The Daily Extraction: January 27, 2011

Extraaction of Teeth #31 and #32 with a 302 straight elevator

In this case, Dr. Tommy Murph has to contend with a couple of bad teeth and a patient who is really scared.
Here is the pre-operative radiograph:

And, the grand result:

Enjoy your daily extraction!

Dr. Murph is a South Carolina dentist who practices general dentistry who really excels in extracting teeth.

For patients in the Myrtle Beach area, I can heartily recommend Tommy as YOUR dentist.

For dentists, Dr. Murph has a number of resources for you in extracting teeth, including one on one courses in his office and travel (outside the USA) courses with "hands on" instruction.

Dr. Murph's website is here and his extraction manuals are here on e-Bay.

Previous:

The Daily Extraction Archive

The Morning Drill: January 27, 2012

The staff of the 143rd Dental Company (Area Support) Forward stand outside the dental clinic with their commander, Lt. Col. Daniel P. Alston

Good Friday Morning!

On to today's dentistry and health headlines:

Dental company commander brings lifetime of knowledge

After 21 years away from the Army and retiring from dentistry in the civilian sector, Daniel P. Alston returned to serve in the Army Reserve, and now commands the 143rd Dental Company (Area Support) Forward as a lieutenant colonel.

When the 143rd Dental Company (AS) FWD was assigned the Kuwait mission, Alston was offered the command.

"At first I wasn't interested, because as a commander, I would be on a 12-month deployment and not a 90-day rotation," said Alston.

After discussing it with his wife, Alston decided that since he was near retirement, taking the command made sense.

"I'm 65 now, so I would be able to finish my time on active-duty status," Alston said. "Reserve retirement changes a lot when you put in more days on active-duty."

Alston had hoped to reach 20 years in service while in Kuwait. However, his current assignment fell short. So when he got word that the 143rd Dental Company (AS) FWD had the 2013 mission as well, he volunteered to stay.

"My wife and I decided it would be the best for us," Alston stated. "It was certainly the best for the unit because they won't have to go through the entire mobilization process to send a replacement."

So now Alston's team will be under his leadership for a total of 20 months, which, according to Staff Sgt. Kevin Morgan, the 143rd Dental Company (AS) FWD noncommissioned officer in charge, will make for an enjoyable deployment.

"Lieutenant Colonel Alston is the easiest going guy I have ever worked for," said Morgan.

Having been a dentist since he was 24, as well as a private business owner, Alston brought a lifetime of knowledge to his command.

"He's a really good guy, and with the experiences in his life, it's easy for us to go to him when we have issues or any kind of problem," said Morgan. "He's like a father figure you can always lean on, which is good to have in this type of atmosphere."

Jury finds dentist not liable for dental malpractice

After a three-day trial, a Humboldt County jury found Dr. Jeremy Keener not liable for dental malpractice in a case involving a root canal gone wrong.  The trial began with jury selection on Monday (Jan. 23) and concluded late Wednesday (Jan. 24).

Natasha Stilwell sued the dentist after a root canal temporarily left her face and a portion of her nose with raw sores.  Additionally, she had lockjaw for months and developed a hole in the palate of her mouth.

She suffered no long-term injury as a result of the incident, but Stilwell sued to recover medical expenses as well as compensation for pain and suffering.

In finding Keener not liable of dental malpractice, the jury determined Keener’s actions did not fall below accepted standards of care.

Kennewick police accuse 3 of prescription drug scheme

Two employees of a Kennewick dental office are accused of pulling off a sophisticated scheme involving at least 167 forged prescriptions.

Nicole Bernice Polus and Chareise Louise Raugust, along with her fiance, Miljan Ignjatic, allegedly wrote, called in or picked up fraudulent prescriptions in the Tri-Cities during a four-year period, police said.

"There were so many names ... including fictitious names," Kennewick police Detective Rick Runge told the Herald. "It is just so large, we just went with the suspects' names and family" to try to track the forgeries.

Polus and Ignjatic made their first appearances Thursday in Benton County Superior Court and pleaded innocent to several charges of obtaining a controlled substance through fraud.

Polus, 40, faces an April 9 trial on eight charges of fraudulently obtaining Lorcet and Vicodin. The charges include the aggravating factor that she used a position of trust to commit the crime. Polus was a dental hygienist in William Craig Stout's dental office.

