Dr. Von Bulow's Articles

Gotta tell ya, I sure do love Invisalign. What I just said is significant.

Back when I was a dental student and O.J. was busy pitching Hertz rent-a-cars while he was running through airports, I sure did hate orthodontics. When I somehow escaped dental school in the dead of night and started out from scratch in TC, I couldn’t believe my one co-worker, Former Office Manager Diane, had previously been paid to bend orthodontic wires. If I had only known FOM Diane while I was a student, I’d have somehow raised the cash to pay her off for a wire job well done.

I’m not suggesting students should go out and hire folks to do their work; I’m just making clear the sort of fantasies this former student used to entertain (the Doc “wrath of” Kahn productions are not suited for impressionable readers younger than grandparents of Baby Boomers.)

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Webster’s defines the word temporary as meaning “not permanent”. Seems my Webster’s trouble started way back in dental school.

For those who are fortunate enough to be uninitiated regarding the crown experience, here’s how it usually goes. The patient comes in for appointment #1 and has the tooth in question shaped; in the process, tooth decay and existing restorations get removed. When the shaping is done and everything’s clean and there’s enough space for a crown to fit over the tooth without sticking out too far or wide, the dentist takes an impression. When poured up in plaster, the impression will show the technician exactly what the tooth looks like after the shaping. The technician then builds the crown to fit the model poured from the impression. The next appointment is for cementing the crown to the tooth. Between appointments I and II, the patient wears a temporary crown.

Everyone confused yet?

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So when I was in dental school back in the day, gas actually went for less than a buck/gallon. I’m not totally sure whether if it had anything to do with the birth of Office Manager Dalila but I remember there was a certain uneasiness in the air. I thought it was Disco. And much like that Florida Gator kid who had a dread fear of being tasered (“Don’t tase me bro!!!”) I was more nervous than Sarah Palin in a roomful of Katie Courics whenever I heard the word “Orthodontics.”

When I was a student I thought orthodontists were just a bunch of wire-bending tooth engineer dweebs who would do just about anything to avoid the sight of blood or the prospect of giving an injection (even if they had to stay in school another two years.)
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I know; what a ridiculous title? But you have to admit, you’re probably totally intrigued about what the Tommy Cruise I’m thinking about or maybe you’re already moving on to unravel that tangled puzzle we know as the City Manager’s Weekly Report.

So I’m not talkin’ about Old-Time Rock n Roll or even the yucky HAZMAT breed of biomechanics that grosses out most of us non-medical specialists. But I just did have an SAT flashback even though back in The Day I didn’t even know I was taking The SAT when I was taking it.

Anyway, I’m just talking about teeth.

So most of us know teeth can be risky business; some of us know the hard way. Here’s the thing; please don’t feel so guilty about having a track record of tooth decay and fillings that seem to expand in size every time the Trojans mop up on the Bruins.

Okay, you win. You can feel guilty if you’re not trying and you know better. And sometimes guilt is good for you; just ask my Sicilian traveling production manager, Aunt Clara.

But getting cavities and suffering from tooth decay is mostly the outcome of our lack of resistance to disease. And yeah, it’s okay to think of tooth decay as a disease. Not being able to stop shoving Jolly Ranchers into your pie hole is not a disease; armies of aggressive bacteria using sugar as a medium to produce acid that will rot away weakly resistant enamel is a disease. Tooth decay, when it comes right down to it, is a bacterial infection. And some folks are more vulnerable to the infection than others.

Doesn’t it make sense to figure out who’s at risk sooner rather than later? Once dentists can assign a degree of risk to a particular oral health challenge, we’re better able to personalize care and make the care more preventive than interventive. Shucks, my world-famous continuing education guru, Seattle’s Doc Kois actually says stuff like, “No dentistry is as good as no dentistry” (And to think I pay Dr K 5Gs a pop to figure out how to best restore broken down teeth and mouths.)

The message is materials and approaches for restoring damaged teeth have made the restorative experience far less invasive than in the past. And the earlier significant tooth decay risks are identified, the more effectively we can follow the natural design of our enamel-coated chewing body parts. Kind of like the dentistry version of “keepin’ it real.”

