Tag Archives: Anxiety

One Man, Two Battles: Vietnam and Dental Health

As a dentist, ADA first brings to mind American Dental Association, but American Disabilities Act is yet another agency for this acronym. It’s responsible for handicapped parking places, wheelchair ramps and many implemented standards to assist handicapped people in living life without having to face more barriers than their handicap already has given them.

Recently, a wheelchair-bound patient entered my office, and based upon the ADA, he had ample room to maneuver his wheelchair in our treatment room, perform a transfer procedure into our dental chair and receive his normal dental cleaning and exam. Our patient history revealed no significant medical findings, no allergies, but did not reveal the most significant aspect of this man’s life. This came later in conversation during a dental consult.

John Higginbotham, at age 19, was drafted into the Vietnam War in October 1968. He was instructed in military procedure, informed of Viet Cong, the North Vietnamese Army and handed an M-16 automatic rifle. By comparison, my daughter recently headed to college at about the same age and I’m worried about whether she will have the insight to wash her cloths and eat properly.

Base Helicopters

John Higginbotham, an Army soldier, was stationed in Pleiku (“playcoo”) Vietnam located in the Central Highlands, a cold mountainous region near the Ho Chi Minh Trail (a supply line between north and south Vietnam). Plieku was the location for Camp Holloway, a helicopter base that flew search and destroy missions and provided air support for ground troops. John’s job was to protect this helicopter base against invading enemy patrols. His bravery was displayed volunteering for dangerous nighttime “roving missions”, that entailed engaging the enemy when radar intercepts of enemy activity were reported. Faced with ambushes, booby traps such as landmines and other explosive devises, John and other infantry soldiers headed out to engage the Vietcong on February 19, 1969, when suddenly John’s body was launched into the air by the explosion of a mortar round ten feet away and a large piece of shrapnel that entered into his back. The damage was instant at the lower part of his spine causing broken vertebrae and loss of the use of his legs. The same helicopters he served to protect now provided the rescue mission for him to be airlifted to the closest hospital for immediate surgery. After 16 months of treatment, despite several medical doctor’s opinions that he would never walk again, was the astounding image of John walking out of Martin Army Hospital on June 26, 1970 with two canes, all thanks to the “magical” skills of his neurosurgeon.

Regaining his life and the use of his legs, John ultimately found a job as a Nuclear Plant Mechanic at Georgia Power in 1976 that lasted him for thirty years until June 2004 when he was forced to go on long-term disability and once again say goodbye to the use of his legs.

John has won many battles, and beat the odds when they were against him. John, however, had another ongoing battle between him and his teeth. Exposed to Agent Orange (a herbicide), especially while crawling on his belly in the jungle, John along with many other Vietnam vets, have experienced unusual dental problems including loss of teeth.

John entered into our dental office displaying tremendous courage because of psychological obstacles created by numerous bad dental experiences in the past. Entitled to the benefits of the Veterans Administration (or “VA”), which provides patient care and federal benefits to veterans, there was no reason John should not have gotten his dental problems taken care of over the past thirty years. His missing teeth, poor chewing and general discomfort instilled his desire for better teeth.

A comprehensive exam created the dental goal of several bridges and coordinated partial dentures to replace his missing teeth. This plan would eliminate poor chewing and alleviate his pain. Through the efforts of dentist and staff working diligently with the VA, we ultimately received clearance for John to enact his treatment plan. John is a man without use of his legs, confined to the total use of a wheelchair, often experiences shooting pains down into his legs and lives with the memories of war. Despite these adversities, John has a great outlook on life, and has recently found great happiness with the “new mouth that I’ve always dreamed of”. His dental health care was pain-free, which was a primary objective for John. His dental outcome achieved all his wishes of having his missing teeth replaced. He was very pleased he finally had overcome the huge hurdle of receiving dental care that he had battled for decades. His dental care restored not only his teeth, but also his confidence in himself. I salute John as an outstanding person and a man that fought for the freedom of this country.

