Paan is chewed in the Southeast Asian and Indian cultures. The above picture well illustrates its composition, though the component ingredients are quite foreign to westerners. Paan has many regional variations, but most commonly it consists of a betel leaf spread with slaked lime (calcium hydroxide and water paste) wrapped about chunks of an areca nut. When I was in school, I was taught that chewing betel nuts was a custom of some Asian cultures. I have since learned that the betel tree has no fruit and in fact it was the areca nut, a component of the paan chew, that was referred to as the betel nut. So, now you know. Some regional variants may include tobacco, herbs, spices and dried fruits. Street vendors, the ubiquitous “Paanwalahs” are expert in the wrapping of the paan chew. Paan is traditionally used as a digestif and breath freshener.

I had vowed to try paan on a recent visit to India. I figured that of the many daring things one can experience in India, paan would be one of the more tolerable and innocuous, driving a car and bathing in the Ganges being more life-threatening. I was immediately exposed to this paan behavior upon arrival in India. Our guide, Papu, was chewing incessantly on his wad from the moment we met. The experience of observing a paan chewer is repulsive on many levels. The largish wad, compared to your typical American dip, distends the cheeks. The constant slurping of excessive salivation and distortion of the spoken word while trying to talk around the bundle is maddening. The excess saliva is too much to swallow, so projectile spitting is unavoidable. The landscape is dotted with the red juices of paan. The appearance of the red dyed teeth and gums only accentuate the severe dental damage incurred by indulging in this habit…which it is…a habit. A strong one. One of the drivers we hired on our tours commented that he needed a chew every couple of hours to remain alert. There are stimulants in the combination of leaves and nuts and lime and tobacco.

My desire to experiment with paan diminished as I experienced the behavior second hand. Maybe next time.

It is an internet service that is designed to inform patients as to the timeliness of their scheduled medical office appointment, sort of like the flight information messages you can get from your air carrier. As long as two hours out from your appointment, you can be informed of the approximate delay in the day’s appointments either by an email or by logging into the medtimewait.com web site. It seems like a clever concept till you   think about it for a few minutes.

In my experience, medical practices always run late.  I hardly need to log on to a separate web program to garner that information.  A call to the office might indicate how far behind they are and allow you to beg permission to queue you up in absentia.  In any event, bring a good book.

Contact: Eric Nelson
American Academy of Cosmetic Dentistry^® (AACD)
5401 World Dairy Drive
Madison, WI 53718
PH: 608.222.8583
FAX: 608.222.9540
E-mail: pr@aacd.com
Web: www.aacd.com

American Academy of Cosmetic Dentistry Unveils Updated Brand Identity
AACD Logo Gets its Own Smile Makeover

Madison, WI – After over a year in the making, the American Academy of Cosmetic Dentistry (AACD) is pleased to release its new logo and identity package to the dental professional and patients worldwide. The new AACD brand is the culmination of a comprehensive organizational assessment in order to solidify the Academy as the pre-eminent resource in cosmetic dental education and information.

“It is an exciting time at the AACD. The Academy is continually growing and adjusting to advance excellence in our profession through responsible esthetics,” said Dr Gregory Daniels, an AACD member from Hinsdale, Illinois. “The new AACD brand represents a combination of the scientific foundation of the organization with an esthetic eye towards the future of cosmetic dentistry.”

Responsible Esthetics
In 2009, AACD established a new mantra of Responsible Esthetics, which forms the foundation for the new AACD.

“AACD will demonstrate that we unequivocally stand for the practice of responsible esthetics. The Academy will be the primary dental resource for patients as they strive to maintain their health, function and appearance for their lifetime. The Academy will clearly state and acknowledge that esthetic dentistry must complement the overall general and oral health of the patient, and do no harm. Our members will strongly encourage that treatment decisions are based on the foundation of evidence-based protocols combined with sound clinical judgment. The Academy will strongly encourage that cosmetic dentistry integrates interdisciplinary medical and dental treatment to enhance outcomes and minimize the loss of healthy human tissue. Our members will champion and provide minimally invasive treatment protocols, when and where appropriate, that are consistent with the long-term health and needs of the patient. AACD will encourage the utilization of innovation in technology and materials to deliver dentistry that is predictable and long lasting.”

About the AACD
The AACD is the world’s largest non-profit membership organization dedicated to advancing excellence in comprehensive oral care that combines art and science to optimally improve dental health, esthetics, and function. Comprised of nearly 7,000 cosmetic dental professionals in 70 countries around the globe, the AACD fulfills its mission by offering superior educational opportunities, promoting and supporting a respected Accreditation credential, serving as a user-friendly and inviting forum for the creative exchange of knowledge and ideas, and providing accurate and useful information to the public and the profession. 

I have had my first surgical experience. I am documenting this now so that I may compare it to whatever the future brings in the coming era of health care reform.

My knee has been giving me increasing trouble and I pursued a diagnosis. My meniscus was breaking down and surgery was advised. I desire to continue with a long life of hiking and biking so getting this repaired in a timely fashion made sense to me. We figured that the longish Memorial Day weekend would allow my recuperation without missing too much work.

