The Acci-Dental Tourist

Ever hear the term medical tourism? It refers to individuals who go to a foreign country for cheaper medical or dental treatment and presumably to enjoy the vacation of a lifetime. Many are uninsured, underinsured or seeking elective cosmetic treatments.

“Patients Beyond Borders” a book by author Josef Woodman, is dedicated to this subject. Woodman suggests you might consider South Africa for cosmetic surgery or open-heart surgery in Thailand or Singapore. (Ahhh, that explains those Singapore sightseeing tourists wheeling their oxygen tanks!) Mr. Woodman claims that the American medical and dental communities are against such tourism because it cuts into their bottom line. Further, he claims there are few reasons not to consider traveling abroad for treatment.------ oh really?

Standards for training, licensure, and cleanliness vary widely from country to country. Don’t believe me? Recently in the UK, with the socialized dentistry of the NHS in a shambles, groups of Hungarian dentists toured England in tents. Yes, tents. The travelling dental circus included all dental doodads, but was anyone checking dental documentation? (Think this scenario could play out in the USA?—Forget it!) Review of credentials takes upwards of a month before a dentist can set up shop in the US.

Remember the media frenzy this past summer surrounding lead in dental crowns made overseas? Might explain part of those lower dental costs outside of the US?

A 2 tiered medical system is created in many of the countries who play host to medical tourists. Hospitals have been created solely to service these individuals, with the top tier dedicated to foreigners. Doc’s can make more money treating tourists than their own citizens. Hospitals and doctors catering to medical tourists are often financially out of reach for the resident population.

What about suing when something goes wrong? Even Mr. Woodman says that “the intricacies of working with foreign statutes, legal systems, and counsel make such action impractical except in the most egregious cases.”

Preparing for this blog The Maven had several email exchanges with Woodman who graciously agreed to answer a few questions. Half of the questions submitted he’d answered in prior interviews – so, easy peasy. The Maven’s questions asked about his educational background and that of his staffers who “researched” the book. Suddenly, Mr. Woodman needed more time. Hmmmm. He agreed that 2 weeks (to answer 7 short questions) would be sufficient (busy man). A gentle reminder after the 2 weeks produced no response.* The Maven suspects that Woodman’s background doesn’t include medical sciences. He is, however, a masterful book promoter, self-promoter, self-publisher and self-appointed authority in a subject he has no demonstrable background in.

Though The Maven has seen some excellent dentistry rendered outside this country, She’s seen plenty of crap. And that stuff usually needs to be completely redone. (hope the vacation was worth it!)

Unlike a facelift, dental work often needs refinement after completion. If you’ve ever had a filling that needed to be filed down or a root canal after a large filling, you’ll understand this concept. These things can turn up weeks after treatment.

Finally, some Maven Math: According to Josef Woodman, 180,000 Americans sought medical treatment outside of the US last year. That represents .059772% of the US population. Quadruple the patients and you’re still waaaaay under 1% of the population. The suggestion that medical and dental tourism is cutting into anyone’s bottom line is pure hyperbole.

True Story:

When President Ronald Reagan’s second term ended he was invited to speak at a business summit in Japan. Before the president’s arrival, a group of high level administration members met their Japanese counterparts to plan. During one of these meetings, an attractive 30 something U.S. female delegate got a wicked-bad toothache (a situation easily stabilized by antibiotics and pain medication). Eager to impress the group and the soon to arrive former US President, our Japanese friends whisked her away to a competent Japanese dentist. Without discussion, he gave her anesthesia and light sedation. She awoke moments later to the triumphantly beaming dentist with her tooth in his plyers! Arigatou Doc!!

It’s probably fair to say that this woman, considering her status, would get the best care in a foreign country. Japan is an advanced industrialized nation, and translators were in abundance. Yet she lost a tooth, that here in the US, would have easily been treated and saved.

