Who Is Easy To Manipulate?

Who is easily manipulated?

This is a question that has real interest to me as a practicing dentist.

Because doctors have the easiest time manipulating patients and good doctors know that they have to fight the temptation to do it.

I'm defining manipulation as working to spread an idea or generate an action that is not in a person's long-term best interest. 

Let's look at how people are manipulated.

The easiest people to manipulate are those that don't demand a lot of information, are open to messages from authority figures and are willing to make decisions on a hunch, particularly if there's a promise of short-term gains.

There are habits and activities that leave people open to manipulation. I'm not saying they are wrong or right, just pointing out that these behaviors make you open to being manipulated. Here are a few general categories of behaviors that manipulators seek out:

* Believing something because you heard someone say it on a news show on cable TV.

* Being a child (or acting like one).

* Repeating a mantra heard from a figurehead or leader of a tribe without considering whether it's true.

* Trying to find a short cut to lose weight, make money or achieve some other long-term goal.

* Ignoring the scientific method and embracing unexamined traditional methods instead.

* Inability to tolerate fear and uncertainty.

* Focus on now at the expense of the long term.

* Allowing the clothes or appearance of the messenger (a uniform, a suit and tie, a hat, body type, etc.) to influence your perception of the information he delivers (add gender, fame, age and race to this too).

* Reliance on repetition and frequency to decide what's true.

* Desire to stick with previously made decisions because cognitive dissonance is strong.  Cognitive dissonance is what happens when what you believe is contradicted by new information. Research shows that, when confronted with challenging new information, many people seek to preserve their current understanding of the world by rejecting, explaining away, or avoiding the new information.

  

It's interesting to note that AM radio used to be filled with ads for second mortgages. And now?  Gold.  Manipulators are tuned in to what people can be scared into or easily convinced of. 

Manipulating people using modern techniques is astonishingly easy (if the manipulator has few morals). You only make it easier when you permit people and organizations that want to take advantage of you to do so by allowing them to use your good nature and your natural instincts against you. It happens every day in Washington DC, online, on TV and in your local community institutions. 

What does this have to do with dentistry?

A lot.  Because the worst kind of dental practice is one which tries to "sell" dentistry to patients by scaring them, not supplying information, not sharing knowledge, and basically recommending treatment because it's good for the dentist, and maybe not the right thing for the patient.

Yes, of course it happens.  All the time.  It makes me angry when I see it or hear of it.

Look back over the list of characteristics of people who are easily manipulated.  Do you see yourself anywhere in that list?

In our office we strive to share full and complete information and we respect your right to your own personhood.

That's one reason why we have a blog and a web site that has huge amounts of information.

We talk about this all the time in our office; we actually have meetings about it, and each of us watches to see that we don't fall into the trap.

Doctors have a special obligation to their patients.  We take that very seriously.

Conversation Gems With My Patients

I'm a dentist, but I actually talk with my patients.  

Some of my colleagues think I'm crazy and they say stuff like "Time is money so get 'em in and get 'em out."   "When a patient is talking, you're not working."  "People come to get drilled, not to talk or to hear you talk."  "What the heck is there to talk about?"  "Hey, I run a dental office, not a social meeting place."

No, really.  I get this all the time.  I wonder what it's like to be a patient in one of their offices.

Here are a bunch of things that came up in conversation with my patients over the years (I write down stuff sometimes when it really tickles me).  Some were said to me and some I said myself.  I'm not telling which is which.

Some might have been read or heard elsewhere, but that doesn't matter.  To me, they are all gems.  My conversations with my amazing patients are one of the best things about my job.  My patients keep me going and make my day fun for me and for my team (they like to talk also).

So here are a few of the hundreds of gems and little bits of wisdom that have come my way from the great people who come to our office.


Enjoy!


1. I think part of a best friend's job should be to immediately clear your computer history if you die.

2. Nothing sucks more than that moment during an argument when you realize you're wrong.

3. There is great need for a sarcasm font.

4. How the hell are you supposed to fold a fitted sheet?

5. Was learning cursive really necessary?

6. I can't remember the last time I wasn't at least kind of tired.

7. Bad decisions make good stories.

8. You never know when it will strike, but there comes a moment at work when you know that you just aren't going to do anything productive for the rest of the day.

