Older, Happier, Healthier
Can I tell you all a little dental industry secret? And I hope this isn’t a weird way to start this article but the month of September within the Dental industry is called “Sucktember.” Every dentist is familiar with this nickname. And for all the reasons you, the reader, can think of why it’s called this, it’s the least fun one. In short, the dental industry experiences the most cancellations and no-shows in the month of September. Our best theory as to why this happens is due to just how busy it can get as we transition from summer to fall with all the school and sports, etc.
I get emails in like July with headings like: “5 steps you can take now to prevent ‘Sucktember.’” In my mind I’m like, “hell, summer was really busy and I could use a little slowdown.” Then I fall right in line and cancel all of my appointments too. Just kidding, I’m not cool enough to have appointments. Now in all honesty I haven’t had a “sucky” month that I can remember in the 12+ years I’ve been dentisting here in Montana. It has gone far better than I could have imagined back in my U-Haul headed up from San Francisco a mere 2 hours post graduation.
But it is indeed September and that means the kids are back in school. I happen to have a Senior in High School (shout out to Nayvee Lee, I love you Bean) and I find myself getting pretty sad thinking about it. By June I’ll be a blubbering mess on my drives to and from work. When you have a senior in high school in a small one elementary, one middle school, one high school town you can easily blow the minds of their past teachers. I ran into her kindergarten teacher recently and they can never believe it when one of their precious kindergartners has aged into a senior. I think the default response is, “Shut Up!! No She Isn’t!?!
That also means that we are all 12 years older. I started dental school at 27 years of age and I had a little conversation with one of my instructors. I was a little older than most of the students in my class, and in addition to being married with 2 kids and I think I gave off the impression that I was impatient to get this career thing going. I remember he said, “you’re going to get out of here and your thirties are going to be hard. You need to work really hard to build your skills as a dentist, to build your business, to pay down your astronomical student debt load, to grow your family, to buy a house, etc.”
He continued, “but, if you work really hard to do all of those things, you’re going to really enjoy your forties and beyond.” This advice didn’t excite me. I already thought I had worked really hard to get to where I was at the time. Now I had to complete 3 more years of intense schooling followed by another decade of hard work? I thought I deserved my comeuppance much sooner than the timeline he just laid out for me.
I think about that conversation a lot and am really grateful for what he told me. It made me manage my expectations for how this career as a dentist was going to play out. It made me mentally prepared to push that checkered flag farther down the road. It made me focus and put in the work to lay the foundation that Smile Montana is built on today. He was right, my thirties were hard. I put in long hours and put on weight, but built a team around me that I consider to be my best friends in Montana.
3 years ago I opened up our 3rd Smile Montana location in Whitefish at 39 years of age and probably 235 pounds. I knew that I had reached the limits of my capacity as the sole owner of Smile Montana and patriarch of my family. I then turned my focus to regaining a work-life balance that would ensure that I loved practicing dentistry for decades to come while being a present father and husband.
This meant getting really good help around me. I truly mean it when I say that when I bring on another doctor, I look for someone better than me or with the potential to be better than me. If a patient prefers another provider over myself that counts as a success in my books.
I’m forty two now and just like my instructor said, I’m really enjoying life. I’m healthier, happier, I love coming to work and love going home, I love the cutting-edge technology that I’ve invested in that makes fixing teeth easy, predictable, and fun, and my hair is much longer just for the hell of it, and I’m 30 pounds lighter. I was asked recently how I find time for a social life? I responded, I work with all of my favorite people and when I get home I find myself with my favoriter (it’s a word) people. Life IS social.
Alright let’s talk teeth and keeping them forever. I have patients who I know are going to keep their teeth FOREVER, and I have the flipside where I’m bailing water out of the titanic…It’s going down baby. Let’s talk about the top reasons humans lose teeth so you can avoid them.
1. Erosion:
a. Erosion simply put is the break down of tooth structure, namely enamel and dentin, by acid. This acid is most commonly associated with diet and oral hygiene habits. Really good habits such as brushing and flossing the recommended amount and the recommended way can somewhat buffer against a poor diet high in sugar. Conversely, a really good diet will buffer somewhat against poor oral hygiene. Key word being “somewhat.” FOREVER teethers do both things well. Erosion is also seen in patients with acid reflux and/or GERD and can be diagnosed by the location of the erosion.
2. Parafunctional Habits:
a. A parafunctional habit (PH) is any habit that causes tooth loss with or without the presence of erosive acid.
b. Attrition is likely the most common PH and is defined as the lossof enamel and dentin by tooth-on-tooth contact. Also known as grinding and clenching of teeth. This occurs most frequently during sleep and a professionally fabricated nightguard is the best prevention for attrition.
c. Abrasion is the loss of tooth structure caused by something other than teeth. Brushing to hard or with poor technique is a common example. Another type of abrasion is using teeth for tools such as ripping tape or fishing line.
3. Trauma:
a. Just as it sounds. Traumatic tooth loss can result in broken teeth or the complete loss of a tooth root and all. It typically occurs during a car accident, a fist fight, or a high impact sport such as hockey or mountain biking. We also see it frequently with pets and toddlers that head butt their owners and parents. If you are involved in a high risk activity known for dental trauma please consider wearing a professionally made sports guard.
4. Periodontitis:
a. This is a big fancy word for bone loss around teeth and is also known as gum disease. In short if food debris isn’t removed often and effectively it will become plaque that will calcify into what we call calculus. This calculus causes the tooth root below the gums to have a rough surface texture which in turn causes an inflammatory response in the surrounding gum tissue and supporting bone. Left untreated this inflamed environment will cause gums to bleed very easily and the bone to slowly recede from the teeth.
I want all of you to keep your teeth forever so lets sum it all up. Have a balanced diet and brush and floss often with good technique. If you grind your teeth consider a nightguard. Be a good driver and avoid getting punched in the face. See your hygienist and dentist every six month at minimum and please KEEP SMILING!! This isn’t going to be Sucktember, it’s going to be KickAsstember followed by KickAsstober and so forth and so on year after year.
Happy to call myself a Montanan and to call y’all my friends and neighbors.
Read Older, Happier, Healthier by Dr. John F. Miller, DDS, in 406 Woman magazine.