Our Little Dental Secret

When Mary bit down on her breakfast creation of an egg muffin with crisp bacon, she suddenly felt her partial denture shift in her mouth and a sharp pain in one of her teeth. “I knew it was just a matter of time before the tooth broke,” she thought.   Mary informed her husband that one of the few remaining upper teeth that held in her upper plate had cracked. Unbeknownst to him, Mary had been enduring pain in that tooth for several months. Mary along with others who grew up in the aftermath of the Great Depression, tolerated many problems, including dental-related problems.

Mary’s husband made a dental appointment that same day so his wife could have her tooth and denture problem resolved.

Mary looked in the mirror as she prepared to leave for the appointment and felt hypocritical as she reflected on many things she had spent time and money on in her life that offered temporary or unnoticeable results. I only have one set of teeth though. Her many trips to the hair stylist, the years of purchasing expensive make up, money spent on one diet program after another, her membership to the gym, her designer clothes — all designed to improve her physical appearance and health. She had not maintained a balance with her dental health,

Mary had gained valuable insight about her long overdue need for dental care. She may have been in her 70s, but she valued keeping her teeth. Her dental health had suffered, and her ability to eat without discomfort was now a primary focus and would remain so the rest of her life.

“I lost so many teeth and wear this old ill-fitting upper plate because I have forsaken my teeth and dental health all my life and always waited until problems escalated to a dental emergency,” she told her husband. “You would think at my age, I’d be smart enough to have figured this out long ago.”

Her dental visit was surprisingly pleasant and peaceful for her. Mary had determined even before walking in my office that she was committed to her oral health and wished to restore her mouth to a healthy condition and be able to chew comfortably. Mary was diagnosed with several areas of gum disease, root decay, tooth decay around old fillings, broken teeth and a very poor fitting denture. Gum disease in the elderly is common because of decreased immune system response, limited dexterity for brushing and flossing and infrequent visits to the dentist. Root decay is one of the most debilitating dental problems faced by the elderly simply because naturally occurring gum recession in later years exposes the roots of teeth to bacteria and can cause terrible tooth decay. Mary’s tooth broke off at the gum line and required extraction because her denture fit so poorly it generated heavy uneven stresses on her teeth when she ate.

Mary’s focus on dental care did not end with herself. Her husband had neglected his dental care just like Mary, but worse. As a heart patient who uses oxygen and has a long list of medications, his need for proper oral health was obvious even to his wife. He agreed to a dental exam, which revealed very debilitated dental health.

Geriatric patients need to value their dental health and realize infection spreads from teeth and gums into the body, sending bacteria through the heart and other organs. The level of an infection in the mouth is often considerably worse than an infected cut on your arm that would require immediate medical attention. We tolerate infection in both our teeth and gums quite well. Out of sight and out of mind leads to neglected dental problems. “Our Little Dental Secret” is that we can have missing or broken teeth, gum disease, abscessed teeth that typically don’t hurt, poor function, and ill-fitting dentures (often not worn any more) all hidden behind the curtain of our lips, and no one knows. The problems only escalate and become worse over time and more expensive to treat. The best time for dental care and a good examination is today. Don’t put off your dental care because it will only be worse tomorrow.

Dr. Scott Harden is a dentist at Fountain View Family Dentistry and has served the Towne Lake area for more than 21 years. He is a Dental Advisor for two nationally renowned dental research companies. You can reach him at (770) 926-0000 or visit FountainViewSmiles.com.O

Enjoy Your Next Dental Visit

April 2010

Can you actually enjoy your next dental visit? This question offers an interesting challenge for today’s dentistry. Is it possible after centuries of rudimentary dental care that still evokes anxiety and apprehension in adults and children alike, that dentistry has risen to a level that can actually permit you, the patient, to consider dentistry enjoyable? Has the pendulum of education and technology swung far enough the other way to extend an opportunity for patients to openly state “I actually look forward to my dental visit”?