9. Can we all just agree to ignore whatever comes after Blue Ray? I don't want to have to restart my collection...again.

10. I'm always slightly terrified when I exit out of Word and it asks me if I want to save any changes to my ten-page research paper that I swear I did not make any changes to.

11. "Do not machine wash or tumble dry" means I will never wash this - ever.

12. I hate when I just miss a call by the last ring (Hello? Hello? Damn it!), but when I immediately call back, it rings nine times and goes to voicemail. What did you do after I didn't answer? Drop the phone and run away?

13. I hate leaving my house confident and looking good and then not seeing anyone of importance the entire day. What a waste.

14. I keep some people's phone numbers in my phone just so I know not to answer when they call.

15. I think the freezer deserves a light as well.

16. I disagree with Kay Jewelers. I would bet on any given Friday or Saturday night more kisses begin with Miller Lite (or wine or Margaritas) than Kay Jewelry.

17. I wish Google Maps had an "Avoid Speed Trap" and "Avoid Bad Neighborhood" routing options.

18. Sometimes, I'll watch a movie that I watched when I was younger and  suddenly realize I had no idea what the heck was going on when I first saw it.

19. I would rather try to carry 10 plastic grocery bags in each hand than take 2 trips to bring my groceries in.

20. The only time I look forward to a red light is when I'm trying to finish a text.  (this one made me worry)

21. How many times is it appropriate to say "What?" before you just nod and smile because you still didn't hear or understand a word they said?

22. I love the sense of camaraderie when an entire line of cars team up to prevent an ass from cutting in at the front. Stay strong, brothers and sisters!

23. Is it just me or do high school kids get dumber & dumber every year?

24. There's no worse feeling than that millisecond you're sure you are going to die after leaning your chair back a little too far.

25. Even under ideal conditions people have trouble locating their car keys in a pocket or finding their cell phone - but I'd bet my behind everyone can find and push the snooze button from 3 feet away, in about 1.7 seconds, eyes closed, first time, every time!

26. Sometimes I'll look down at my watch 3 consecutive times and still not know what time it is.

I love my patients!

Is Sleeping Killing You?

Is Sleeping Killing You?


Maybe.  You may not even know it.  But if you have a bed partner, for sure he or she knows it.


OK.  Millions of people snore.  It's annoying.  It drives those you share a bed with crazy.


But it won't kill you if that's all it is.  


But for many snorers, the situation is way more serious.  


Because what they have is called Obstructive Sleep Apnea (OSA for short).


OSA is a killer.  Let me tell you a little about it.  And then let me tell you how a dental office can help you.


Obstructive sleep apnea is a common disorder that affects more than 18 million people in the United States. In many of these people, the condition is undiagnosed. People with OSA literally stop breathing repeatedly during their sleep, often for a minute or longer and as many as hundreds of times during a single night.

Sleep apnea can be caused by either complete obstruction of the airway (obstructive apnea) or partial obstruction, both of which can wake one up. OSA occurs in approximately 2 percent of women and 4 percent of men over the age of 35.

It is important to emphasize that, often, the person who has obstructive sleep apnea does not remember the episodes of apnea during the night.

The main symptoms are usually associated with excessive daytime sleepiness due to poor sleep during the night. Often, family members, especially spouses, witness the periods of no breathing.

A person with obstructive sleep apnea usually snores heavily soon after falling asleep. The snoring continues at a regular pace for a period of time, often becoming louder, but is then interrupted by a long silent period during which there is no breathing. This is followed by a loud snort and gasp, and the snoring returns. This pattern repeats frequently throughout the night.

During the nonbreathing episodes, blood oxygen levels fall. Persistent low levels of oxygen may cause many of the daytime symptoms. If the condition is severe enough, pulmonary hypertension may develop, leading to right sided heart failure.

Symptoms that may be observed include:

Abnormal daytime sleepiness, including falling asleep at inappropriate times. Awakening unrefreshed in the morning.  Depression (possibly).  Episodes of no breathing (apnea).  Lethargy.  Loud snoring.  Memory difficulties.  Morning headaches.  Personality changes.  Poor concentration.  Restless sleep.  Abnormal heart rhythm (arrhythmia).  Excessive carbon dioxide levels in the blood.  High Blood Pressure.  Heart disease.  Sleep deprivation. Stroke.

