Speaker Suggests Clowning Around in the Office

If you’re cruising down the highway and see a woman driving beside you wearing a red foam clown nose, it may be Fall Scientific Session speaker Christine Holton-Cashen. No, she’s not late for her next circus appearance; she just believes in making people smile.

"People have a need for stress relief now more than ever before," she explained. "It’s impossible to feel stressed out or angry while wearing a clown nose."

An award-winning speaker, Holton-Cashen will give two presentations at the fall Session on how dentists can incorporate humor into the workplace and how it aids overall office productivity and harmony.

"It’s amazing how many people are terrified to see the dentist," she said. "When a dentist has a good sense of humor, it trickles down. The staff is happy and it creates a fun atmosphere, which the patients can sense."

Holton-Cashen told of a dentist’s office that had a poster on an operatory wall of the Three Stooges with Curly and Larry pulling Moe’s tooth. Another dentist would sit down and greet his patient wearing big goofy glasses and say, "Let’s have a look in here. Oops, these are my reading glasses."

Humor comes naturally to Holton-Cashen, since she grew up in a self-proclaimed "family of lunatics." As part of a large Italian family where humor was mandatory, she was shocked when she moved out into the world and found how serious most people are.

"It scared me," she confesses.

She said she feels that, especially in the workplace, people have lost their sense of humor.

Although Holton-Cashen is a natural at tickling funny bones, she said that it is a skill anyone can acquire.

"It’s possible to be humorous and light-hearted, even if it’s not in your nature," she said. "People don’t try it because it’s a bit of a risk, but the benefits are on many levels."

"It doesn’t have to be anything major," she added. "Humor is not about telling jokes. You can be childlike without being childish. It’s a matter of looking at things a different way. It’s keeping your stress gauge on low and your fun gauge on high."

In her presentations, Holton-Cashen’s goal is to get everyone laughing to the point of tears. She explained that the endorphin release that accompanies a good belly laugh brings on a feeling of calm and relaxation. She also gives 20 humor triggers, or specific things you can do to elicit a smile.

These techniques include keeping a Smile File, making a Good Mood Commitment, and going on a Secret Mission. The Smile File can be filled with patients’ thank-you cards and notes, and even letters you’ve written to yourself.

"I encourage people to send themselves a postcard every time they go on vacation telling about what they’ve done and closing with ‘Wish you were here.’ I call it a mini mental vacation. You can even feel the sand between your toes."

Her Good Mood Commitment challenges people to commit to saying they are in a good mood for the first two hours of every day. She said that you have to make a conscious effort not to be brought down by co-worker’s complaints, and to tell everyone who asks that you are in a good mood.

"Your brain is like a computer, and it is programmed by the things you say," she explained. "Even if you are feeling lousy, just fake it. Those two hours will set your mood for the rest of the day because you’ve created it as such."

The Secret Mission technique works particularly well when an office staff member is stressed out or aggravated by a difficult patient. Holton-Cashen suggests you carry a file or something in your hand so that you look busy, or like you are on a mission. Take two minutes and walk around briskly, even though you have nowhere to go.

"Shifting from mental to physical makes a big difference," she explained. "Act very serious, like you have something important on your mind, even though it’ll make you laugh on the inside. I call it a two-minute stress buster."

At the upcoming Scientific Session in San Francisco, her first talk, titled "Got Humor? Get Calcium for Your Funny Bone!" will be held on Saturday, Sept. 28, from 9:30 a.m. to noon. It focuses on how humor can enhance brainstorming, increase job satisfaction, create higher productivity, and improve relationships.

Her second talk is from 2 to 4:30 p.m. the same day and is called "Why Can’t Everybody Just Get Along?" During this course, attendees will learn the secrets to defuse anyone in any situation, maintain emotional control, and find the perfect words for any discussion.

Holton-Cashen runs her own business, A Dynamic Speaker, and gives talks all over the United States, as well as Canada, South Africa, and Australia. She is a member of the National Speakers Association and holds a bachelor’s degree in communication and a master’s degree in adult education.

More American Children Have Health Coverage

A new Health and Human Services report shows that American children are significantly more likely to have health insurance today than in 1997, when the State Children’s Health Insurance Program was enacted.

In 2001, 10.8 percent of American children did not have health coverage, down from 13.9 percent in 1997, according to the new report from the HHS’s Centers for Disease Control and Prevention. During that period, the number of children without health insurance fell from 9.9 million to 7.8 million. This 21 percent reduction occurred as HHS worked to establish programs in every state to expand health coverage to uninsured children.

"This report shows that governors have turned SCHIP into a genuine success story, with healthier children all across America. Still, we know we must do more," HHS Secretary Tommy G. Thompson said. "We have given governors more flexibility to use SCHIP to expand coverage in their states. We’ve also asked Congress to give states more time to use unspent SCHIP funds so we can build on our successes in getting children health coverage."

