Ancient Remedies Still Effective, Again

After long being ignored by Western medicine, ancient systems of treatment and healing again are coming of age and are being embraced by some medical institutions and practitioners. Some experts believe that dental professionals, subject to specialized kinds of stress and injury, may find benefits in the age-old therapies.

From acupuncture to yoga, these therapies date back to an ancient ideas and methods of healing developed over centuries as part of the traditional medicine of China, Japan and other Eastern countries. Records of some early techniques date back more than 2,000 years, but those techniques have not been widely embraced where Western medicine has held sway.

"We’re slowly getting in touch with the value of these therapies, so we’re back to the future again," says Peter L. Jacobsen, DDS, PhD. "But we’re now just beginning to scientifically appreciate how this works."

Jacobsen, a member of CDA's Council on Dental Research and Developments, was to present a seminar titled "Health of the Healthcare Provider" at the association's Fall Scientific Session, held in San Francisco in August.

Sixty percent of medical schools nationwide have begun to teach students about alternative medicine practices, and hospitals are creating complementary and integrated medicine programs. Stanford University Medical Center has been in the vanguard in offering a variety of health techniques to patients since its Complementary Medicine Clinic opened in April 1998.

"The reason we were considering opening the center was there was clearly a growing demand from patients: 42 percent of Americans use some form of alternative medicine," says David Spiegel, MD, a psychiatrist and medical director of the Stanford clinic. "We also thought it would complement the regular care of our center, which devotes itself to coping with serious illness. It was a way to apply to the community at large the same level of high-tech medicine to ‘high-touch’ (non-traditional) medicine."

Bay area dentist Dr. Mark Abramson spends part of his time deeply involved at the Stanford clinic. He specializes in face and neck pain at his practice and teaches mindfulness meditation at Stanford to help people relax, cope with stress, and better deal with chronic pain.

"There is always stress for dental professionals in a normal smooth-running practice," Abramson says. "Just going from procedure to procedure all day long builds stress. Frustration with the staff, frustration with patients who are late and other things add more stress. As we get busy and focused on getting procedures done, we’re not paying attention to our bodies, and this even affects the mental attitude we hold toward what we’re doing or about to do, and that can affect quality of care."

According to Abramson, many practitioners anticipate problems and try to stay ahead of themselves.

"That puts them in a physiological stress state, and the immune system is being shut down because the body can’t differentiate between what’s real and what’s imagined," he says. "So this meditation technique keeps you focused on the moment and helps you to respond to what’s present in that moment, helping to take you away from anticipating and fighting things that aren’t even happening."

G.K. Akhoshi, DDS, a general dentist practicing in San Jose for 27, took Abramson’s course.

"I had an episode that a cardiologist thought might be a heart condition, and I was suffering from a lot of stress," Akhoshi says. "I thought it would be good to take the course."

Akhoshi says it confirmed the effectiveness of meditation.

"For me it was good, and I saw the positive effects on other people, too," he says. "There was a noticeable difference in my attitude and my physical and mental well-being. It’s been very useful when I make it part of my everyday routine."

Dental professionals use their hand and arm muscles in intricate ways, so mindfulness can be a direct benefit there too, according to Abramson.

"We build tension in the muscles, and muscles become sore," he says. "I’ve learned at the end of the day to focus on my wrist, forearm, and fingers, and relax the muscles. This program teaches us to relax and recognize that pain is good because it helps us recognize where the muscles are hurting. This is important because ignoring it can be catastrophic."

Jacobsen says dental professionals tend to focus on patients’ health to the exclusion of their own.

"Patients are in the office for an hour or two, but we’re there for a lifetime," he says. "We often neglect our own health. Understanding and being attentive to our health is crucial for us and the longevity and quality of our practice and patient care."

The National Center for Complementary and Alternative Medicine within the National Institutes of Health conducts and supports basic and applied research and training and disseminates information on complementary and alternative medicine to practitioners and the public. Its former director, Wayne B. Jonas, MD, says that alternative medicine is here to stay.

"It is no longer an option to ignore it or treat it as something outside the normal processes of science and medicine."

For more information on the national center, call toll-free (888) 644-6226, or contact the center online at http://nccam.nih.gov/nccam/clearinghouse/.http://nccam.nih.gov/nccam/clearinghouse/

The National Center for Complementary and Alternative Medicine recommends doing the following before getting involved in any alternative therapy:

1. Get objective information about the therapy.
2. Ask about the training and expertise of the person administering the treatment.
3. Consider the costs, because many health plans won’t cover treatment.
4. Discuss all treatments with your primary care provider.
5. Be open-minded, but don’t accept every treatment at face value.
   