So why is a dentist talking to you about this? Because specially trained dentists (that's us) can be terrifically helpful with mild to moderate OSA.

Dentists with a special interest in this issue know how to make an oral appliance that advances the jaw in sleep and keeps the airway open. Sometimes this is all that is needed to stop the problem.

These appliances are easy to wear in sleep and the improvment in sleep quality, to say nothing about the improvement of the sleep for the partner, can be remarkable.

The alternatives are for the OSA person to use CPAP (continuous positive airway pressure) devices, which involve a mask that fits over the face and a machine that pumps air under pressure to force breathing. And there are surgical procedures that may be able to help.

I personally favor the oral appliance called Somnodent, and my patients have found it to be comfortable and effective.  The SomnoDent is a custom-made device, which improves the effectiveness and comfort level of treatment, as the jaw is moved only as far as is required to alleviate the condition.

The SomnoDent is a clinically proven treatment of snoring and mild to moderate OSA.   96% of patients with proven OSA stated they would like to continue to use the SomnoDent.  91% of patients reported substantial improvement in sleep quality with the SomnoDent. 

The SomnoDent works by moving the lower jaw forward slightly, which tightens the muscles in the upper airway preventing them from collapsing and vibrating at night. 

If you are told you snore loudly or stop breathing in sleep, or if your partner does this, please seek help. The diagnosis is usually made by having a sleep study at a sleep center.

But here is some terrific great news: 

Our office can now arrange for you to have a sleep study done right in your own home, in your own bed.  It's so comfortable to be in familiar surroundings without the cameras and observers in a sleep center.

And the cost of a home sleep study is only about $350 instead of the $2000 to $3000 for a sleep center study.

Don't neglect OSA. It can kill you.

If you even suspect you might have OSA, or even if you simply want to stop or reduce your snoring, call us. We can and will help you.  Do it now.

Dental Pain Truths - What You Need To Know

Dental Pain. It's the worst!

But dental pain comes in many different forms. Let's go through some of the common types and put them in some perspective.  Smart Patients know stuff and they keep their teeth.

Brief, sharp momentary pain to something cold.

Goes away as soon as the cold is removed.  Teeth are normally a little sensitive when exposed to real cold.  No problem.  

But: if the cold sensitivity happens when the food or drink is only slightly cold, then it can be from a gap in a filling, actual decay, an exposed root surface (happens if the gum is receded) or if there is a crack in the tooth.  Call us. 845-297-6206.

Or: If the pain lasts for more than a few seconds or a minute, that can mean that the pulp (the living tissue inside the tooth) is stressed or deteriorating.  Call us. 845-297-6206

Deeper, more aching pain pain, especially if heat makes it worse.

More serious.  This indicates that the pulp of the tooth is badly inflamed and is on the way to becoming necrotic.  Call us promptly.  This is going to get worse.  845-297-6206.

A real long lasting, steady, throbbing toothache that is agonizingly painful and is worse if you bite on the tooth or press it with your tongue or finger.

This is an emergency.  It means you have an abscess (infection) and it must be treated quickly.  It can become a deep space infection and can become dangerous.

I have a broken tooth or a hole in my tooth but I have no dental pain.  Nothing hurts.  Am I OK?  Can I wait to take care of this?

No.  Any opening in a tooth beyond the enamel is a wound.  It gets infected.  Bacteria enter the microscopic tubules in the dentin and travel to the pulp and then you are on the way to a dead pulp and a toothache.  Many times the reason the tooth doesn't hurt is because the nerve endings in the pulp are already dead.  Call us. 845-297-6206.

I had a toothache but it went away.  Did it heal?

No.  The pulp of the tooth probably died, so the nerve tissue is no longer able to transmit the pain impulses.  Dead pulps need to be treated.  The body does not like dead tissue and it will create problems if it is left.  Call us. 845-297-6206.

I bit on something hard and it hurt, but the pain went away quickly and the tooth isn't sore.  What should I do?

If the tooth stays comfortable, just don't bite hard on it for a day or two.  

But: If the tooth starts to ache or gets tender to temperatures or pressure, call us. 845-297-6206

My teeth are just sort of sore a lot, especially when I wake up in the morning.  What's happening?

