Facial pain

I can only apologise that I have not posted lately, I have had a few personal comments about this fact and so I will endeavour to get back on track.

My last post noted the up and coming visit of Dr Ron Presswood from Texas and I am pleased to say that his visit was great. His Masterclass in Portmarnock was preceded by a round of golf on the Thursday and an ITI meeting on the Thursday night. What he is now proving with his research into the treatment of facial pain is fascinating and truely goes against pretty much everything I had been taught about how teeth work together and their relationships to the muscles of the face. It is fairly controversial and I am sure many felt uneasy about it for obvious reasons but I think that the proof is simply in the use of his theories in general practice and the fact that his methods which are completely non invasive help many patients who have found no success elsewhere. I have been open to his teachings now for 2 1/2 years and thought that I was well on the way to getting things right and understanding his message, his visit to us on Saturday to treat in person 6 of our clients taught me that I had an idea of his message that worked in most cases, but I had a lot to learn to perfect it.

For any who doubt what he says and I had been as seceptical as the next, just ask the 6 clients he treated with his splint (PGA) for facial pain, clicking joints and grinding. They ALL have had improvement, they all continue to improve and 2 in particular have had their quality of life dramatically improved, within 24 hrs!! What you need to realise firstly is that many had been treated elsewhere at significant cost with no benefit…….

WHY does his splint for pain work? well Ron’s work is based on the wonderful quality of listening, he believes strongly that as dentists our patients have all the answers and that we are trained to be too DIRECTIVE! towards our patients and the treatments we choose. In this directive approach especially in the treatment of facial pain we lose our most valuable gift of information.. the experience of the patient. Watching him work was enlightening and will be career changing for me, this is a big statement I know but I found the whole experience uplifting and engaging. I think I am now ’seeing’ what he has been telling me for over 2 years now and I look forward to developing my skill in this area for the benefit of our clients. If you or any of your family or friends have been suffering from facial pain and feel that help does not exist then get in contact with us, we may have the answer.

From then we have introduced a new dentist to the practice Dr Chris Barrowman BDS MFDSRCSEd. Chris actually trained with me in Dundee and we have maintained a close relationship for many years, we have many similar interests and both to date have followed a similar path. Chris has his own practice in Scotland but has opted to do 2 days a fortnight with us in Blueapple as the workload here continues to mount. This has just been great news for us, he is a gentleman and a very talented clinician and we are blessed that he has come our way. He will be a fantastic addition to our team and many of our clients will benefit from his skill.

Most of our client base comes from the Republic Of Ireland or as we say ‘accross the border’ and lately there has been a change to their taxation in terms of the tax relief that can be claimed against certain aspects of their dental treatment. This has been reduced (in the case of higher rate tax payers) from 41% to 20%. We have had an influx of clients wishing to have treatment sorted by or brought forward from the end of 2008 and our diaries are heaving. If you have treatment planned with us or were thinking of joining the practice then please let us know as now is the time to get the ball rolling.

Finally we wish Angela (those who attend will know her well) a speedy recovery from her recent operation, our thoughts are with her.

Cerec night

Just finishing up after anotheer busy week. I was lucky enough to be invited to speak at a meeting last night on technology in dentistry at the Henry Schein headquaters in Belfast. I was one of 2 speakers giving our personal feelings on the Cerec machine to the gathered group of dentists. It went well I felt and as always at these things I enjoyed it. Nice to be asked, I had given of my time FOC and was delighted to recieve a lovely gift of a case of wine…. a nice touch and a moment of delight for me.

I am looking forward to the weekend, its my birthday and cant wait to spend it with the Sonay, kids, pups and my family.

Next weel is full as always, Larry our technician is over for his monthly visit, in fact I was just speaking with him and was delighted to hear that our name will be on the big stage in Brussels where he is the keynote speaker at a conference….. We have a trip to an occlusion Masterclass in Dublin with an Ireland ITI meeting thrown in and then working Saturday with the speaker of the Masterclass, Mr Ron Presswood form Texas. Ron sepcialises in treating problems associated with facial pain, clicking joints, neck pain and grinding problems. We are delighted to be welcoming this world authority to Belcoo and look forward to him persoanally treating some our clients. I will post some photos after the event.

