Connecting with Dr. Risbrudt, DDS

Wilckodontics, Accelerated Osteogenic Orthodontics (AOO), Surgically Facilitated Orthodontic Therapy (SFOT), TADs, Osteotomy, Corticotomy—Wow, what an array of terminology, and, for a dental consumer, it’s like navigating a minefield out there!

So, let’s review:  In a prior post I mentioned “The Four R’s” of consideration when looking to prevent money pit mouth.  Remove, Restore, Re-shape, Reposition.  (Take a look at “Got TMJ? Part VI, published 12/05/10) Orthodontics is all about Repositioning teeth, but with a host of advanced microsurgery techniques, the whole landscape is changing in terms of what can be accomplished with regard to function, appearance and long-term stability in a significantly shorter amount of treatment time.

One of the most frequent objections that prevents adults from doing adult orthodontics revolves around the length of time and embarrassment for treatment.  18-24 months just seems like an eternity for an adult to have hardware cemented to their teeth.  I get that!  I hear it often!!  Hey, I have had orthodontics three times in my life, so you won’t hear any argument from me!

Now, let’s be clear:  This kind of treatment can’t be done with a coupon out of the PennySaver–it’s going to take a team of astute practitioners:  Restorative dentist, surgeon and orthodontist.  Huge improvements can be made with the orthodontics, but some Restorative may need to be done, depending on the pre-existing conditions.  It’s all about experience and creativity!!

With economic conditions the way they are, it can be managed financially as well with good prior planning. That’s what we’re about here in this practice:  Comprehensive prior planning!!  That way, each step of the way is fitting in to the whole picture, and the financial part is wisely spent.  No surprises–no “do overs!”

The thing you need to know is this:  There is so much available for the discriminating dental consumer today!  If you have esthetic or functional problems that have been deemed rather hopeless or problematic in the past, it’s time to look again with a progressive, astute and informed practitioner!

Don’t get overwhelmed by what looks like an insurmountable problem!   How do you eat an elephant??  One bite at a time!!  The very first thing to do is: Make a diagnosis by finding a comprehensive-oriented dentist who’s not afraid to be the quarterback.

Food for thought!!!

THR

“The world we have created is a product of our thinking.  It cannot be changed without changing our thinking.” –Albert Einstein

Better think again!!  I love this story.  I’m going to summarize it, but it’s found in a book entitled: Space, Time and Medicine, by Larry Dossey, M.D.

A group of researchers were studying a diet high in fat and cholesterol on rabbits.  At the end of the study the rabbits were sacrificed and their arteries studied for the anticipated atherosclerotic deposits.

The results of the study should have been rather predictable, since it was known at the time from previous studies that a diet high in fat and cholesterol would regularly cause flagrant atherosclerosis in the arteries of rabbits.  But when a certain group of the test rabbits demonstrated atherosclerotic changes which were 60 percent less than that of the overall group, the investigators were astonished!

What happened?  After investigation an unplanned and unexplained variable was detected in the experiment.  Seems the group of rabbits with the 60% reduction were regularly petted, stroked and talked to by one of the investigators.

So, that couldn’t be it–or could it??  Was this mere coincidence??  Many bioscientists would have considered laughable the possibility that such rabbit-human interchanges could play a significant role in atherosclerotic vascular disease and would have passed over this possibility.

Long story short:  The study was repeated two more times to eliminate the possibility that petting and talking to one group of animals would have a positive effect.  The results?  The petted and talked-to group showed a 60% lower incidence of atherosclerosis–again.  Hello??!!

In an unexplained way, the human factor emerged.  Touching, petting, handling, and gentle talking emerged as a crucial element in the disease process from which a large segment of our population will die:  atherosclerosis.  *

Dis-ease–could it be rooted beyond the cellular and molecular level??  Surely the psyche can’t have anything to do with it!!  It bothers me that we look more and more to technology to tackle illness, largely ignoring matters of the psyche and the spirit.  Hence the doctor-patient relationships get minimized more and more each year in favor of more drugs, technology, etc. I think we’re missing something very important here, but culturally, we are set up to spend less and less time with patients and devote more time to high tech stuff that skips the ministering to the souls of people presenting for care.

Taking good care of people.  An old-fashioned notion?  I hope not!!  And, NOT on my watch!!

Something to think about!!