You are probably clenching or grinding your teeth in sleep. Some people do this in the daytime too. This is not good for teeth, or for your jaw joints or the chewing muscles in your face.  You need help.  Call us. 845-297-6206.

The bottom line is this: Call and get advice when you are not sure.  We are glad to advise you.

Check out our web site.  It has a ton of information.  We're here for you.

So Glad To Be Here

Today I want to share a communication I got from one of my colleagues on the Academy of Comprehensive Esthetics forum.  June is not a dentist.  She is a Ph.D. who focuses on development and performance.  She's very smart.

So here's a Guest Blog from June Darling.

And as always, you can read my blog at our website.

Enjoy!

-----------------------------------------------------------

So Glad to Be Here

Perched in her high chair, the toddler seemed extremely thoughtful. She must have something big on her mind. As a matter of fact she did, because when her mother asked her what she was thinking about, she said, "I'm thinking about my pancakes."

That thought seemed all too appropriate, perfectly sensible, and somehow funny since she was at that very moment eating her pancakes. Why did it seem so humorous?

Quite often we aren’t thinking about what we’re actually experiencing. The toddler was thoughtfully focused on her pancakes, being right here, right now, in the present – a sound, practical, and unusual way for many people between the ages of four and ninety-four to live (The young and the old are often the best practitioners of what some call “being present.”)

Many of us spend much of our time hovering around somewhere outside our present experience. We may be worrying about something bad which could happen in the future or feeling depressed about something that’s already happened. We are quite unaware of what is actually happening now.

We are often so unaware of what is going on with us and around us at this particular moment that we live our present on auto-pilot. That happens to me.

A number of years ago I was on my way to work. I parked my car. When I started to get out, I realized I was not in the parking lot of my present workplace, but rather in place I had worked previously.

Test yourself. How many of these “unpresent” situations or similar ones are happening to you?

I experience some emotion and may not be conscious of it until some time later.

I break or spill things because of carelessness, not paying attention, or thinking of something else.

I tend to walk quickly to get where I’m going without paying attention to what I experience along the way.

I forget a person’s name almost as soon as I’ve been told it for the first time.

I get so focused on the goal I want to achieve that I lose touch with what I am doing right now to get there.

I find myself listening to someone with one ear, doing something else at the same time.

I snack without being aware that I’m eating.

If you’re like I am. A good dose (or two) of “being fully present” would be useful.

According to psychologists, in addition to helping us get where we want to go, being present helps us feel healthy, happy, and aware. It's an antidote for stress and worry (and can also improve our relationships and help us perform better).

I'm not suggesting that we live every moment in the present (though some people do recommend that), but for most of us a bit more thinking about our pancakes, when we are in fact eating our pancakes, could make for more enjoyment of our pancakes – that is… our lives.

This month let’s use the toddlers' and old folks' cure for anxiety, depression, and unhappiness (which I am personally calling “thinking about my pancakes”) by being more present - right here, right now. We won’t be upset if we notice that our attention has skittered off. We won’t beat ourselves up if we find ourselves in the past, the future, or our old parking lots. We’ll just smile and gently bring ourselves home.

Our life is an experience we don’t want to miss.

How might being “more present” help you move up To The Good Life?

June Darling, Ph.D.
President of Summit Group Resources, An Executive and Personal Coaching Company specializing in organizational and personal development, peak performance, and happiness.

Follow June on Twitter

Migraines and the NTI

Is this you?

We can help.

Over 29 million Americans suffer from migraines. And some dentists are trained to deal with them

We are one of them.

We can design and create an amazing little piece of plastic that fits between your front teeth that can dramatically reduce or even eliminate your migraine symptoms.

It's called the NTI-tss.  The NTI-tss is an FDA approved migraine prevention option. It is a small nightguard that comfortably fits over your four front teeth. It's patented design keeps your canine and back teeth apart. This separation minimizes the intensity of your nighttime clenching forces.

Check it for yourself

To demonstrate how the NTI-tss works, simply hold the muscles of your temples (like the woman in the photo) while biting down on a pencil with only the back teeth. The temporal muscles will bulge and intensely contract. But  when you bite down on a pencil with only the front teeth, the temporal muscles remain relaxed.  There is a reflex (it is actually called the "Nociceptive Trigeminal Inhibition" reflex) that prevents hard contraction of the biting muscles when only the front teeth touch.