Ignjatic, 34, is charged with six counts of obtaining Lorcet, hydrocodone and diazepam through fraud. His trial is also set for April 9.

Raugust, who was Stout's office manager, pleaded innocent to one count of obtaining a controlled substance -- hydrocodone -- through fraud, with the aggravating factor that she used a position of trust to commit the crime.

She also was in court Thursday. Her trial is April 9.

Ex-Sussex County dentist accused of groping patient indicted for perjury

A former Sussex County oral surgeon who lost a civil lawsuit in 2009 that claimed he groped a 25-year-old woman as she recovered from anesthesia following surgery was indicted today on charges that he lied during the jury trial.

Joel P. Kurtz, 67, now of Bethel, Conn., was indicted on two counts of third-degree perjury and two counts of fourth-degree false swearing.

Following a six-week jury trial in Newton, Kurtz, formerly of Livingston, was found liable of groping Amy Metzler, now 27, of Frankford, at his Andover Township office in 2002 and 2003. The jury awarded Metzler $275,000 in compensatory damages and $100 punitive damages.

“The indictment relates to his claim made during the trial that he was never a plaintiff in any other lawsuit during his 30-year practice when, in fact, he had been sued earlier by another female patient,” said First Assistant Prosecutor Gregory Mueller, who presented the case against Kurtz to a grand jury.

In the earlier case, Mueller said Kurtz was sued in December 1976 by a woman who claimed she was sexually assaulted by him earlier that year. That case was resolved in 1979 when the victim reached a $20,000 out-of-court settlement, he said.

Enjoy your morning!

The Morning Drill: January 26, 2012

Good Thursday morning!

On to today's dentistry and health headlines:

Valrico Dentist Heads to Court Over Neighbor's Cigar Smoke

In the 23 years Dr. Edmund Rahal has had his dentist office in the strip shopping center at 3646 Lithia-Pinecrest Rd., Valrico, he's had his share of neighbors.

But, up until now, none of them have stunk, Rahal said.

That all changed when the Twisted Cigar moved into the storefront next to Rahal's dental office in October.

Rahal said smoke from the combination cigar shop and smoking lounge has filtered into his dental office, making employees sick and eliciting complaints from patients.

"It's not just a cigar shop. It's a place where patrons come in and smoke. There are big-screen TVs for them to watch," said Rahal. "And now they've applied for a beer and wine license.

"Since they opened, we've been losing existing patients, and there's no way to gauge how many new patients we've lost because of this," Rahal said. "We had a women just this morning complain. She said she couldn't stand the smell."

He said employees say they go home at night smelling of cigar smoke and one employee who's allergic to smoke coughs and wheezes in the office.

Twisted Cigar owner Jim Brown has tried to alleviate the problem by installing filters and sealing the drywall that separates the two storefronts.

However, Rahal said the problem persists. "The cigar store has done what it could, but nothing's made a difference," said Rahal.

Report outlines 5 elements for improving oral healthcare

Accountability, data collection, and new ways of delivering care are critical if the U.S. is going to improve the quality of its oral healthcare, according to "Oral Health Quality Improvement in the Era of Accountability," a new report funded by the W.K. Kellogg Foundation and the DentaQuest Institute.

Dental expenses are now among the highest out-of-pocket health costs to consumers, second only to expenses for drug prescriptions, according to the report.

The report, authored by Paul Glassman, DDS, MBA, a professor of dental practice and the director of the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry, lists five elements for improving oral healthcare in the U.S.:

•     Increased use of electronic dental records and integrated health records
•     Better measurement of oral health outcomes
•     New payment and incentive mechanisms
•     Expanded delivery of care by nondental professionals, as well as new types of allied dental professionals
•     Use of telehealth technologies to reach people in remote areas

Exercise may boost mood for some chronically ill

Working out regularly may brighten the mood of people with chronic health problems like cancer, heart disease and back pain, according to the first sweeping look at previous research.

But it's no miracle cure: On average, six people would need to hit the gym or go for a jog for one person to see a mood improvement.

"It's a nice piece of evidence and I'm pleased because I like the concept," said Dr. Alan J. Gelenberg, who chairs the department of psychiatry at Penn State University in Hershey.