THR

*Space, Time and Medicine, by Larry Dossey, M.D., pp. 61, 62

You’ve probably figured out I’m a Mayo Brothers fan.  They epitomized to me what true professionalism should be.  They passed away in 1939, but some of their wisdom is timeless even today.

“Worry affects the circulation, the heart, the glands, the whole nervous system, and profoundly affects heart action. ”   Charles Mayo, MD

“Sometimes I wonder whether today we take sufficient care to make a thorough physical examination before our patient starts off on the round of the laboratories.”   Wm. J. Mayo, MD

“The highly scientific development of this mechanistic age has led perhaps to some loss in appreciation of the individuality of the patient and to trusting largely to the laboratories and outside agencies which tend to make the patient not the hub of the wheel, but a spoke.”  Wm. J. Mayo, MD

We’ve always felt that if we listen long enough and intently enough, each patient will make their own diagnosis.  Problem is, we’re in a hurry-up world!!  Taking adequate time to listen may seem counter-cultural to many of my colleagues, but in this practice as long as I’m vertical the patient will be the hub, not the spoke!!

Their creed with regard to mentoring other physicians:  Guidance without pampering; help without meddling.  We feel the same with the patients of this practice:  Mouths need not become money pits; guiding without the harness; knowing without needing to be right; setting free without wandering aimlessly……….How many doctors do you know who feel this way anymore?????????

Something to think about!!

THR

“Every year, it’s another grand!!  Seems like I never catch up on my dental work!  I’ve paid for the dentists sports car already!!”

Well, we covered a good deal of prevention in the series entitled:  “2-5 Minutes a Day….”, but let’s visit one of the biggest issues that many patients and dentists fail to appreciate that contribute to tooth decay or cavities.

Food habits!!! When something, (anything, healthy or not!) goes into your mouth, the body’s chemistry goes to work on it.  The pH (acidity for you non-chemistry folks) goes into the acid range to help preliminarily break down the food for the process of digestion in the stomach.  The pH of the saliva in your mouth stays acid for 30 miunutes after eating.  That’s fine, as long as food or drink doesn’t go in there for a few hours.  (Other than plain water, of course!)

Let’s say, however that a guy is sitting there at his desk with a can of soda that gets sipped on every few minutes.  The pH NEVER gets out of the acid range!  A guy could brush after bite/sip and still go on having cavities in an acid environment like that.  Make sense??  Acid (phosphoric and citric) in the soda + acid saliva = cavities!!

Frequent grazing on anything, healthy or not, will result in higher dental bills.  So, what to do?  Frequent smaller meals are in vogue these days for weight control and keeping energy levels at the maximum.  Frequent doesn’t mean, however, that there’s something constantly in the mouth all day.

Here’s the classic:  A long time patient, a registered nurse, had very little disease incidence over many years in the practice.  Suddenly, there were small cavities starting in numerous locations.  I immediately thought:  “A hidden food habit?”  I questioned her closely about any changes in diet, snacking, etc.  She denied it.  We scheduled our first visit to do some of the necessary restorative work.  When she came into the treatment room, she didn’t even say “Hi!”  She said:  “Prunes!”  “Prunes?”, I asked.  “It’s prunes!!  I took a job in a care center, and they have this big bowl of prunes for the residents to pick on, and I’ve been grazing on them all day every day!”  Get the point?  A small item, consumed on a regular basis in between meals, can ultimately cause significant dental problems.

Hidden sugars come in any number of forms: chewing gum, fruit leather, trail mix, breath mints, soda, tea/coffee with sugar, you get the drift….  How to minimize the damage?  Short of brushing and flossing after every bite, try rinsing with plain water.  At least the water will neutralize some of the effects of the higher acidity.

Time to examine your diet and food habits??

A word to the wise is:  Prevention!!

THR

” The body is not a home, but an inn, and that only briefly.” –Seneca

We get that!!  The economic conditions in this country may have affected your ability to do major treatment.  Pretty exasperating when you feel a measure of health slipping away! But in terms of return on investment right now, your health beats anything else out there, hands down!!  My advisors tell me that lots of investors are on the sidelines right now, waiting for a better day to be in the various financial markets.  One market with a very decent return at this time is health–what better way than to prevent future breakdown and increased dental costs later??  One thing is for sure:  Ignoring dental health needs ain’t gonna get any cheaper!!