Today, systems exist that can measure risk before tooth decay disease has even started. One particular technology, the Carifree system, takes only a few minutes in the office to quantify risk. Clinically, the experience is pain free and involves swabbing plaque off two different tooth surfaces. Carifree can even be used to measure risk in infants. The cost of the screening is less than the cost of one filling.

We can also detect risk for tooth decay just by studying patterns. If someone has active tooth decay or has had a history of tooth decay on the smooth enamel surfaces between teeth, we know there’s an increased risk. And we’re all at greater risk as we age and produce less saliva. Reduced saliva flow is also a common side effect of numerous medications.

Folks with a higher risk for tooth decay can receive fluoride in any number of ways and increase their cavities resistance. And we know the sugar substitute Xylitol potentiates the anti-bacterial capability of fluoride. Antimicrobial rinses help. Oral hygiene instruction and heightened monitoring are musts. Plus today, laser technology helps us detect tooth decay at very early stages.

So don’t feel guilty…unless you don’t stop by for a quick risk analysis from your dentist.

So it’s been about eight weeks since I’ve written anything more than E-mail and my world was starting to get a little shaky. And wouldn’t Miss Winters from mid-60s Mark Keppel High English crack a smile if she knew just how much I’ve missed putting down some words? Haven’t typed out veneer or “cosmetic” or Invisalign. Ugh!

For about the last ten years or so I’ve shared something in print every seven days for the San Gabriel Valley Weekly. My weekend ritual went something like: see a movie, get inspired, and write a column. And I’ve had worse dates. Trust me.

But like with most good things and me (women and my topspin backhand included), I tend to take them for granted and they must therefore someday end. One Sunday morning I was writing all about health and veneers, my beloved USC Trojans, and the big Temple City shifting pile of dirt we call “The Piazza (coming soon.)” The next thing I knew I was writing a tribute to our fallen founder/ publisher/ editor, Dana Baskin.

So the Weekly was history and my not turning out a column for eight weeks has accessed way more time for me to hit golf balls and perfect any self-loathing techniques I might have missed since the Tenth Grade. Wow! Sure feels good writing some stuff down again. All praise the Temple City Tribune!

I started writing just for the pure pleasure of it, recognizing the obvious limitations of my verbal skills and jumping at the opportunity to edit. Also, when you’re a DDS type, the expectation bar is set even lower than the sun setting on Bruin football.

I’ve been practicing dentistry for about thirty years and that’s a lot of rehearsal time but I know you won’t think I look old enough. You’ll have to settle that timeless debate with my Office Manager, OM Dalila (She’s referred to me as the Older Gentleman since we were both about thirty.)

I promise to tell you all about the latest cosmetic advances in dentistry. And I know from social interaction (with the few friends molar jockeys like me tend to have) that most of you have a morbid curiosity about things dental. If you’ve ever met a DDS at a party and haven’t once pointed inside your mouth while asking a question like, “Utt’s up with my lowa mowa?” you just need to get out more.

Well, I couldn’t be more excited to share about all the latest clinical stuff (especially Invisalign) and I’m even more enthused about my being your advocate. I take a ton of continuing education (CE) and travel all over the country accumulating 200 hours of CE per year (It’s like, be a slow study and see the world!)

I’m also really looking forward to sharing about the human and compassionate side of health and dental care and the role you can play in having the kind of experience you want. I realize going to the dentist isn’t fun for most folks but it can be. Patients, students, and health care providers all do better when they smile; research shows that laughter really is powerful medicine. Shucks, part of our practice intention is actually “…making dentistry fun.” And we’re not kidding.

I’ll be happier than VP Cheney in a roomful of Big Macs if you’re generous with your feedback; your input will serve as a great guide for my putting out the info you want.

Dentistry has amazing potential to impact the quality of your life and even the length of your life. If you don’t believe me, just look up the Surgeon General’s Oral Health in America report of May, 2000.

So I can’t wait to catch up with you guys. Please remember, don’t be a stranger.