Gelenberg, who wasn't involved in the new work, said the findings jibe with guidelines from the American Psychiatric Association, which recommends regular exercise against the blues.

"There is some evidence for its use to prevent depression, and there actually is evidence for exercise as a treatment in itself," he told Reuters Health.

The Write Diet: Lose Weight With Just 15 Minutes and a Journal

Can losing weight really be as simple as a 15-minute writing session? It worked for a group of women who recently took part in a psychological study. But it depends on what you write about.

Women who wrote about their most important values for 15 minutes lost an average of 3.4 pounds over the next few months. Women who wrote about something less important gained an average of 2.8 pounds.

The researchers think the weight loss was due to increased self-affirmation or self-esteem. Writing about their values made the women see themselves as better people and feel better about themselves. It may also serve to strengthen resolve. Often, heavy eaters eat in an attempt to elevate their mood. Who hasn't felt better after eating a brownie? But some people take this to an extreme and over time, the pounds can add up.

The researchers speculate that writing about one's values can kick off a chain reaction. It starts when writing about an important value makes you feel better about yourself. Maybe when you go home that night you skip the brownie or cookies you've been using as an emotional crutch. In time, skipping the brownie becomes a habit.

Enjoy your morning!

California Dental Association Supporting Dental Mid-Level Providers?

Welcoming sign of the California Dental Association Spring Meeting in Anaheim, California

Perhaps, but it is unclear whether the California Dental Association supports a study, supports increased access to care or what. Read this piece and make up your own mind.

Is California gearing up to be the next state to consider midlevel providers? Lawmakers are considering a bill that would allow the state to study the benefits of alternative dental care providers.

The California Dental Association (CDA) supports the proposed legislation, but two other state dental groups, the California Academy of General Dentistry (CAGD) and the California Association of Oral and Maxillofacial Surgeons (CALAOMS), oppose the concept of midlevel providers, saying they lack the necessary training to do irreversible procedures.

SB 694, introduced by state Sen. Alex Padilla (D-San Fernando Valley), would also establish a state dental director who could help California secure federal funds for subsidized dental programs.

As originally written, the bill would have allowed the dental director to "design and implement a scientifically rigorous study to assess the safety, quality, cost-effectiveness, and patient satisfaction of irreversible dental procedures performed by traditional and nontraditional providers for the purpose of informing future decisions about scope of practice changes in the dental workforce that include irreversible or surgical procedures."

But with a January 31 deadline looming, opponents stepped up pressure and the bill was amended to remove references to "irreversible procedures," "workforce," and "scope of practice changes."

My experience with the California Dental Association over decades (I am no longer a member, for a variety of reasons) is that they really won't fight the left-wing controlled Democratic Legislature and Democrat Governor Jerry Brown.

With ObamaCare providing "free" dental care for children in 2014, there will be a scramble to find sufficient numbers of dentists to provide the required services. Of course, there will not be enough, so why not open it up to Community College trained dental therapists?

Well, there will be problems with that as well, and I will not go into the debate on whether these folks are trained to do irreversible procedures or not. But, you see where the CDA is going with this.

The funny part is that California dentists are actually paying real money dues to an organization which is undercutting their own business by supporting competition. I wonder what the pediatric dentists organization will do?

I think the California Dental Association will lose even more members with this latest gambit.

If you want to follow the legislation, SB 694, a link to the bill and its legislative history is here.

By the way, when the U.S. Supreme Court throws out ObamaCare this late spring on constitutional grounds or President Obama is not re-elected, everything will change again.

The Morning Drill: January 25, 2012

Good Morning!

On to today's dentistry and health headlines:

Suit: Web site developer harassed Grayslake orthodontist

A Web site developer harassed patients and emailed the alma mater of a Grayslake orthodontist after the two became embroiled in a dispute about the design of a site, a libel lawsuit filed Wednesday claims.

The two-count suit claims libel and breach of contract. It seeks unspecified damages.

Dr. Michael Stosich hired Zenman Productions, Inc., to develop a Web site for his orthodontist practice, a suit filed in Cook County Circuit Court claims. The contract called for Zenman to provide search engine optimization so the Internet site would be displayed on various search engines, including Google.