So, what to do?  I don’t think any rational person wants a money pit mouth if they can help it.  With careful planning, we can help you plan and/or phase treatment at a rate that you can afford, so that you won’t be going backwards in the interim.

If it’s a new Mercedes or some other “goodie” you’re after, remember, it sits in the garage a good portion of the time.  Teeth are on duty 24/7. That’s different from a new car parked in the garage which only gets used a few hours each day–something to think about!!

It’s all about prevention and disease control.   (Read our series entitled: “2-5 Minutes a Day Can Save You Thou$ands in Dental Bills”)  How do you eat an elephant??  One bite at a time!!

Feels like you’ll never have an opportunity to address your problem, or you know someone in that condition?  Then please nominate them for our “Give Back A Smile” campaign.  (Our version of Extreme Makeover)  We will be doing dentistry for deserving individuals with limited means once a quarter in the New Year.  If you’d like to be considered, or know someone who really deserves it just because of who they are in terms of their contributions to others or due to some untimely luck, please do let us know.  Our latest nominee, for instance, was a lovely lady who is a missionary to Kenya.  Between our network of specialists and me, we were able to get her in shape to smile and chew again, despite a significant loss of a measure of dental health.  Heartwarming all the way around!!

Count your blessings and make it a healthy 2011 !!  THR

What’s wrong with being as thorough with teeth as medical health?  The mouth and oral cavity merely reflect what is going on elsewhere, it’s just that we can more easily access seeing what is going on through the mouth.  Beats me how folks can think of dentistry like the “tooth housing group.”  Completely separate from general health.  That’s one of the things I really like about being in dentistry–you can head off or diagnose bigger problems by giving a patient a “heads-up” when you see subtle changes taking place in oral health.

Maybe in the New Year a no-charge consultation might be a good first step to a more predictable dental future.  No harm, no foul, right??

“It is not the patients who should comply with their doctors’ demands, but doctors who should comply with their patients’ informed and considered desires.” –S. Holm

It’s not news to anyone that modern technology in both medicine and dentistry has come a long way.  I think about state of the art for implants, for instance, when we first started placing them in the 80′s compared to what they are now–Wow!!  We have computerized everything, from digital x-rays to CAD CAm milling of crowns, just to name a couple of things.  So–technology is great–what would we do without it??

Unfortunately, we have come to rely on technology for replacement of God-made parts so much, that we have failed to spend much time on preventing the need for many of these procedures in the first place. Prevention is infinitely cheaper in terms of dollars.  The problem seems to be injecting the time commitments that it takes into busy lifestyles.  We need time to exercise, to relax, to meditate.  Time to actually prepare or consume healthy kinds of foods.  Time to floss our teeth, irrigate the gums, watch our snacking, etc., etc.

Tooth decay is simply a matter of watching the frequency of intake of sugar or any kind of carbohydrate, refined or not,  in the diet.  Oversimplification, you say??  I don’t think so!!

Every time the teeth are exposed to any kind of food, soda, snack, chewing gum, etc. the pH or aciditiy of the mouth changes.  For the next 30 minutes the mouth becomes highly acid, preparing the food for the digestive process.  If something is going in there all day long, the mouth never returns to a more normal pH, and cavities are inevitable.  That’s why I cringe when I meet a new patient who’s in the food preparation business.  They have to “piece” or snack all day, and their teeth are usually a liability–a money pit mouth, as it were.

Frequency can be something as innocuous as sipping a diet soda on the desk all day, tea with honey, raisins, chips, crackers, etc.  Even so-called healthy stuff.  It’s frequency that catches up to us.  So best have six smaller meals a day than to snack or piece all day if we want to control dental repair costs.

Hate to rain on your parade, but that’s the way it is.  You can’t change the laws of chemistry and physiological chemistry.

Hate to rain on your parade.  New Year’s resolution, anyone??

THR

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Blessed are the available.

Blessed are the conduits, the tunnels, the tools.

Deliriously joyful are the ones who believe

that if God has used sticks and rocks to do His will,

then He can use us.*

Merry Christmas!–

Doctor R. and staff

*From: The Applause of Heaven, by Max Lucado

I was 30 years old when my Dad died just short of his 60th birthday.  That really got my attention!!  Our son was just two years old, and Grandpa Risbrudt had seen him but twice in his young life.  I felt a huge loss as you can imagine, but when our daughter was born three years later, the first girl in the Risbrudt family in 60+ years, you can imagine the huge disappointment that Grandpa was not around to celebrate.  I resolved that I’d be a grandfather to my grandkids when that time came, God willing.  This chain of events necessitated some lifestyle changes if I was to be around for my grandchildren, and therein started my odyssey in studying whole person health, nutrition and preventive medicine.

