Dr. Von Bulow's Articles

So I’m part of a really progressive national dental organization (Crown Council) that includes big-time educators, top clinicians, and even a few molar jocks that get regular TV face time. The group is really committed to the community and has collectively raised more than $25 million over the last decade to help children in need.

This week, the group wasn’t too thrilled with energetic Oprah disciple surgeon/author/TV personality Dr. Mehmet Oz. And it’s one thing to get feisty with another know-it-all physician but it’s quite another matter to annoy Ms. Winfrey.

I happen to like ole Mehmet and I appreciate his personalized, human approach; he connects with people the way I wish all physicians could.

But this time Doc Oz goofed up when he, in passing, carelessly cautioned folks regarding dental x-rays and a possible increased thyroid cancer risk. These days, lead protective aprons come with collars protecting the thyroid from radiation that’s a drop in the bucket compared to what we get from five-minutes of SoCal sunshine. One more thing, dentists can’t diagnose or treat disease without x-rays.

I visited Dr. Oz’ website to check out the “x-ray” interview. Something I found in the process was one of the most clearly written pieces I’ve seen on the importance of seeing the dentist.

Here’s the article (and of course, I’ve improved it without editing content.) I give you Dr. Oz:

“When you think of efforts that can stave off a heart attack or stroke, you don’t immediately zero in on your teeth and gums. But a growing body of evidence says that what goes on in your mouth could harm the health of your heart and beyond. Dodging the dentist can actually put your life at risk.

If the eyes are the window to your soul, then the mouth should be the door to your heart. Not just because it’s key to a loving kiss, a pretty smile and savoring a meal, but also because poor oral health can be the root cause of some serious health problems, including heart disease. Yet, many Americans, even those with good access to healthcare and insurance, don’t give oral care the attention it deserves. We bypass brushing, forgo the floss and dodge the dentist until there is a problem. Some adults have enough dental anxiety that they never set foot in a dentist’s office.

But research is unearthing evidence that says skipping mouth care is a dangerous strategy because what begins quietly at the gum line can later set off a chain of events that can lead to heart attack, memory loss, stroke and miscarriage. And of all the measures we know that can avert a potentially life-threatening disease, oral care is probably one the most effortless activities one can do.

Even a healthy mouth is home to bacteria. And bacteria love plaque because it is a particularly cozy environment in which to grow. As soon as plaque begins to build, bacteria colonize. And so begins the insidious infection we know as periodontal disease.

And periodontal disease not only impacts quality of life (cosmetically, nutritionally and socially), but also our overall health…and even length of life. The problem with chronic inflammatory diseases like periodontal disease is the assault can be relentless and when unchecked, the body doesn’t get a chance to recuperate. It’s in a perpetual defense mode.

The theory holds that the high load of inflammatory chemicals and leakage of bacteria into the bloodstream can wreak havoc elsewhere in the body. Researchers are finding chronic infection and inflammation can make blood vessels more favorable for the build-up of fatty deposits, and affect insulin resistance, blood clot formation and brain cell activity. Conditions linked to periodontal disease include heart disease and heart attack, stroke, diabetes, preterm birth, lung diseases, and, cancer of the blood, pancreas, tongue, lung and kidney.

Major risk factors for periodontal disease include genetic susceptibility (30% of the population), diabetes, medications (oral contraceptives, antidepressants, blood pressure drugs, and chemotherapy), autoimmune diseases (Rheumatoid arthritis, Crohn’s disease, and lupus), pregnancy, and poor diet.”

So please be responsible; live longer and better. Listen to Dr. Oz…and see your dentist.

*Evaluation and treatment of periodontal disease cannot be performed at a professional standard of care without dental x-rays.

Don’t know about you guys but for me, change is a difficult thing. And it’s clear to me some stuff just needs to stay (like your gums!)

Shucks, if it weren’t for the turnover nature of fitness operations, I’d still be going to the same ole gym I suffered through some 20 years ago. And even though I fire Singing Dental Assistant Kolleen 3-4 times a week, she’s been around for seven years and still taunts me almost every day with, “So you wanna fire me again huh; go ahead…make my day.”

Things come and go way too often to suit me. Yesterday, our power went out and Chase cut my limit on one card and offered me a new one all in the same day. Last weekend, I actually had a cordial golf conversation with my freakin nemesis, deposed USC Athletic Director Mike Garrett. If next week, I wind up hangin out on the range with Doc Ricky “wrath of” Kahn, you have my permission to use my nine-iron on me ala Tiger Woods’ soon-to-become ex-wife. Looks like the only change that’s comfy for me is hypocrisy for cryin out loud. Good thing I have the shifting pile of dirt aka The Piazza/Whatever to provide some solid stability.

