Dentists Find Ways to Balance Family Life, Career

In California, half of all children have two working parents. Not surprisingly, as dentists become new moms and dads, few quit the profession to stay at home. Instead, the balancing act begins.

Just how well-suited is a dental career to juggling parenting? And, is there time leftover for a mate, let alone oneself?

"I went into dentistry thinking it would be more flexible," Ariane Terlet, DDS, Berkeley, Calif., begins. "Obviously, you can set your own schedule, but you are responsible to pay the bills. Ultimately, what determines how much work you do is the bottom line."

Judee Tippet-Whyte, DDS, of Stockton, Calif. (children ages 6, 9, and 13), thinks dentistry isn’t much different than other careers when it comes to the balancing act.

"As your own boss, you’re flexible to work as many hours as you want, but it’s less flexible if a girlfriend plans a last-minute birthday lunch. You can’t sneak away without disrupting the patient’s schedule, who made arrangements for time off of work." Tippet-Whyte works four 10-hour days per week.

Cynthia Brattesani, DDS, San Francisco, finds dentistry ideal for parenting her 3-year-old as she was able to arrange her patient schedule to a comfortable three days a week.

But who does the cooking and cleaning in such a household?

"Whoever gets home first starts dinner," explains Terlet, who works full-time. As for housework, the babysitter does laundry, vacuums, and cleans the bathroom. "I won’t give up my sleep to have a spotless house. We’d rather spend our free time with our children (ages 3, 12, and 13) instead of doing dusting that no one will see."

When her kids (age 10 and 13) are with their friends or dad on the weekends, Debra Finney, DDS, of Folsom, Calif., catches up on the housecleaning. And luckily, her new husband helps in all aspects of household duties and doesn’t have strict culinary demands.

"McDonald’s does more cooking than I’d like to admit. If it isn’t microwaveable, it’s not in our house," Finney says.

Finding time to sustain a marriage, and a scrap of time now and then for oneself is the ultimate challenge with a career and one or more children to raise.

In Parenting magazine, the August 2001 feature, "The Marriage Factor," listed tips for maintaining a love life. Among them:

* Make rest a priority. Less housework and phone time, more naps and use of answering machines.

* Work in time to work out. Even a daily walk clears the mind, and increases energy.

* Get away from the kids. Swap babysitting with a friend, use family or pay a sitter to have alone time.

Although most parents don’t get to spend a day for themselves weekly, they probably should take an hour a day to "recharge the batteries." Going to the gym, meeting one’s mate or friends for lunch, or reading dental journals at a café works. Realistically for many, however, commuting time is all they can "steal away" for themselves.

In addition to the logistics of day-to-day responsibilities, the working dentist occasionally has other issues to contend with -- such as illness.

When the flu strikes and there isn’t another dentist to cover, appointments must be canceled. When a child gets ill suddenly, if someone isn’t available to help out, desperate times call for desperate measures. Finney has brought her kids to the office. Terlet, too, has had to bring her kids to the office when they were sent home sick from school.

"Even though they are in back, patients are sometimes concerned they will catch whatever the kids have," Terlet explains. One patient of hers, disgruntled because her child’s illness delayed his appointment, wrote a complaint letter.

"His letter began, ‘I understand the plight of the working mother, however …’ but really he didn’t have a clue."

"Remember to spend more time making a life than making a living," Terlet advises. "I have seen many people put their practices first, and you can’t do that for too long or you won’t have a family left by the time you want to interact with them."

New JADA Editor Named

Marjorie K. Jeffcoat, DMD, a renowned dental researcher, will be the next editor of the Journal of the American Dental Association. A 1976 graduate of the Harvard School of Dental Medicine and immediate past president of the International Association of Dental Research, Jeffcoat will be the first woman to hold the JADA editorship.

Jeffcoat was formerly chair of the Department of Periodontics at the University of Alabama School of Dentistry in Birmingham. She is set to begin working with current editor Lawrence H. Meskin, DDS, this month. He will officially step down on Dec. 31.

A widely published author, Jeffcoat most recently has been exploring the link between oral infection and systemic disease. She is a long-time member of the JADA Editorial Board and a frequent contributor to the publication.

New Books Offer Guidelines for Evidence-Based Medicine

The AMA Press in conjunction with the editors of the Journal of the American Medical Association have released two new books that provide clinicians with a solid foundation and quick reference for understanding and applying evidence-based medicine.