That arthroscopic surgery has become so commonplace, with athletes seemingly being scoped one day and back on the playing field the next, I was surprised at all the preliminary falderol that was necessary before the cutting actually took place.

First there’s the exam with the doctor. Then, there’s the MRI, followed by the consultation with the doctor and MRI results. Next came the lab tests, EKG, chest x-ray, and extensive health history forms. All this was followed by a phone interview reviewing the health history data. Finally, one week pre-op was another visit with the doctor’s assistant to answer questions and clear me for the surgery.

I have no complaints at all. All of this was done with the highest of competence. I spent little time in waiting rooms and all prep work went smoothly and efficiently. A tremendous amount of duplication and redundancy exists in medicine these days. I imagine much of it is to avoid human error and abide by risk management protocols. Basically, so things don’t get screwed up and people don’t get sued.

This morning I was asked to show a picture ID at the surgicenter. My imagination took flight, wondering as to the need for ID. Was there concern that I sent a proxy to have the surgery for me? Might someone walk in off the street to steal a meniscectomy in my name? Can you sell a stolen surgical procedure on EBAY? Or, could it be that a brother-in-law, who is uninsured, is actually having the procedure done and billing it to my insurance? Any and all are possibilities.

I was asked to sign the HIPAA privacy agreement, a two page waste of paper never read by anyone and signed to satisfy the bureaucrats. Why doesn’t the EPA sue these people for wasting valuable resources. This form along with the six inch sign affixed to my extension cords warning of the hazards of their use, but not warning of the danger of tripping over the sign qualify as my latest peeve toward an all too large government. But I digress. I signed the privacy form and return the HIPAA statement to the clerk so it could be re-used and ignored by the next patient.

The nursing staff was cheerful and competent. Their jobs are apparently very specialized. One nurse took vitals and started the IV. Another shaved my knee and did a preliminary scrub. I was handed an indelible marker to indicate on my thigh, which knee it was that was to receive the surgery. Both nurses re-iterated the same questions about allergies and stomach contents.

The surgeon popped in to greet me and initialed my knee to affirm which one got done. Finally, the anesthesiologist arrived to explain his special cocktail designed to render me unaware and comfortable during the procedure. He was followed by the scrub nurse and her introduction. Meeting this large cast of characters served to pass the hour and a half that I waited in pre-op similar to the way the snaking lines pass the time at Disney World.

All the nursing staff, auxilliaries, doctors and patients were dressed in color coordinated blue duds topped by blue hairnet/ shower cap things. Unfortunately, only the patients’ garb had the peekaboo back.

The surgeon has one different element of attire. He is wearing boots. I could exaggerate and describe them as hip-boots or waders, but they actually resemble the knee high rubber boots worn by the plumber cleaning out your sump pit. These serve to keep his tootsies dry from the overflow of the irrigating solution used during surgery. The boots added a bit of class to the standard issue uniform of the surgery center.

When my time had come, I was walked past the cells of the other inmates to the …whoa that’s a different story! I was walked to the frigid OR exchanged pleasantries again with the anesthesia guy, got an answer to why it was so cold in here and things went black like the end of the Soprano’s finale.

I awoke to the smile of my concierge nurse, the last in the line of contacts at the center. She gave me post op instructions and a snack and ushered me out of the building.

It is now three hours post-op and I am surprisingly comfortable. The medicine used for anesthesia these days is effective yet mild. I feel competent and alert, though a little unsteady on my feet. The pain has not yet hit me, but I am well prepared if and when it does.

My maiden journey through the current US healthcare system has been a good experience so far. If Blue Cross does its job and pays its fair share, I will say that this is a system that has done me well. I realize that surgical centers are different than hospitals. I also realize that I am not an ill person needing comprehensive care. So, my experience is very limited. It is my hope that our health care professionals receive the financial rewards, respect, and satisfaction in a job well done throughout their careers so that we all can have positive experiences in medical care in the future.

Blackhawk defenseman, Duncan Keith took a puck to the face when he got in the path of a zone clearing pass by a San Jose Shark player during Sunday’s NHL playoff game. Keith had seven of his upper and lower anterior teeth sheared off at the gum-line. This type of injury, referred to by the players as “spitting Chiclets,” is an all too common occurrence in this day and age.

As a dentist from Hinsdale, Illinois, I am surprised that the hockey players of this generation continue to eschew the use of readily available and comfortable mouth and tooth protection while playing this most dangerous sport. I do not know about the type of mouth guard Keith was wearing. In any case, the impact of such a direct hit may still have caused serious tooth damage. Certainly, the flimsy mouth guard sported by teammate Patrick Kane offers no protection whatsoever considering that he chews on it as it hangs outside his mouth most of the time he is on ice and off. This being said, I cannot imagine that affixing a protective cage to the helmet would interfere greatly with vision, movement or comfort. I have not seen the protective gear that the junior players wear, but I’d bet it is more substantial than that worn by the pros.

I was introduced to hockey in the era when no one wore helmets and no goalies wore masks! I remember a Life Magazine issue which had a cover graphic displaying the scars on the face of the famous Detroit Redwing goal tender, Terry Sawchuck. He was not smiling in that photo. I doubt that he had teeth to smile with.