Demographic Makeover Comes to California

The traditional view of immigration to the United States elicits images of Irish, German, Italian and central and eastern European people hopefully working their way through the gates of Ellis Island.

California's ethnic history brings to mind a stream of Chinese who helped populate the state during its early years and helped create the country’s most abundant and influential state.

But on the eve of the 21st century, a new wave that has been building for several years is ready to crest and further enhance California’s diverse makeup. The demographic changes anticipated show a significant increase in the state’s Hispanic and Asian populations and certainly will be reflected in the patient base of dental practices.

In 1990, California represented 12 percent of the nation’s population compared with less than 10 percent in 1970. California’s population has grown at roughly twice the rate of the other 49 states with much of the growth since 1990 specifically attributed to the increase in the Hispanic population. That trend is projected to continue at least through the next 50 years.

The state Department of Finance projects that in just 10 years, Caucasian and Hispanic populations in the state will be 46 percent and 36 percent, respectively. Conservative projections show a decline in Caucasian and Black populations, while the projected total growth will be attributed to the increase of Hispanics. The department projects that in 2040, one in two Californians will be Hispanic.

Those changes will mean a lot to dentistry.

Depending on the city or town of practice, the patient base of most dental offices will mirror demographic trends. A similar trend is noted when statistics from California’s dental schools are examined.

The number of graduates from California dental schools in 1965 totaled 257. Although the schools were not tracing race, gender and ethnicity figures at the time, it is known that there were two female graduates and one Asian graduate that year.

The 1999 dental school classes are 48 percent Asian and 37 percent female. California’s senior dental students are the most diverse in the country. And the number of Caucasian students is steadily declining, only 44 percent of the 1999 class, mirroring the projected decrease in the general population of the state.

The needs of these new dental dentists are not the same as they have been in the past. Different cultures have different views on all aspects of life, including dentistry. According to Russell Webb, DDS, chairman of the CDA ad hoc Diversity Committee, "I assumed that with the type and location of my practice (Upland, Calif.), the demographic shift wouldn’t really be an issue. However, I recently hired an associate who happens to be a 30-year-old Asian male. It has been a challenge for me as a 54-year-old Caucasian male to see the practice and the needs from his standpoint."

"As an association, and as colleagues, we need to understand these differences and embrace the changes. If we don’t, the new dentists will join other groups who do understand them, or they form their own groups. This loss of numbers will eventually reduce the programs CDA provide because of the loss in dues income. Eventually we will have a second-rate organization. We need to know what these new dentists need to succeed, and possibly change our approach to these new demographics, in order to remain an effective, well-represented and viable organization."

Lessons From the Geese

By Gary Henson

While some practitioners and their staff know how to work in sync with each other, many others don’t. Working at cross-purposes rather than as a cohesive unit wastes energy, time and money. In that regard, a gaggle of geese can teach us a lot.

Lesson 1: As each bird flaps its wings, it creates uplift for the bird following. By flying in a "V" formation, the whole flock adds 71 percent greater flying range than if each bird flew alone.

So what? People who share a common direction and sense of community can get where they are going quicker and easier because they are traveling on the thrust of one another.

For the practitioner: If dental office players don’t have clear goals and specific means of achieving them, the lack of vision will pull the team down. If the staff does not buy into the common purpose or is hostile to it, those individuals will drag the group down even further.

Lesson 2: Whenever a goose falls out of formation, it suddenly feels the drag resistance of flying alone and quickly gets back into formation to take advantage of the lifting power of the bird immediately in front.

So what? If we have as much sense as a goose, we will stay in formation with those who are headed where we want to go and will be willing to accept their help as well as offer ours.

For the practitioner: Use a methodology that looks at the strengths and weaknesses of procedures, not people. By doing so, one can fine-tune or revamp the system, which will help everyone do their job better. "How can I help you do your job?" could be a mantra.

Lesson 3: When the lead goose gets tired, it rotates back into formation and another goose flies at the point position.

So What? It pays to take turns doing the hard tasks and sharing leadership. With people, as with geese, we depend on each other.

For the practitioner: Individuals often are a problem, but blaming the person rarely solves the issue. Before criticizing the person, see if there is a problem with the system that could be fixed. If we address the system, we may not need to question the person.

Lesson 4: If the geese in formation honk from behind to be supportive, they will be empowered to lead. The united staff functions as a much more powerful team than as isolated individuals.

So what? We need to be sure our honking from behind is encouraging.

For the practitioner: If everyone learns to be supportive, they will be empowered to lead. The united staff functions as a much more powerful team than as isolated individuals.

Gary B. Henson is a profession coach and owner of Advanced Business Consulting in Sacramento, Calif.