Users’ Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice and Users’ Guides to the Medical Literature: Essentials of Evidence-Based Practice were edited by the physicians who coined the term evidence-based medicine and include contributions from more than 50 of the most renowned evidence-based medicine educators and practitioners worldwide.

"The original medical literature has become part of the essential landscape of clinical practice," says Dr. Gordon Guyatt, professor of medicine and clinical epidemiology and biostatistics and medicine at McMaster University and co-editor of the Users’ Guides. "The Users’ Guides provide the compass that can first orient the clinician and ultimately provide an in-depth understanding of the topography."

These detailed, clinician-friendly guides offer tips, examples, and thorough explanations of the concepts necessary for clinicians who wish to use information in the medical literature to more effectively treat their patients and provide the tools necessary for a thorough understanding of the principles of evidence-based medicine.

"These resources put the practitioner in charge of the single biggest resource they have -- the medical literature," says Dr. Drummond Rennie, deputy editor of JAMA and co-editor of the Users’ Guides. "The literature is already overwhelming and growing daily, getting control over the literature, and using it to help patients, presents the clinician with an apparently insuperable problem."

The Users’ Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice covers what every practicing physician, resident, and student needs to know about reading and applying medical literature to improve the care of patients.

Users’ Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice is a condensed version of the manual. The paperback-sized Essentials can fit easily into clinicians’ pockets and offers a concise yet thorough introduction to evidence-based medicine.

To order a copy of either Users’ Guides, call (800) 621-8335 or order online at http://www.amapress.com. Refer to order number OP427700 for the manual and order number OP740001 for Essentials.

New System Will Monitor U.S. Blood Supply

Health and Human Services Secretary Tommy G. Thompson recently announced that a new "real time" monitoring network is being launched to measure the blood supply in key local areas, regions, and nationwide.

The new system will receive daily reports from selected hospitals and will measure current demand as well as supply on hand, giving hospitals and blood suppliers a more useful picture of supplies and possible emerging problems.

"Our nation’s blood supply network needs good, current information if it is to operate with maximum effectiveness," Thompson said. "This new system will be unlike anything we’ve had before in providing widely available, real-time information on both supply and demand for blood and blood products."

The system is to include 29 hospitals, which will provide their daily reports to the Department of Health and Human Services. Exact plans for compiling and sharing the information will be developed over the coming weeks as the information begins to be provided. Ultimately, the department plans to make the information available on a public Web site.

"The Web site will provide easy access to the information for all interested health care providers and blood collection agencies, and we hope it will also help raise awareness in the public of the always-important need for blood donation," Thompson said.

The new system is being implemented at a cost of about $350,000 per year.

Study Gives Glimpse of Human Painkiller System

A unique study that looked at chemical activity in the brains of human volunteers while they experienced sustained jaw pain and reported how they felt is providing new insights into the importance of the body’s natural painkiller system -- and the reasons each person experiences pain differently.

The results confirm long-suspected connections between pain-dampening changes in brain chemistry and the senses and emotions experienced by people in pain. The findings may help researchers better understand prolonged pain and find more effective ways to relieve it.

Results from the brain imaging study were published in the July 13 issue of Science by National Institute of Dental and Craniofacial Research-supported researchers from the University of Michigan Health System and School of Dentistry. It is the first study to combine sustained, induced pain with simultaneous brain scan monitoring of a key neurochemical system and the self-reported pain ratings of human participants.

The research cements the critical role of the mu opioid system, in which naturally produced endorphins match up with receptors on the surface of brain cells and reduce or block the spread of pain messages from the body through the brain. The mu opioid receptor in particular has been found to be a major target for both the body’s own painkillers, as well as for drugs such as heroin, morphine, methadone, synthetic pain medications and anesthetics, which also numb pain.

The study found that the onset and slow release of jaw muscle pain over 20 minutes caused a surge in the release of the chemicals. It also found that the flood of those chemicals coincided with a reduction in the amount of pain and pain-related emotions the volunteers said they felt. Specific brain regions, especially those already known to play a role in affective, or emotional, responses, and those known to help process signals from the body’s sensory systems, had the biggest increase in the level of opioids when pain was introduced.

The research also revealed major variation among volunteers in the baseline and pain-induced levels of opioids.