Since the incident on Sunday, I have been surprised at the cavalier attitude in the press and blogosphere which trivializes the loss of one’s teeth. Ask a denture wearer or someone who has lost their teeth in a less preventable way about what a life changing experience it is. Modern dentistry has some effective and beautiful materials and techniques which will allow the eventual restoration of Duncan Keith’s structure and chewing function. However, it will never be as good as the natural teeth he has lost. In my practice, I see many injuries sustained in sports that do not enforce the use of mouth guards. These include basketball and soccer. I hope Keith’s injury encourages the parents and coaches of young athletes to advocate the use of quality mouth and tooth protection.

- – FOR IMMEDIATE RELEASE
Gregory J. Daniels, DDS
950 York Rd Ste 100
Hinsdale, IL 60521-8608
Phone: (630) 655-8815

Web site: www.hinsdaledentist.com

Local AACD Member Dr. Gregory Daniels to Attend Worlds Largest Continuing Education Program for Cosmetic Dentistry
April 2010 – Dr. Gregory Daniels will attend the American Academy of Cosmetic Dentistry’s® (AACD) 26th Annual Scientific Session, in Grapevine, Texas from Tuesday, April 27 – Saturday, May 1, 2010. The AACD is the world’s largest international dental organization dedicated to advancing excellence in the art and science of cosmetic dentistry through responsible esthetics, of which Dr. Gregory Daniels is an active member.
“Contemporary cosmetic dentistry is a comprehensive approach to total oral health care that combines art and science to achieve optimal dental function, health, and esthetics,” said AACD member Dr. Gregory Daniels. “The annual AACD scientific session is the world’s premier venue to get the in-depth training necessary to stay up-to-date in cosmetic dentistry and ultimately provide the best care to patients in our community.”
AACD Recommendations When Seeking a Cosmetic Dentist
In order to make sure a dentist is skilled in cosmetic dentistry, the AACD recommends that patients ask for the following items before undergoing treatment As is the case before undergoing any dental treatment, patients should consult with an AACD member dentist to find out which procedure is right for them.
Before and After Photos – Examine the dentist’s treatment results on other patients to make sure his or her work
fits your dental needs.
References - Get a sense from other patients as to what type of quality care the dentist provides.
Continuing Education – Be certain that the dentist is an active MCD member and has taken continuing education courses to keep up-to-date with the latest techniques in clinical cosmetic dentistry.
The American Academy of Cosmetic Dentistry
The MCD is the world’s largest non-profit membership organization dedicated to advancing excellence in comprehensive oral care that combines art and science to optimally improve dental health, esthetics, and function. Comprised of over 6,000 cosmetic dental professionals in 70 countries around the globe, the AACD fulfills its mission by offering superior educational opportunities, promoting and supporting a respected Accreditation credential, serving as a user-friendly and inviting forum for the creative exchange of knowledge and ideas, and providing accurate and useful information to the public and the profession.
For more information regarding the AACD and the 26th Annual MCD Scientific Session, visit www.aacd.com, send an e-mail to info@aacd.com, or call 800.543.9220 or 608.222.8583.
Dr. Gregory Daniels is located in Hinsdale, IL. To learn more or arrange an interview, call (630) 655-8815.

For the past fifteen years, I have attended the annual meeting of the American Equilibration Society. The AES was founded in 1955 and is the largest organization in the world that deals with the diagnosis and treatment of diseases of dental occlusion and disorders of the temporomandibular joint and the muscles which make that whole system work. It is heady group with attendees flying in from all over the world. Membership includes acamedicians and clinicians. It is humbling to share a meeting with the the movers and shakers of our profession. These general dentists, oral surgeons, prosthodontists , orthodontists and periodontists include those who are the teachers and innovators of modern dentistry. Additionally, practitioners and educators from other allied health disciplines attend to learn and share their knowledge. It is always a valuable two days of learning.

I am sure that most of you might think that when I am out of the office in mid February, that I have traveled to enjoy a warm vacation. This meeting has managed to keep me here in frigid Chicago all these years.

It was an excellent day of continuing education and I feel that I had many questions answered and my base of knowledge on the subject was elevated.

The meeting was held at the Bolingbrook Country Club. It is a fabulous venue with a comfortable hall for such events. The fact that the weather was inclement today made it much easier to stay indoors. We practitioners from Chicagoland and this dentist from Hinsdale are fortunate that Chicago is such a magnet for high quality dental educators.

Tuesday night I attended the opening meeting of the 2009 season of the Advanced Dental Study Club. This is the fourth year that I have participated in the monthly meetings of this club. We are a diverse group of general dentists of varying background, age and experience. The interesting mix provides an opportunity to get my head out of the box that I practice in daily. We are an informal group and the meetings are loosely structured. We usually begin with a social session to catch up on the latest news in our lives and then slide into discussion of practice management challenges. The balance of the evening is consumed by discussion of interesting dental cases. We might bring models and pictures of our patients and discuss treatment options at one meeting and return later in the year with pictures of the work at completion. The energy is high and opinions fly as we all have our own idea of how something can best be done. In the end, we are all the better for the sharing of ideas.