*more than a week after his self imposed deadline to submit answers, Woodman suddenly sent an email to The Maven. He asked for an additional 5 weeks to address the 7 questions. (excuse me, isn't "writing" your thing?) The Maven suggested he might want to comment on this post instead. He kindly agreed.---now let’s see if he shows up.

Dental Humor - It's Not an Oxymoron

So, you might be wondering, why a dental blog? After all, dentists are, well, boring, right? The only reason someone goes to dental school is because they lacked the charisma to become an undertaker---isn’t that what you’re thinking! Shame on you! The Dental Maven has many colleagues who are not only smart, they’re hilarious! Take the Academy of General Dentistry for example. An organization driven to provide the BEST possible care for all dental patient’s, and these are some hard workin’ folks! But when 5 p.m. hits, whooooooweeee! But, don’t get me started…

Anywho, blogging is a totally new experience for The Dental Maven. But it’s a great way to talk about important things while demonstrating, hopefully, that dentists are not the impertinent, threadbare, humor-less individuals you thought they were. And how the heck did we get that assignation any way! Why don’t medical doctors or lawyers get ribbed about some negative personality trait? Like they don’t have any???? Sheeeesh. The Maven has yet to see a good, irreverent medical blog. However, She admits to being an ardent follower of a blog by one attorney which never fails to entertain. A Lawyer Mom’s Musings. Smart, funny, cheeky, yeah…the Lawyer Mom definitely gives the barrister a good name.

Now, that’s not to say dentistry is without its, uh, er, problem members. All professions have their share. Take for example, the oral surgeon who, while his assistant was under anesthesia, inserted fake boar tusks into her mouth and photographed her without consent. (Photodontist) He then shared the pics with his staff.

Then, there’s the oral surgeon who botched a breast reduction surgery. Yeah, you heard that right. The woman sued after her less than ideal, um, cosmetic outcome. DUDE! It’s DENTAL Implant, not……oh, just forget it!

Now where was I? Oh yeah. My point is that there’s a place for a dental blog which doesn’t take itself too seriously. There will be times when a weighty matter requires sober, honest discussion. But in the mean time remember these words from the late Katherine Hepburn: “If you obey all the rules, you miss all the fun.”

Mistletoe - User Error!

Okay, so mistletoe season is here and you’re pumped! Can’t wait to maneuver that special someone underneath the strategically placed evergreen cluster. But hold on, is your breath okay? Are you sure?


The Dental Maven’s office staff refers to bad breath as "hewnt.” (pronounced hoon’t) Hewnt comes in many forms: coffee hewnt, gum disease hewnt (aka "perio hewnt"), ethnic food hewnt, and garlic hewnt (aka "gewnt") are a few notables. The verb form is used as well. For example, The Maven’s assistant might say, “Doc, let me know if I’m hewnting, I’m dealing with some wicked post nasal drip today.”

How do you know if you have Hewnt? Here are some strategies to help find out:

• Ask someone you trust if you have Hewnt (can you r e a l l y trust them to tell you?)
• Lick the inside of your wrist, when it dries take a sniff, if it has hewnt, so do you
• Take a spoon (plastic works best) place the spoon, scoop side down on your tongue and drag, sniff the spoon for hewnt
• Buy an Etiquette Checker – for $55, it's a TopMan product which gives you a numerical value from 1-6 with “6 being really bad.” Its’ dual function allows you to check your alcohol level as well.

Even if your Japanese is limited to “Sayonara,” you can figure out what’s going on in this youtube video that's advertising the Etiquette Checker:

So what causes the “reactor” to meltdown? Here are some common culprits:

Smoking

Stinky food

Coffee

Dry mouth

Sinus problems and post nasal drip

Teeth with untreated cavities or gum problems

To avoid you own personal three mile island, ditch the cigs and can the kimchee. It’s asinine that people think breath mints will take care of coffee hewnt. Can I tell you? Coffee hewnt is like plutonium, NOTHING, short of time gets rid of it - so stop kidding yourself! Be sure to hydrate properly which also helps alleviate the stink from post nasal drip. And for the love of Pete, see your dentist every six months so your teeth remain healthy and you don’t get perio-hewnt.