Thank you, Dr. Boyd

The NTI-tss therapeutic protocol was developed by a California dentist, James Boyd, DDS. Having suffered chronic, daily headaches and frequent migraine attacks for 12 years, Dr. Boyd developed the protocol to rid him of pain. He is now an associate with The Headache Center Neurology clinic in Encinitas, CA. He is something of a genius.

There's a neat website about this at www.TheHeadacheRemedy.com.  And you can check out our website page on this at http://www.drsteveross.com/migraine-tmj-facial-pain.html.

Don't live with pain. Call (845-297-62063) or send e-mail (DrSteveRoss@aol.com) and we will be glad to evaluate you.  We can help! 

Fixing Cavities - The Old Way and the New Way

One of the most common questions asked in our practice concerns our choice of the material that we use to repair cavities in teeth.

Amalgam: The old stuff (we don't use this)

Silver-mercury (amalgam) fillings were introduced to dentistry over 100 years ago. At the time, this mixture of silver and mercury was considered a miracle material (of course, at that time, so was indoor plumbing).

Is it safe?

Today, amalgam fillings are made of a mixture of silver/zinc/tin/copper alloy and mercury. And as of today the American Dental Association believes that amalgam is a safe and effective material for use in the human mouth. They are entitled to their opinion. Here is my personal opinion about amalgam:

It is possible that the mercury in amalgam is not harmful to us. However, mercury is a toxic substance and according to the EPA, must be disposed of in a Toxic Waste Disposal Site. In my opinion, anything that must be disposed of in a Toxic Waste Disposal Site should maybe not be placed in our mouths. 

But this may simply be an over-cautious position on my part. I do not actually know what the long term outcome of on-going research will be. I do know that some European countries and a couple of states in the U.S. have regulated amalgam use, mostly because of environmental contamination reasons. Some European countries have banned the use of amalgam in pregnant women and young children.

I want to be clear on this. I have not used amalgam since April of 1982. And I'm not going to use it again. And the reason has nothing to do with its safety or non-safety. The jury may still be out on that.

So what do I like?

The reason I do not use amalgam is that, in my opinion, it is a poor restorative material compared to newer materials we have now. Like everything else, improvements have been constant over the last 100 years. It took science until the 70’s to develop an alternative to amalgam, and into the 2000s to improve it to its current excellent level.

The material I favor and use as my first choice is bonded composite resin. This material is extremely biocompatible and flexes and wears like natural teeth. A silver-mercury restoration has no bond to tooth structure. Expansion and contraction of amalgam over the years causes cracks in teeth and eventually, many teeth will fracture. You may have had this happen to you, even when you were eating something soft. Amalgam tends to leak after five or ten years, causing recurrent decay. Amalgam corrodes and turns black.


M.I.D.
Another reason I like to use bonded resin is because I am a strong proponent of what dentists call Minimally Invasive Dentistry.  Those of us who have this philosophy believe that as much natural tooth structure as possible should be preserved when restoring teeth to good form and function.  You would think that every dentist would believe this, but they don't.  It is easier to drill away teeth and make crowns than to artfully sculpt and bond modern resins onto the natural tooth. It takes time, skill and care.  But it's better for the tooth and that's what matters to me.  Crowns are very appropriate in many situations, but not as often as many dentists use them. I prefer to preserve if possible. The easy way is not always the best way.

I also restore teeth with various types of wonderful ceramic materials (usually called porcelain) and the always terrific old standby, gold.  You can use these in minimally invasive ways also.

When aging amalgam restorations are replaced by bonded composite resin or ceramic restorations, the strength of the tooth is improved and underlying tooth structure is sealed.

Plus, of course, composite resin and ceramic restorations are tooth colored and are so much more attractive and natural looking than metal fillings.

Let's talk about cost

Now let me talk with you about the economics of composite resin. Composite resin and ceramic restorations are more technique sensitive and are more time consuming to place. Special care must be exercised to operate in a controlled environment that can be moist when desired and dry when desired. These bonded restorations are more sensitive to moisture control procedures than amalgam. When placing these fillings, we use bonding agents to seal the dentin against bacterial infiltration and protect the dental pulp from irritation. As a result of this necessary expertise and the increased time associated with composite and ceramic placement, the cost of restoring teeth is a little higher than with amalgam.

