Dr. Von Bulow's Articles

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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