Smiling Swimmers Lament

Those who swim more than six hours a week continually expose their teeth to chemically treated water. Pool water contains chemical additives such as anti-microbials, which give the water a higher pH than saliva. As a result, salivary proteins break down quickly and form organic deposits on swimmers' teeth.

The hard, brown deposits, known as "swimmers' calculus," appear most frequently on the front teeth. Incidence of brown tartar is as high as 58 percent in children who swim regularly in elementary through high school.

Brushing more often and more carefully hasn’t been proven to help. However, swimmers’calculus can normally be removed by a professional dental cleaning. Dentists should encourage those who swim competitively to visit the office for regular cleanings.

Get To Know the Locals

The company polled more than 100 benefits managers of small business in Southern California and found that 80 percent of them would like to learn more about specific dental services available to their employees.

"Typically, we find that only 10 to 20 percent of most employers (100 employees and above) are receptive to learning more about medical providers in their area," says Henry Lew, president of the company. "This was our first assignment for dentistry, and we were surprised that there was such positive feedback from employers. This data underscores our position that employers are constantly being presented with medical provider resources but very little in dentistry."

Dentists with multiple offices and large dental groups should add direct employer marketing to their arsenal of business development activities, Lew says. He added that dentists could ask to participate in employer health fairs, conduct employer screenings and provide free seminars about oral health. In return, the dentist can distribute group information, educational materials, and educate employees about their office locations, services and insurance programs.

"Many dental groups rely only on word of mouth or direct advertising to drive their new patient business development activities," Lew says. "For those looking for sustainable growth, make sure you don’t overlook your business community."

UCSF Receives $1 Million Endowment

The University of California, San Francisco, School of Dentistry recently was given a $1 million endowment from the Bernard Osher Foundation in an extension of the Osher Scholars Program.

The dual purpose of the Osher Scholars Program is to assist students with tuition costs to reduce the amount of debt that they would otherwise accrue by the time of graduation and to place a visible emphasis on the community services aspects of a professional health career.

"The Osher Scholars Program addresses a pressing need among those training in the health professions," says Charles Bertolami, DDS, DMedSc, dean of the UCSF School of Dentistry. "Many of our students want careers in community service and education, but the burden of debt significantly diminishes career options upon graduation."

Honors

David Chambers, PhD, has been appointed to the 1999 Board of Examiners for the Malcolm Baldrige National Quality Award. Chambers is the associate dean for academic affairs at the University of the Pacific School of Dentistry. (photo)

Donald W. Lippincott, DDS, has received ADA’s Certificate of Recognition for Volunteer Service in a Foreign Country from the Council on ADA Sessions and International Programs.

Thomas Schiff, DMD, has received fellowship to the International Association of Dentomaxillofacial Radiology. Schiff is chair of oral and maxillofacial radiology and emergency services and director of clinical research at UOP School of Dentistry. (photo)

Guillermo C. Vicuna, DDS, has received a special citation for his significant contributions to advancing the oral health of the public and the profession of dentistry. Vicuna is co-founder of the Su Salud Disease Prevention Center.

Baldwin Marchack, DDS, has been elected to the Executive Council of the American Prosthodontic Society.

Random Facts

59% -- Proportion of Americans who say they would rather visit a dentist than sit next to anyone using a cell phone.

Source: USA Today

Web Watch: Special Interest Organizations

Pages of interest to dentistry.

The home page for the National Dental Association.

The page for the Hispanic Dental Association.

Home page for the American Association of Women Dentists.

Web site for the Iranian Dental Association of California.

The site for the Alpha Omega Dental Fraternity.

Upcoming Meetings

1999

Oct. 9-13 ADA Annual Session, Honolulu, (312) 440-2500

Oct. 21-23 American Society for Dental Aesthetics International Conference on Aesthetic Dentistry, Bal Harbour, Fla., (800) 454-2732

Oct. 28-Nov. 1 FDI Annual World Dental Congress, Mexico City, +44 171 935 7852

Jan. 27-29 Miami Winter Meeting & Dental Expo, (800) 344-5660.

April 6-8 Dentistry 2000 -- British Dental Association Annual Conference and British Dental Trade Association Dental Showcase Exhibition, Birmingham, England, 01934 844408

April 13-16 CDA Scientific Session, Anaheim, Calif., (916) 443-3382, Ext. 4470

May 15-20, World Biomaterials Congress and Exposition, Kamuela, Hawaii, (612) 543-0908

Sept. 17-20 American Academy of Periodontology Annual Meeting, Honolulu, www.perio.org

Oct. 28-Nov. 1 ADA Annual Session, Chicago, (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.