Thursday, November 10, 2011

The Morning Drill: November 10, 2011

Dr. Allen Short

A collection of dentistry and health related links/comments for your day.

Local longtime dentist shares tales from a lifetime in Lemoore

Short opened his dental practice in Lemoore a few months after graduating in September 1959. In the beginning, Short said, he might have three or four patients in a morning and spend the afternoon playing golf. Some of his early patients left a lasting impression.

“I had this man come in and he said, ‘I want a tooth pulled,’” Short said. “And I said, ‘OK,’ and I sat him down in the chair. He had one tooth left — one tooth. He said, ‘I’ve been taking them out myself, but every time I grab a hold of that one, it hurts clear down to my toes.’”

Short numbed the man’s one tooth and went to care for another patient while the medication took effect.

“When I came back, there was a tooth laying on my bracket table,” he said. “He had pulled it out, and he said, ‘How much do I owe you?’ I said, ‘Well, given I just gave you a shot and didn’t do anything else, I’ll charge you a dollar.’”

Through his 52 years in dentistry, Short said he’s learned that different people feel pain differently. One patient of his, a medical doctor, called Short to his office to extract two teeth that had been giving him trouble. Short brought all the instruments he thought he might need for the job.

Short insisted on numbing the doctor before pulling the first tooth, but the doctor refused. Short pulled the tooth and the doctor went pale.

“Then he started analyzing pain,” Short said. “He said, ‘You know, when you go through pain you see different colors in your head. Everything goes white, everything goes red — different pain thresholds,’ and he was describing how he went through the pain. I said, ‘Do you want me to numb the other one?’ He said, ‘No. Take it out, too.’”

Another patient who came in asking Short to extract a tooth had clearly been drinking, but not enough to be seriously impaired. Short numbed him and went to tend to another patient. The woman who came in with the mildly drunk man left the office several times, only to return a short time later.

“By the time I got back in there to see him, he was completely smashed,” Short said. “She was going out there and getting him more liquor. He was drinking straight shots. I don’t like to take a tooth out of someone like that. If he had been that loaded at first, I would not have given him a shot.”

Dentists' hearing loss being studied at ETSU

A doctoral student at East Tennessee State University is studying whether the drills cause hearing loss in dentists. Krisztina Bucsi Johnson is recruiting area dentists for her project, with $5,000 in funding support from the National Hearing Conservation Association Foundation.

Johnson, who was a dental assistant for eight years, said some studies have already been done on the subject, but she wants to compile more detailed data.

The study will be done at dental offices using portable instruments. She will measure a dentist's hearing threshold prior to the start of the day and then again at the end of the day.

Dentists prepare to treat as many as 1,000 people at free, 2-day dental clinic in Greensboro

A first-come, first-served free clinic that may treat as many as 1,000 people will be held at the Greensboro Coliseum, where dentists will clean and fill teeth for people who otherwise couldn't afford the treatment.

The News & Record of Greensboro reports ( that the Missions of Mercy clinic will be held Friday and Saturday. The Cone Health Congregational Nursing Program is working with the N.C. Dental Society, which sets up makeshift clinics and works with local dentists and volunteers to staff them.

The group's goal is to treat 1,000 people this weekend. The volunteer dentists, dental assistants and hygienists are setting up 72 treatment chairs.

Services range from teeth cleaning to routine fillings and surgical proceedings.

"I know that the premise is we try to take care of the one or two most urgent things they have, but my experience is practitioners try to do as much for an individual as they can," said Dr. Charles Norman, one of the participating Greensboro dentists. "I think we try to eliminate as many of the urgent issues as they have, so they won't be back in that position."

Last year, that included a man in a low-paying job without health insurance who was missing work because of abscessed teeth. He had been to the emergency room three times and had received antibiotics, but he couldn't get the teeth pulled until he got to Greensboro.

The donated services in Greensboro should total at least $500,000 for this weekend. A 36-hour clinic in Charlotte recently provided care for 2,145 people, with an estimated value of $1.1 million.

"Many of them sat there for 30 hours to get treated," said Dr. Bill Blaylock, who oversees Missions of Mercy. "We have seen a trend of more and more people who had good paying jobs and dental benefits, and now they've lost the jobs and the benefits, and they're turning to us to get their routine care."

AIDS: Pioneering dentist looks back on early hysteria around HIV and AIDS

In 1998, Mayor Richard M. Daley completed a multi-million dollar restoration on Halsted Street with nearly two-dozen rainbow-linked bronze pylons. One of the unique charms of the city in the past decade and a half has been its official nod towards the vibrant gay community.

Seeing a street lined with monuments that mark the city's official acceptance of the gay community, it is hard to imagine this was ever a place you could lose your job for being HIV-positive. A mere seven years prior to the city's official recognition of its own gay neighborhood, Chicago had a very different attitude towards the gay community, especially people infected with HIV—a virus associated with gay men. (Although AIDS discrimination is no longer officially sanctioned, it does of course still occur.)

Prior to revealing his HIV status to his superiors in 1991, Dr. Larry Spang recalls how a fear-induced media began affecting his performance at work. "Even though we knew we were being very careful, we were still very nervous," Spang explained of HIV-positive doctors. "If somebody found out you were positive, [it] could end your career."

Spang was the chief dental officer at the Metropolitan Correctional Center (MCC) on the corner of Clark and Van Buren. MCC is a federal prison famous for its jagged triangular shape, mustard exterior and razor-thin windows. Spang recalled losing sleep as headlines rolled in daily with high tales of patients becoming infected by their doctors, "Every day I would open the newspaper and see another headline," he said.

In January 1991, following a statement released by the U.S. Centers for Disease Control that a Florida dentist may have transmitted the virus to three of his patients, the Chicago Tribune reported that the American Medical Association and the American Dental Association urged its HIV-positive members to avoid invasive procedures or otherwise reveal their HIV status to patients. "I felt threatened," Spang said, "not by anyone in particular but by the world in general."

As the months went by, stories began to surface about Dr. David Acer, the HIV-positive Florida dentist who was in trouble for passing on the virus to his patients, "knowingly," Spang said. One of Acer's patients, Kimberly Bergalis, became the poster child for implementing policies that would mandate HIV testing for all doctors.

Bergalis exhibited signs of AIDS in 1989, two years after an invasive dental surgery performed by Dr. Acer. All signs of the otherwise healthy 22-year-old pointed towards her contracting the virus from her dentist. As the nation's media witnessed her health slowly failing to the disease, the American public fell victim to fear and Spang grew increasingly nervous about his job. With panic about HIV-positive doctors and dentists widespread in America, Spang decided it was best to reveal his status.

"I used an over-abundance of caution, because I had to," Spang said of his decision to reveal his status. "I was really getting into iffy situations." He made an appointment with the assistant surgeon general in Washington, D.C., one of the chief officers for the U.S. Public Health Service, which had given him the job at the prison.

"I went to Washington and walked into the assistant surgeon general's office and said, 'I'm HIV positive,'" Spang explained, "And he asked me if it had anything to do with IV drugs, and I said 'absolutely not' and so he told me, 'then you have nothing to worry about.'"

Enjoy your morning!

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