I now have four grandchildren, and what a blessing!!  Not just the fact that I have grandkids, but that I have my health to enjoy watching them grow up.    For example, last week-end, two of them advanced in their respective soccer leagues to the finals.  I got to watch both of them play in championship games for all the marbles.  What fun!!  (Our granddaughter, 10, finished an undefeated season and the division championship, our grandson, 7, had to settle for runner-up in his league, losing 1-0 in a heart-breaker. )  a 12-hour day, with each of them playing two matches–what a happy time of non-stop activity!

After making dietary changes when Dad died, our next project was to help our kids battle illness in a more natural way.  This came about when our then 5-year old son was about to start a third round of antibiotics for chronic colds and sinus problems.  We had met a naturopath that we respected, and he acquainted us with food sensitivities, and homeopathic means of combating illness, and we were off and running into alternative health.  I’ve spent the last 35 years getting to understand more and more about the immune system, what riles it up, and what nourishes and supports it.

So….yes, I’m into nutrition!  And yes, I believe nutrition is a significant factor, not only for dental health but for systemic health.  I don’t want to be repetitious, so I’ll refer you to our website to read my story about my decision to choose dentistry over medicine.  (www.drrisbrudt.com)  That doesn’t diminish my fascination with medicine, and how a person’s general health is often reflected in their oral health.

Nutrition becomes a significant cornerstone in our concept of prevention of dental disease.  The best dentistry is NO dentistry!!  Think about it!  Unblemished teeth, healthy pink gums, and viable bone represent God’s perfection.  It’s pretty arrogant of me to think I can improve on that.  If you can stewardship that , so much the better.  On the other hand, we live in a fallen world–we get that, so it’s our job to help you pick up the pieces and move on, hopefully to a more predictable future.  It’s about accountability, NOT judgement!!

Something to think about!!

THR

“Every man desires to live long, but no man would be old.” –Jonathan Swift

My team and I recently attended a seminar given by a periodontist (Gum Specialist) who was the immediate past president of the American Academy of Periodontics, the premier professional association for periodontists.  Among the profound statements he made was that the important thing about using floss or any other cleaning aid was that the end result was to “clean the spaces” between the teeth.  If you’re handy with floss that’s great.   Floss is still the gold standard, but it requires patience and finesse.  Cracks me up to occasionally see “clefts” or “notches” in the gum tissue around teeth when folks come in for their cleaning visits.  Usually it indicates zealously going after the floss for the few days before the cleaning, in order to avoid a lecture from the “Hygiene Nazi.”   Kinda like avoiding all “bad” foods for a few days before having your blood test for lipids and cholesterol.  I can still remember as a kid having some cavities diagnosed, and brushing like crazy before that first appointment for repair, hoping against hope that the dentist would find that there was no need to fill those teeth after all.  (Just cuz I’m a dentist doesn’t mean I’m not human!! )  What makes that kind of ambivalence, anyway?  We know what we should do, but we don’t do it consistently.  Sounds like a subject for a future blog to me!!

Let’s get something straight about this practice:  We learned a long time ago that there is very little evidence for the belief that people will change if you can just make them feel bad (scared, ashamed, humiliated) enough.  To the contrary, empathy is a whole lot more effective.  It’s a busy world!!   (I invite you to be looking for a blog that I have entitled:  “Spiritual Aspects of Health-Centered Dentistry.” We’ll be talking all about this “saving harsh judgement” kind of thing that the profession seems to have a reputation for in that series.) But, I digress………

Many of our male patients find that it’s not easy to use floss with big hands, so they sheepishly let us know that they (Gasp!) don’t floss.   Hey, it’s OK!!  Since our mission is to clean the spaces between teeth, whatever it takes!!  There are a lot of tools available for effectively cleaning spaces between teeth.   We’re glad to share these with you.  If there is something you want to know more about, indicate it in the “comments” box at the end of this post.  While you’re at it, how about sharing a “Hygiene Nazi” story??  I’m sure we can all get a laugh out of some of those stories!!

THR

“The search for truth and beauty is a sphere in which we are permitted to stay children all our lives.” –Albert Einstein