On the relationship front, it’s been so bad that I’ve basically locked-down the revolving door. Office Manager (OM) Dalila is always saying I’m way too old and decrepit for a girlfriend (try elderly female companion), “Why not just put your AARP Platinum number on your Facebook Page; it might work better.” And yeah, OM Dalila has been around for 11 years; think I need another consultant (uh-oh, one more revolving door coming up.)

But I am not a victim. I am responsible. I get to choose my attitude and be the author of my own life story.

So here’s the thing, you need to be responsible too. Do not be a victim. You know why? The gums gotta stay!

If you’re reading this column, open a window and shout out loud, “I’M AS MAD AS HELL AND THE GUMS GOTTA STAY!!!” Okay, one more time.

One of my Fav Five resolutions for 2010 is to make loud fun of my buddy Mike Garrett’s uglier than cow-pie golf swing every time I have the courage to look at it up at Altadena GC’s driving range. Another is “being Estelle Getty fearless” (sometimes confused with being annoying or obnoxious; I’ve already mastered that skill set.)

So, if you have the common sense you were born with, find a way to drag your irresponsible, excuse-making, orally infected selves to the dentist and see a hygienist! Am I clear? Can you he-e-ear me? In the U.S., about 50% of the populace is not listening…and around 80% of ‘em have gum disease.

These days, if your teeth are fine but the gums gotta go you’re probably going with ‘em…about seven years ahead of schedule. Geez, and those coulda been seven consecutive PAC-10 titles, BCS bowls, and at least 11-win seasons; 3 Heisman Awards, and 2 National Championships…or seven years of watching your children grow up into their own parenthood.

Research provides strong evidence connecting oral infectious disease and inflammation with systemic challenges such as heart disease, lung disease, diabetes, and low-weight premature births (among many others.)

Chronic oral infectious disease is transmissible within the mouth and between individuals; the disease is managed much like hypertension and diabetes, not cured. And the disease can effectively be measured, monitored, and controlled.

You’ll never make a better investment than the investments applied to your health. If the investment is preventive it means you’re saving money while you preserve quality of life.

So let’s hear it one more time, “I’M GLAD AS HELL AND THE GUMS GOTTA STAY!!!”

Please make 2010 the year you invest in your health; there’s still time but the clock’s tickin’.

Whoopi Goldberg talks about her recent experience at the dentist caused by neglecting her teeth and how the health of your mouth is linked to your overall health.

So I probably haven’t gone more than two days in a row without doing some serious cardio exercise since I was just old enough to go out and play, locked and loaded with only my training wheels and a vivid imagination.

When you’re a kid, running around all the time comes naturally. And if you were growing up back in The Day like me, Sheriff John conducted the video games and they were called cartoons. Don’t know about you guys, but for me, the Mouse and the Duck wore out their welcome in about 15 minutes; Goofy was good for one toon and out. I needed to be outside; I had places to ride and people to antagonize. To this day, the only videos that will slow me down are shown on big screens.

My shingle had been hanging out here in Temple City for only about two months when I came home one night for Saturday dinner with my folks and saw my Dad die in a matter of minutes from a massive heart attack.

I’ll never forget that awful March 6; doubt I’ll ever really recover from it.

And I still love doing my cardio. Always privately thought exercise was my shield; my armor to stuff like heart disease and diabetes (both of which can be found in my family history.)

Even though Dental Assistant Extraordinaire Dani laughs at the mere mention of my ever having played basketball at any time since Naismith invented it, I played roundball almost every day of my life from age 12 to 30.

But approaching apprehensive patients with a handful of experience, power tools, and jammed fingers didn’t seem like the formula for inspiring confidence…or returned visits. So I took up tennis. My idol was John McEnroe.

McEnroe was a little guy and a world-class athlete…with a Universe-class mouth. He dictated the points with a great serve and volley game. He was creative and smart. He didn’t like practicing. He was a punk and he got away with it. I thought we had sooo much in common.

McEnroe’s nemesis and mine was Ivan Lendl. Lendl was mechanical, methodical, and relentless. He wasn’t as physically gifted as McEnroe but he was superbly conditioned. He had no visible personality and if he had ever smiled “train wreck” would have been the first words popping into your cabeza.

So I guess even though I wanted to be McEnroe, I was way more like Lendl. Right down to our cock-eyed teeth and increased risk of early age heart attack.

While I could hope to match McEnroe on the court as a world-class mouth, my athleticism has always been a distant cousin to my conditioning. I’ve always had to work hard and while I definitely have punk potential…I never seem to get away with it.

And until Temple City’s own Doc Fong won his Orthodontic Nobel Prize by unraveling my teeth, my computer Silent Hal had a more pleasing smile than either Ivan or me. As it turns out, Silent Hal was also at less risk for heart attack.

Crowded teeth turn out being safe havens for anaerobic bacteria, the most virulent microbes causing periodontal disease. And in a study published in Circulation, April of 2008, periodontal disease was associated with the incidence of fatal coronary heart disease among younger men, independent of any other cardiovascular risk factors.

