Umm ... brush??!!

Jan 19, 2009

Editor's note: Jimmy Earll (not his real name) is a practicing dentist in Northern California and a stand-up comic who performs all over North America. His column, Laughing Gas, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

Welcome to Laughing Gas, my take on the ups and downs and ins and outs of daily dental practice. As a stand-up comic as well as a general dentist, I'll be sharing my observations, my spins, and some of the funniest and most heart-warming anecdotes to come out of my 15 years in practice.

For example, I hear it at least once a month: "My grandmother had soft teeth and had dentures in her 20s. My mother had soft teeth and had dentures in her 30s ... and with all these fillings I need, it looks like I have soft teeth, too. What should I do?"

Umm ... brush??!!

At least, that's what I say in my head. But maybe my patient's question is a lot deeper than I give her credit for. I had the privilege of attending a continuing education (CE) course in Seattle last month that opened my eyes to CAMBRA.

What is CAMBRA? "Caries management by risk assessment (CAMBRA) represents an evidence-based approach to preventing, reversing, and treating dental caries. The risk assessment and the emphasis on the whole disease process, not just the cavitated stage of lesion progression, make CAMBRA different from the traditional restorative approach in treating dental caries" (Journal of Dental Education, May 2007, Vol. 71:5, pp. 565-600).

The course I attended, "A New Standard for Caries Management: A Team Approach Using Chemical Treatments and Minimally Invasive Dentistry," was taught by Douglas A. Young, D.D.S., M.B.A., M.S. Among other things, Dr. Young discussed a whole new breed of attorneys coming after dentists who are not treating the oral bacterial infection of the rampant decayed patient.

"All we're doing is filling holes," Dr. Young said.

He also emphasized that dentists need to start thinking of the high-risk caries patient like a driveway full of nails. As dentists, he said, we spend most of our time fixing the flat tire instead of sweeping the nails off the driveway.

So, to my patient and her lineage of soft teeth, I say the real answer is CAMBRA!

The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.