Cost is not the same as value

Teeth matter.  They deserve the best chance for lifetime function, comfort and good appearance.  Replacing teeth is much more costly than preserving them. We opt for the best value for our patients.

You have insurance?  That's good!  But...

Insurance companies are slow to embrace newer techniques, especially when it could cost them money to provide state-of-the-art care to their insured. Many insurance companies will only cover the cheapest material to restore teeth. Yup, that’s amalgam, and many will pay their amalgam benefit even when composite resin or ceramic materials are used. Yes, they are allowed to do that. That should irritate you, in my opinion.

My patients have mostly learned about the ways insurance carriers pay benefits. For example, they have learned not to be fooled by the “usual and customary fee” jive. They know that this is bogus and is intended to drive a wedge between patient and doctor. If you are concerned about anything you read in an Explanation of Benefits you receive, just call us. We’ll explain it with straight, honest talk. You don't have to be my patient to get advice; we'll be glad to help anyone.

The bottom line

Composite resin, porcelain and gold are wonderful, modern, state-of-the-art beautiful materials we use to help you have the strong, functional teeth and great smile you have always wanted.

Lose Your Teeth, Lose Your Mind

Ever have a senior moment? Then you might be missing some teeth, too.

I'm sharing today a remarkable piece of research published by Boston University Henry M. Goldman School of Dental Medicine just a few days ago (yes, I actually do read this stuff).

We know that the connection between dental disease and system diseases are becoming better understood every day. We now know that there is a correlation between periodontal disease and heart disease, pancreatic and maybe other cancers, low birth weight babies and a bunch of other problems.

But this one is really startling. Read the article for yourself. Let me know what you think about this. If it makes you worry, that's not a bad thing, really. Worry is sometimes the first step to doing something important for yourself. I'd love to help you with that. All it takes is a phone call or e-mail.

Here's the article. It will also be available on our website at Dr.SteveRoss.com (click on the section called Blog):

April 30, 2010

Researchers at Boston University Henry M. Goldman School of Dental Medicine (GSDM) link tooth loss and periodontal disease to cognitive decline in one of the largest and longest prospective studies on the topic to date, released in this month’s issue of the Journal of the American Geriatrics Society.

Dr. Elizabeth Krall Kaye looked for patterns in dental records from 1970 to 1973 to determine if periodontal disease and tooth loss predicted whether people did well or poorly on cognitive tests. She found that for each tooth lost per decade, the risk of doing poorly increased approximately eight to 10 percent.

More cavities usually meant lower cognition too. People with no tooth loss tended to do better on the tests.

Dr. Kaye says inflammation is a possible cause, noting that other studies found higher levels of inflammation markers in people with Alzheimer’s. “Periodontal disease and caries are infectious diseases that introduce inflammatory proteins into the blood,” she says. “There’s a lot of circumstantial evidence that inflammation raises your risk of cognitive decline and it could be that gum inflammation is one of the sources.”

The men studied—veterans living in the Boston metropolitan area—enrolled in the VA Dental Longitudinal Study in the late 1960s and early 70s and came back for medical, dental, and cognitive exams, which started in 1993, every three years.

Participants took two cognitive tests. The first, the Mini-Mental State Examination, tests orientation, attention, calculation, recall, language, and motor skills. The second, a spatial copying test, asks participants to copy nine geometric designs ranging from easy to complex.

“The ability to copy is one of the things people lose as they lose cognitive ability,” Dr. Kaye says.

Physicians might want to think about the dental health of their patients who test poorly, according to Dr. Kaye. “The findings should also give dentists yet another reason to prevent tooth loss and periodontal disease and encourage patients to do as much as they can to prevent dental disease,” she says.

Dental School faculty Drs. Kaye, Raul I. Garcia, Avron Spiro, III, and Thomas Dietrich; dental student Aileen Valencia, and Boston University School of Medicine nutrition student Nivine Baba worked on the study, which is a group effort among GSDM, the Veterans Affairs Boston Healthcare System, Boston University School of Public Health, and the University of Birmingham School of Dentistry in the United Kingdom.