To appreciate where we are in dentistry today requires a historical view of where we have been. Dentistry has unfortunately seen little advancement for nearly 5000 years because of the complex issues involving hard teeth interacting with soft tissues, and functioning of teeth related to moving jaws. The earliest recorded extractions of “bad teeth” were noted by ancient Egyptians around 3000 B.C. The Etruscans of Central Italy devised clever pioneering techniques to replace missing teeth dating back to 700 B.C. that compared to standards upheld until the 1870s. In 1759, the designation “dentist” was first used. Organized dentistry began in 1840 with the founding of the first dental school in the world, founded by Dr. Harden, a very special name as determined by this author. The American Dental Association was formed in 1859. The first functional and durable dentures were created by the Goodyear Tire Company in 1864. Professor Roentgen of Germany discovered “x-rays” in 1895. Dentistry transitioned in the last half of the 19th century from being a trade to more of a science. The 1950s saw three revolutionary breakthroughs that occurred in dentistry including fluoride added to the water supply, modern local dental anesthesia and the development of the high-speed water-cooled drill. Patients still complain about the high pitch of this drill, but this is a vast improvement over its predecessor, the old belt driven slow-speed “bump & grind” drill.

The last half of the 20th century has exploded with the introduction of new products, equipment and techniques, that further support the notion of a patient finding being able to achieve enjoyment in dentistry. A partial list would include the following: tooth-colored fillings that bond to tooth structure, which makes the tooth stronger and more attractive; bleaching materials applied in the office or at home to provide a whiter smile; air abrasion units that use air blasts of small sand particles to remove decay; decay detection equipment that uses a laser-like beam to detect hidden decay; lasers which currently treat gum disease and will soon remove decay from teeth in the future; intra-oral cameras and digital cameras to provide the patient immediate high quality images of oral conditions for better communication with the clinician; computers to organize diagnostic findings and treatment plans also permit patients a concise form of communication; digital radiography that improves x-ray techniques; and implants used to replace missing roots, which act as a foundation for dentures, crowns and bridges.

The biggest change in dentistry over centuries has been our focus on redirecting care from reactive to preventive. This means that patients have better dental health because of fluoride, sealants, better access to dentists, earlier diagnosis, and more conservative treatment utilizing the latest technology.

The contention of this author is that patients can actually enjoy today’s dentistry. There have been extraordinary advancements in technology that have greatly improved diagnosis, treatment, communication and comfort — all together which permit a patient to look forward to their next dental visit. This can be mathematically proven based upon a recent patient poll conducted in our office. Today’s technology in dentistry means

TREATMENT today on most any level, ranging from cleanings to root canal therapy, received neither a negative or positive rating from the patient. Our poll concluded that patients interpret treatment as necessary, and although they do not find it negative, it is typically not something they look forward to either.

Patient Rating: Neutral.

Technology has also improved CUSTOMER SERVICE, an area important to dentistry. With new trends in spa dentistry, including chair massagers, paraffin wax hand treatments, DVD movies, music, nutritional shakes, etc., patients can literally be pampered in a unique way that they typically do not experience anywhere else. The additional benefit of quality staff to deliver these services to patients remains essential. Patient Rating: Positive.

Technology has improved PATIENT COMMUNICATION in dentistry by utilizing equipment that introduces an entirely new understanding and new level of confidence for patients as never before experienced. Equipment includes early decay detection equipment, intra-oral cameras and digital cameras, and computers (all noted above). Patient Rating: Positive.

COSMETIC DENTISTRY provides patients enthusiasm about achieving a “smile makeover” from beginning to end of treatment.

Patient Rating: Positive.

All of these new technologies now make dental procedures much easier for the patient. The scale is certainly now tipped toward patient comfort and patient satisfaction, which is mathematically proven based upon the above statistics. As dentists, we are delighted with the opportunities we can now offer our patients, and it is truly clear that you, the patient, can actually enjoy your next dental visit. Congratulations!