanin’ my gun.

One persistent and perennial story is the case of a gun owner “cleaning” his / her gun and it “going off.”  Or the gun was dropped and fired upon striking the floor.   And, someone “accidentally” gets shot.  Let me put this as simply as possible:  That’s BULLSHIT.  Absolute bullshit!  Earlier this week, my hygienist brought me this article.  The newspaper story is full of “fail” and full of shit.  (See news article after the jump) Continue reading

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Posted in Guns & Knives | Tagged , , , , | 11 Comments

Why Can’t the ADA Be More Like the NRA?

join todayI’ve been a member of both.  I’m now only a member of one… the NRA.  I quit the ADA several years ago.  I recognize that some of my readers may not identify or agree with the NRA, in particular.  But, let’s try to simply compare two organizations that claim to support and advance their members’ interests.  And, let’s consider their relative effectiveness.

  • ADA annual operating revenue:  $120 million. (157,000 members)

That comes to about $770 / member.  Back when I was a member, my total “tripartite” dues came to about $1200 / year (going by memory).  For what?  So, the ADA could acquiesce to the political winds and suggest that WE are at fault for the fictitious issue of “access to care?”  And, I’ve repeatedly heard local association board members claim that our best move is to “sit at the table, or be left out.”  That’s COWARDICE!  Grow a pair, ADA!   Stand up!  I paid about $1200 a year, for many years, and I didn’t feel represented.  I’m certainly not the only one, either.  In a thread on Dentaltown, I learned that $53 million (44%) of the ADA’s budget goes to salaries and benefits!##  Holy crap!

  • NRA annual operating revenue:  $231 million.  (5 million members)

That comes to about $46 / member.  THAT is a BARGAIN!  My interests (and Constitutional Rights – pretty important stuff) are being protected for less than $50 a year!  (The minimum annual dues comes to $25.)  The NRA files lawsuits and will take them all the way to the Supreme Court, if necessary… and usually WINS.  The NRA’s total administrative expenses come to 13% of their budget.  THIRTEEN percent compared to the ADA’s FORTY-FOUR percent (for salaries)!  Read that last part again.

When the NRA talks….

NRA buildingThe NRA has a nearly legendary  reputation regarding its legislative prowess in representing its members.  Furthermore, it’s truly a grassroots movement.  The real power of the NRA is in it’s members.  The NRA’s members are cohesive, politically active (writing letters, visiting legislators, etc.), and they are avid voters.  The NRA, as an organization, also actively keeps its members INFORMED.  They tell us what’s happening.  They tell us who’s involved.   They tell us what they’re doing about it.  And, they encourage us to get personally involved.  CONSTANTLY.  It is common knowledge that the NRA stands strong and does not back down.

The ADA?  Not so much. Continue reading

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Posted in Editorial | Tagged , , , , | 15 Comments

Retrofitting a Crown to an Existing Partial Denture

I first posted this “article” on Dentaltown back in 2007.  A friend just reminded me about it, so I thought I’d re-post it here.

We all know what a pain this can be – fitting a new crown to an existing partial denture.  I learned this technique from the Parkell advertorial “magazine” they send out.  I changed it up a bit.  I’ve been using it for years, and it works very well in my hands.  Unfortunately, I didn’t take any photos of the clinical aspect of making the special impression for the clasp duplication.  But, I’ll try to describe… Continue reading

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Posted in Clinical Technique, Tips & Tricks | Tagged , , , | 7 Comments