SCHIP is a state and federal partnership designed to help children without health insurance, many of whom come from working families with incomes too high to qualify for Medicaid but too low to afford private health insurance. According to state figures, about 4.6 million children received health coverage through SCHIP at some point in fiscal year 2001. SCHIP plans operate in all 50 states, five territories and the District of Columbia.

Researchers Identify First Case of Periodontitis in Marfan’s Syndrome Patient

Researchers from the Eastman Dental Institute at the University College in London identified the first case of severe periodontitis in a person with Marfan’s Syndrome, a rare heredity disorder that causes connective tissues to be weaker than normal. The case report is published in the July issue of the Journal of Periodontology.

"Reports of oral findings in Marfan’s syndrome patients have focused mainly on skeletal abnormalities. This case is notable since the detected periodontal breakdown was severe and could be only partly explained by known risk factors, such as cigarette smoking and inadequate oral hygiene," said Maurizio Tonetti, DMD, PhD, professor and chair of the Department of Periodontology at the University College London. "It also supports our hypothesis that a variety of connective tissue disorders may increase susceptibility to periodontal tissue breakdown."

An oral examination determined the 41-year-old patient had swollen and receding gums, severe periodontal ligament attachment loss on all teeth, and bleeding gums at 76 percent of the areas examined. The patient had no family history of periodontitis.

"It is important to note that this case report does not show a causal relationship between Marfan’s syndrome and periodontal diseases," said Kenneth Bueltmann, DDS, president of the American Academy of Periodontology. "More research needs to be conducted to determine if there is an association between the diseases."

However, Tonetti recommends that Marfan patients follow a preventive oral program based on professional tooth cleaning and daily brushing and flossing, and that they receive regular screenings by a periodontist.

Marfan syndrome is a heritable disorder of the connective tissue that affects many organ systems, including the skeleton, lungs, eyes, heart, and blood vessels. The condition affects both men and women of any race or ethnic group. Scientists estimate that as many as 1 million people in the United States may have a heritable disorder of connective tissue, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Sensitivity to Culture Important Part of Providing Care

With new immigrant groups flocking to the United States each year, it becomes more challenging and important for health care professionals to be sensitive to cultural and religious traditions while still providing optimal care, Julie A. Brow wrote in the May/June 2002 issue of the Dental Assistant.

Dentists and their staffs must work together to ensure that patients feel understood and respected, Brow said. One of the most common complaints of patients is that no one listens to them anymore. By listening to patients, dentists can learn valuable information that can alleviate cultural conflicts that may arise over the course of treatment.

Sometimes listening is not enough, Brow said, and other tools must be used. In some instances, patients will cite religious reasons for not having a procedure done, but those reasons may turn out to be erroneous and show a lack of understanding of their own religious doctrine. Brow said it is important to be respectful and nonjudgmental when confronted with this possibility and for the dentist to ask if he or she might speak with the patient’s religious leader on the patient’s behalf.

Another key component to providing good patient care to a culturally diverse population is being proactive and learning as much as possible about the cultural heritage, beliefs, and customs of patients. Brow said misunderstanding other customs can create a breach of the trust needed between a patient and dentist for effective care.

Fixing Fillings the Natural Way

Researchers at the University of Texas Health Science Center at San Antonio have identified specialized protein cytokines that stimulate odontoblasts.

Mary MacDougall, PhD, associate dean for research and professor of pediatric dentistry and H. Ralph Rawls, PhD, professor of biomaterials in the Department of Restorative Dentistry, have developed a liquid "carrier" system to deliver the cytokines to the site of a cavity, reports an article in the June 2002 The Mission, publication of UTHSC.

They noted that the usual filling materials, amalgam or tooth-colored composites, are not perfect solutions; and the liquid carrier system helps preserve the cytokines and stimulates dentin formation.

Rawls said tertiary dentin is the tooth’s own natural defense mechanism, and over time a tooth will naturally produce tertiary dentin, which forms a barrier against bacteria leaking into the pulp.

"Stimulating this natural repair mechanism is the first step toward being able to replace part of the tooth with its own natural material," Rawls said.

"This is the body’s own natural process," MacDougall said, "We are just enhancing it."

Associate Buy-ins a Viable Option for New Dentists

Although associate buy-ins are more complex than outright practice purchases and sometimes result in the associate not buying into the practice, the associate buy-in remains a viable option for many new dentists, wrote Larry R. Domer, MBA, in the spring 2002 issue of New Dentist.

Domer defined an associate buy-in as a transition strategy that includes a formal associateship phase followed by the associate purchasing a portion of the practice. An associate buy-in implies that the associate and practice owner will become co-owners of the practice.

Domer said that an associate buy-in differs from a simple associateship because of the intent of the parties: that the associate dentist eventually becomes a co-owner of the practice.

An important advantage of an associate buy-in is that it provides a trial period for both the associate and the owner. According to Domer, this trial period provides the owner with first-hand information concerning the associates’s clinical capabilities, philosophy of practice, management skills, and compatibility with patients and community.

Another advantage of a buy-in for an owner dentist is that it allows the owner to begin phasing out of practice, reducing the number of days practiced per week, while retaining control of the practice. Domer said a buy-in also helps to preserve the value of the practice during the phase-out process.