The New England Journal of Medicine, March 2007, has also published research showing marked improvement in vascular function only 60 days following periodontal treatment.

Pink gums and straight teeth matter. And the stakes could be length and quality of life. Apparently, even if you’re young, a male, and in good shape.

My Mom and Dad both had diabetes. And I know having the disease wasn’t part of their plans. My experience helping out my parents has helped me in more ways than one; here’s a shot at passing it forward.

My Dad was diagnosed with diabetes at age 50; he had had no obvious symptoms. The elevated blood glucose level showed up in a blood test taken during a check-up. Dad immediately transformed his diet; couldn’t possibly have been more compliant. Never saw Dad drink another cold one; good thing he wasn’t allergic to salmon and vegetables.

When Mom was diagnosed with the disease in her late-70s; she had loads of symptoms. In a health care/gender role reversal, Mom almost had to be dragged to an appointment with a physician. By the time Mom finally agreed to a visit, we nearly had to carry her in.

Dad enjoyed going to the dentist the way I enjoy Bruin football. In fact, one story has it he once sneaked out of a waiting room on hearing some distressing sounds coming from some poor soul receiving dental care nearby…and no, it wasn’t my office. Dad died of a heart attack a couple of months after I opened my practice here in Temple City, just one year into his retirement. We never did get around to even an exam and x-rays.

My Mom loved going to the dentist. After an early debate over Mom’s vision of ideal painless care with no local anesthetic (a rare debate I actually won) and some early fillings, Mom pretty much cruised through the next 15 years or so with no cavities or gum problems.

Mom didn’t walk anywhere up until about age 75. She ran. Mom used the Diabetic Diet way before she’d ever heard of it. Dripping wet, my 5-foot tall Mom never weighed more than 100 pounds. Up until diabetes-related neuropathy, mini-strokes, and progressive kidney failure, Mom could have danced teenagers off the floor.

A diabetes symptom I happened to pick up during a dental check-up explained my finding Mom with a whopping totally out-of-character 13 cavities. The cavities had resulted from “dry mouth,” an oral condition common with diabetes.

An even more common oral condition is periodontal disease (or gum and bone disease.) It’s estimated that 80-90% of people with diabetes also suffer from periodontal disease. Diabetes has a major impact on the ability of small blood vessels to facilitate the flow of nutrients to and removal of waste from body tissue. The result is tissue that doesn’t effectively heal.

So it’s bad enough that periodontal disease is a leading cause of tooth loss. For diabetics, the worse news is periodontal disease makes controlling diabetes even more challenging. And I often wonder about my Dad’s periodontal risk. Could proper diagnosis, continuing care, and consistent monitoring of possible periodontal disease have made a difference?

The irony is both diseases have so much in common. Diabetes and periodontal disease are both chronic and episodic; they’re managed not cured. Both diseases have an insidious onset but can easily, painlessly be diagnosed by objective numbers; and both have been proven to be connected to other health challenges such as heart disease and stroke.

If you’ve been diagnosed with diabetes, seeing your dentist is a must. And as in my Mom’s case, 6.3 million Americans suffer from the disease without the benefit of a timely visit to a physician and a diagnosis.

Please be responsible and see your physician and dentist. The statistical consequences for unmanaged periodontal disease alone equal about seven years of life expectancy and untold years of life quality.

So just do the right thing.

So maybe I’m a little sensitive about another birthday, okay?  But what’s the big deal with questions like “Is this one special?” or “How old are you now anyway?”   I wanna know how my vital stats make a world-class difference for others?  And even if they did, what’s in it for me?

I’ll tell ya right now, if any of you are VP Cheney rude enough to ask, you’ll get a lie in response.  And it’s your own dang fault.  Any questions?

Sometimes nature has an over-underestimated sense of humor and there you have my long overdue tribute to President Dubya.  Yeah, if son of Big George and I were both 75, we’d look pretty good for our age.  But there are some telltale Nature jokes/subtleties that give us away and make our old beat-up classmates feel totally better about themselves.

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So here’s the thing; when DDS-types like me start yammering around in dentalese right in front of patients, that’s bad enough.  But when we minimize disease and then go extreme on describing the proper care, that’s just plain stupid.

I’ve seen the dentalese approach practically put folks into a deep trance.  Patients just sit there absently nodding with eyelids aflutter hoping somehow I’ll finally stop verbalizing so they can escape.  But these days my dental assistants do a good job keeping me on track (Singing Dental Assistant Kolleen just points to her watch while Dental Assistant Extraordinaire Dani prefers a more dramatic Sicilian hand gesture.)  And I guess if I hired on assistants to support me in every aspect of life I’d have more friends and fewer broken tennis rackets.  But I digress.

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