Stosich, whose practice is at 1275 E. Belvidere Road, Suite 100, paid the initial deposit and Zenman missed numerous deadlines and didn’t provide features Stosich wanted on the site, the suit said. The Web site went live Dec. 2, 2011, and did not appear during a Google search.

Zenman told Stosich that this was normal and that the search capability would be effective in six months, the suit said. Stosich hired a third-party developer who discovered Zenman imbedded a file that intentionally left the Web site unsearchable and blocked the site from the Web results of search engines.

Dental Exam Went Well? Thank Fluoride

I admit to being jealous of my sons for growing up in a time when vaccines spared them miseries like the measles, mumps and polio scares that marred my childhood. But I’m most envious of their freedom from the dental decay that forced me to spend countless miserable hours with my mouth propped open while the dentist did his best to stay on top of rapidly rotting teeth.

By my mid-20s, I had already lost one molar and all four wisdom teeth, and every remaining molar had been restored with fillings.

It’s not that I failed to brush my teeth or that I noshed constantly on sweets. It’s that my teeth lacked the protection of fluoride, which was introduced to New York City’s water supply in 1964, five years before my twin sons were born but 23 years too late for me.

More Americans Uninsured in 2011

More American adults lacked health insurance coverage last year than in any year since Gallup and Healthways started tracking it in 2008. The uninsured rate has been increasing since 2008, climbing to 17.1% in 2011.

The Gallup-Healthways Well-Being Index asks 1,000 American adults each day about their healthcare coverage and reports monthly, quarterly, and annual averages. The monthly percentage of uninsured adults increased to 17.7% in December 2011, tying July for the highest on record. The uninsured rate was 17% or higher in most months in 2011.

Gallup first documented an increase in the monthly percentage of uninsured adults in November 2008, rising above 16% for the first time in February 2009 and above 17% for the first time December 2010.

Myths and misses about Alzheimer’s Disease

Mark Twain, the American author and humorist once said, “It ain’t what you don’t know that gets you into trouble.  It’s what you know for sure that just ain’t so.”  In my experience as a geriatrician, I’ve encountered many misunderstandings about this degenerative neurologic disease that devastates both patients and their families.  Countering these can help patients, families, professionals, and all those who have someone in their lives with Alzheimer’s disease.

There’s no difference between Alzheimer’s disease and dementia.  The confusion here is understandable, as Alzheimer’s disease is the cause of at least 60% – and perhaps a much larger proportion – of all those diagnosed with dementia.  Although the terms are used interchangeably, dementia is the umbrella which covers all diseases that cause cognitive decline in adulthood, including Alzheimer’s disease.  The next most common cause of dementia is vascular disease, such as occurs after multiple strokes or one very large one.  Other etiologies of dementia are Parkinson’s disease (and a similar entity called Lewy body dementia), trauma (e.g., head injuries from motor vehicle crashes or playing professional football), infectious diseases like syphilis and HIV, and miscellaneous causes like hypothyroidism and vitamin B12 deficiency.  Because there are a myriad of causes of dementia with varying treatments, it is imperative that families seek out experts to diagnose loved ones with suspected dementia.

Enjoy your morning!

No California Deaths Due to Whooping Cough or Pertussis in 2011

Good news in California.

Nobody in California died from whooping cough in 2011 -- the first time in more than two decades that there were no deaths due to the disease, public health officials announced early Tuesday.

The previous year, 10 infants died from whooping cough, or pertussis. In addition, the number of people infected dropped from 9,000 in 2010 to 3,000 last year.

Whooping cough reached epidemic levels in 2010, prompting public health officials to launch a massive effort to reduce the number of cases and deaths. They advised physicians to look for early signs of the disease and offered free vaccines to hospitals and clinics. The California Department of Public Health also created public service announcements and partnered with local health departments to get out the word about the dangers of whooping cough. And the state passed a law requiring students in grades 7 to 12 to get vaccinated.

I have a new grandchild being born in a few months and my physician recommended a pertussis booster to be included when it was time for my tetanus shot.

It is important for people to realize that before routine vaccinations, many of these, then common diseases, really reeked havoc on children and adults alike.

Please make sure you are up to date of your own vaccinations.