Dentistry and Guns

The title is confusing, what have they got to do with each other I hear you ask, well I hope to explain.

I am often in a situation with clients where I am trying to explain to them the work that is involved in making their crowns, veneers, bridges and dentures. For most people and I dont for once lay blame at their door, these are things that a dentist makes him/herself or sends to someone else (a technician) to have  manufactured. What is involved in this process is poorly understood and I understand why. We historically as dentists have been happy to do 1 of 2 things….

1)Take the praise when a crown is great and everyone is happy, it fits and looks well. We are happy to revel in the asumption that many patients have, that the dentist did a great job and no one else was involved. I am sure that the technician who has made this unique piece of work by hand is never mentionned.

2) Be the first to blame the technician when things dont quite go so well ie: the crown is the wrong colour or fits poorly. Its usually only at this stage the patient becomes aware of a technician existing at all.

You see crowns, veneers, dentures and bridges are not available to buy ‘off the shelf’ they are all hand made bespoke items that will fit ONLY the tooth or patient that they are intended for. To handmake anything from scratch takes time and expertise and this is solely in the hands of the often under praised technicians in the dental world. The time spent and the expertise used, costs money, and it is this cost factor that suprises many, but is understood once explained to them. Take for example a jeweller making rings, he will go through a similar process for making say a gold band as a dental technician will for making a bonded crown (metal with porcelain over the top). The difference is that the jeweller can reproduce the ring many times over, the dental technician can’t… the crown is completely UNIQUE!!

What has this to do with guns?? well I was reading an article about a gunmaker ‘Westley Richards’ who like us pride themselves on the quality of what we deliver. They are a family business producing only 30 guns per year each having approximatley 700 man hours each to finish…… you can imagine the expense. The MD refuses to give his company over to what he describes as the ‘number crunchers’, as they will simply want 50 guns produced per year to increase profits…. but to produce 50 guns the time spent on each would have to decrease and the end product quality would suffer, something the MD will not allow. So he has stood strong to protect his name and product quality and I am sure this will simply make his product more desirable…

For us in dentistry I think this is an important parallel, I could use a technician who worked in a ‘high output’ laboratory, my fees would be less there is no question BUT I want to maintain the quality. This has to suffer in a laboratory set-up where numbers and output are the main goals, the finesse and attention to detail cannot be sustainable.  So we at Blueapple use, and will continue to do so, a bespoke low output laboratory (LS Browne techincal services)  where like at ‘Westley Richards’ the man hours per item is high and the product speaks for itself. This I trust will make us more desirable and allow us to continue to offer our clients the best products we can source.

Can you tell which is the crown??

Dancing Shoes

I have used all ceramic restorations (metal free crowns and inlays) since my graduation over 7 years ago. They have served me well and I feel offer for the majority of my clients the most realistic rehabilitation of their teeth. I personally avoid the standard metal based crowns simply because the alloys used (contain nickel) I dont feel are very compatible in the mouth, and I would not like them in mine. My mainstay anterior (front) crown is called an ‘INCA’ crown and they are a beautiful and realistic means of restoring many teeth. They gain their strength from a chemical bond to the tooth and in the case above you will see them used very successfully to rebuild this lower arch of teeth.

Traditionally these ‘all ceramic’ crowns were not recommended for back teeth but this has changed as the materials have improved and we are now using them for approximately 90% of what we do. My faith in the materials is sound and I look forward to their continued use in our practice.

In  terms of the comments we hear about our work, those cases involving these materials usually get the most notable. In the case above we were delighted to hear that a famous Irish dancing King was impressed with what had been achieved….. Blueapple the musical?….. dont think so some how.