"This result gives us new appreciation for the power of our brain’s own anti-pain system, and shows how brain chemistry regulates sensory and emotional experiences," says lead author Jon-Kar Zubieta, MD, PhD, assistant professor of psychiatry and radiology at the University of Michigan Medical School and assistant research scientist in the Mental Health Research Institute.

Diet and Exercise Dramatically Delay Type 2 Diabetes

At least 10 million Americans at high risk for type 2 diabetes can sharply lower their chances of getting the disease with diet and exercise, according to the findings of a major clinical trial announced at the National Institutes of Health.

"In view of the rapidly rising rates of obesity and diabetes in America, this good news couldn’t come at a better time," said Health and Human Services Secretary Tommy G. Thompson. "So many of our health problems can be avoided through diet, exercise, and making sure we take care of ourselves. By promoting healthy lifestyles, we can improve the quality of life for all Americans and reduce health care costs dramatically."

The same study found that treatment with the oral diabetes drug metformin (Glucophage) also reduces diabetes risk, though less dramatically, in people at high risk for type 2 diabetes.

Participants randomly assigned to intensive lifestyle intervention reduced their risk of getting type 2 diabetes by 58 percent. On average, this group maintained their physical activity at 30 minutes per day, usually with walking or other moderate intensity exercise, and lost 5-7 percent of their body weight. Participants randomized to treatment with metformin reduced their risk of getting type 2 diabetes by 31 percent.

The findings came from the Diabetes Prevention Program, a major clinical trial comparing diet and exercise to treatment with metformin in 3,234 people with impaired glucose tolerance, a condition that often precedes diabetes.

Honors

Jack S. Broussard, Jr., DDS, has been named University of California at Los Angeles Alumnus of the Year for 2001. Broussard, who is currently president of the California Dental Association, will formally receive the honor Nov. 3.

Ronald S. Mito, DDS, has received a $5,000 grant from the Foundation of the Pierre Fauchard Academy to support indigent care at the Wilson-Jennings-Bloomfield UCLA Venice Dental Center. Mito is a professor and associate dean at the UCLA School of Dentistry.

Glenn T. Clark, DDS, MS, has received the Pierre Robin Academic Award from the Academy of Dental Sleep Medicine. Clark is professor and section chair of oral medicine and oral facial pain at UCLA School of Dentistry. He is a clinical professor at the University of Southern California School of Dentistry, where he teaches the course in chronic orofacial pain.

Liviu Eftimie, DDS, has received a Certificate of Recognition for Volunteer Service in a Foreign Country from the American Dental Association.

Lee Nelson Wiggins, DDS, has received a Certificate of Recognition for Volunteer Service in a Foreign Country from the American Dental Association for service in Cambodia, China, and Ghana.

Joel M. White, DDS, MS, is the recently inducted president-elect of the Academy of Laser Dentistry. White is professor and chair of the Department of Restorative Dentistry at the University of California at San Francisco.

The University of Southern California School of Dentistry has been reorganized and has made several new appointments as follows:

Michael J. Mulvehill, III, DDS, is co-chair of the new Division of Primary Oral Health Care.

Mahvash Navazesh, DMD, leads the new Division of Diagnostic Sciences.

Roseann Mulligan, DDS, serves as chair of the new Division of Health Promotion, Disease Prevention, and Epidemiology.

Robert Gerald Keim, DDS, directs the new Office of Advanced Specialty Education.

Upcoming Meetings

2001

Sept. 27-Oct. 1 FDI World Dental Congress, + 44 207 935 7852, www.fdi.org.uk

Sept. 30-Oct. 3 Pacific Coast Society of Orthodontists Annual Session, Honolulu, (800) 445-8667

Oct. 5-7 Hispanic Dental Association Annual Meeting, Philadelphia, (800) 852-7921

Oct. 6-10 American Academy of Periodontology Annual Meeting, Philadelphia, (312) 573-3210

Oct. 13-17 ADA Annual Session, Kansas City, (312) 440-2500.

Nov.3 Association of Managed Care Dentists Annual Meeting, Los Angeles, (310) 453-3439. www.amcd.org

Nov. 4-10 U.S. Dental Tennis Association Annual Meeting, Palm Desert, Calif., (800) 445-2524

2002

April 4-7 CDA Scientific Session, Anaheim, (916) 443-3382, Ext. 4470

April 12-14 International Dental Exhibition and Meeting, Singapore, 212 -974-8835, www.idem2002.com

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

Oct. 19-23 ADA Annual Session, New Orleans, (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.