Another advantage of the buy-in is that the arrangement can provide security and comfort for the owner dentist and family as well as the associate. Domer said there is usually a buy-sell agreement between the associate and the owner (and later the co-owners) that provides for the mandatory sale of the practice, or portion of it, to the associate or new partial owner in the event of permanent disability or death of the original owner.

In some cases, Domer wrote, a practice is too large or too unusual for a new dentist to purchase or for a senior dentist to sell outright to one dentist. An associate buy-in may be the only way an owner can sell a large general practice or specialty practice. And, Domer said, it may be the only way a new dentists can finance and learn to run a large practice before full ownership.

Jigsaw Puzzles A Guide to Life

Everything I needed to know about life, I learned from a jigsaw puzzle, wrote editor Jeffrey B. Dalin, DDS, in St. Louis Dentistry, June/July 2002.

* Don’t force a fit. If something is meant to be, it will come together naturally.

* When things aren’t going so well, take a break. Everything will look different when you return.

* Be sure to look at the big picture. Getting hung up on the little pieces only leads to frustration.

* Perseverance pays off. Every important puzzle went together bit by bit, piece by piece.

* When one spot stops working, move to another. But be sure to come back later.

* The creator of the puzzle gave you the picture as a guidebook.

* Variety is the spice of life. It’s the different colors and patterns that make the puzzle interesting.

* Working together with friends and family makes any task fun.

* Establish the border first. Boundaries give a sense of security and order.

* Don’t be afraid to try different combinations. Some matches are surprising.

* Take time to celebrate your successes ... even little ones.

* Anything worth doing takes time and effort. A great puzzle can’t be rushed.

Modified Yogurt Bacterium Works Against Tooth Decay

Researchers have genetically modified a common bacterium found in yogurt to fight the Streptococcus mutans bacterium that can cause tooth decay, the Karolinska Institute in Stockholm reported.

According to a report in Nature Biotechnology, researchers modified the Lactobacillus zeae bacterium, which is responsible for the fermentation process in dairy products, to carry an antibody against S. mutans. They said the antibody works by sticking to the S. mutans molecule that normally sticks to teeth, causing the two species to clump together and go harmlessly down the throat.

In a trial using laboratory rats, animals whose mouths were swabbed with the modified bacteria showed a sharp reduction in S. mutans in the mouth and developed fewer cavities compared with untreated animals. The researchers believe the antibody might also have the secondary effect of killing the streptococcus bacteria with the lactic acid the lactobacilli produce.

The Karolinska team is also investigating how to modify the lactobacilli bacteria with antibodies to work against a range of infectious agents including rotavirus and helicobacter, agents that cause severe diarrhea and stomach ulcers.

Correction

Scott Jacks, DDS, was incorrectly referred to as a general dentist in the July 2002 issue of the Journal. Jacks is a pediatric dentist.

Honors

John C. Greene, DMD, of San Rafael, has been chosen to receive the Oral Health America Tuttle Award for leadership in spit tobacco education and prevention.

Theodore T. Fortier, DDS, was recently appointed as commissioner to a second term on the West Vector Control Board, an Los Angeles County Agency. PHOTO

Upcoming Meetings

2002

Sept. 25-28 Academy of Periodontology’s 8th Annual Meeting, New Orleans, www.perio.org.

Sept. 26-28 American Society for Dental Aesthetics, 26th International Conference on Aesthetic Dentistry, Las Vegas, (813) 264-2772, www.asdatoday.com.

Sept. 27-29 CDA Scientific Session, San Francisco, (916) 443-3382, Ext. 4470.

Oct. 7-11 Comprehensive Dental Infection Control Course, Annapolis, MD, 800-298-OSAP

Oct. 11-13 National Association of Filipino Dentists in America Annual Meeting, San Francisco, (818) 988-3910.

Oct. 19-23 ADA Annual Session, New Orleans, (312) 440-2500.

Nov. 2 Association of Managed Care Dentists, Los Angeles, (310) 453-3439, www.amcd.org

Nov. 3-9 United States Dental Tennis Association Annual Meeting, Palm Desert, Calif., (800) 445-2524.

Nov. 6-9, American College of Prosthodontists’ Annual Session, Orlando, (312) 573-1260

Nov. 7-9, Excellence in Dentistry, Las Vegas, (800) 337-8467.

2003

April 24-27 CDA Spring Scientific Session, Anaheim, Calif., (916) 443-3382, Ext. 4470.

April 29-May 4 19th Annual American Academy of Cosmetic Dentistry Scientific Session, Orlando, Fla., (800) 543-9220, www.aacd.com

June 19-22 OSAP 2003 Symposium, Tucson, Ariz., 800-298-OSAP

Oct. 25-29, ADA Annual Session, San Francisco, (312) 440-2500.

To have a meeting included on this list, please send the information to Upcoming Meetings, CDA Journal, P.O. Box 13749, Sacramento, CA 95853 or fax the information to (916) 443-2943.