Happy Hewnt-Free Holidays!

Oprah’s Favorite Holiday Gifts – the Zapi

Oprah Winfrey. She’s credited with getting a country to read with “Oprah’s Book Club” and millions to vote with her endorsement of President Elect Barack Obama.

In the latest issue of O magazine, with her Top 10 Stocking Stuffers, Oprah advocates the use of a toothbrush sanitizer called the Zapi. And, of course, with Ms. Winfrey’s nod, they are flying off the shelves. It’s an ultraviolet light cleverly packaged in a cool egg shaped canister looking very high tech and oh, so marketable. No doubt, ultraviolet light kills bacteria. It’s used in the meat processing industry for exactly that purpose. But is this an oral hygiene must have? What’s your rogue toothbrush doing when not on active duty? Is your brush steppin’ out? This speculation merited further investigation. Time for The Maven to get her Sherlock on! And yes, it’s revealed, many brushes are leading double lives:

How to deal with the wanton behavior of these corrupt brushes???

When off duty, store your brush in an upright position in a dry environment. Don’t share your brush with anyone, including family members and don’t keep family brushes in clusters where they can touch each other. Change your brush every 3 months or after being sick. That’s all you need to do – no special equipment required. If you follow those EASY (and cheap) instructions there is NO SCIENTIFIC evidence which indicates your toothbrush will be spreading infection!

So Oprah, keep your brush away from Stedman and the dogs. Do that, and you can dispense with your little egg thingy. You’ll be 30 bucks richer!

White Teeth? British Opt To "Dye Another Day"

You’ve got to love the Brits. Self-effacing humor, polite to a fault, and that accent—say anything with a British accent and you’ve got instant credibility! But what’s the deal with their disdain for American teeth?

Ricky Gervais, star of the recent film “Ghost Town,” was asked about the “ugly fake teeth’ he wore in the movie. “No,” he told the redfaced, American interviewer, “actually, they are my own.” This sparked a media firestorm in the UK where writers explained why the Brits like their teeth just as they are - thank you very much. Phrases like “rate character above perfection,” “nice natural smiles-natural in colour,” and “a more functional view of teeth,” played prominently. It’s reported that Her Highness the “Queen would never submit to bleaching or the laser,” because---- “it would frighten the horses.”

Poor Elizabeth Taylor got caught in the fray as one UK author, admiring Liz’s beauty at 75, claimed Liz’s teeth “shouldn’t be neon or incandescent,” and that – “teeth should match your face.” The intense glare apparently causing the author to completely miss ol’ Liz’s jet black hair! HELLO!

The Dental Maven concludes that all this attention can only mean the Brits secretly admire the American devotion to a beautiful smile. Character is nice, function is necessary but a healthy, attractive smile is always an asset.

So go on and do up those dodgy dentiles! It makes you neither superficial nor American. You might love your smile as much as the Yanks love the Brits!

Speaking In Tongues

Tongue piercings can cause multiple problems in the mouth yet they remain a popular form of self expression. The needle used for the piercing is 7 times larger than that used for dental anesthesia. Pain and swelling are expected with projected healing time of 4 to 6 weeks.

See youtube video of piercing.

Tattoo parlors, where many of these piercings are done, are largely unregulated. Studies show there is wide variation in sterilization practices. Body Artists often know little about the prevention of disease transmission. Of course, other common piercing venues include concerts, garages and bathrooms.


The Dental Maven would like to point out that the tongue is vital to speech, taste, swallowing, and assists the process of chewing. This sets it apart from other commonly pierced areas such as the ear, nose, brow, lip, and, er, whatever. Damage to the tongue is life altering.

Broken teeth are the number one problem associated with the tongue barbell. Mouth jewelry collects plaque just like teeth and becomes an irritant. Inflammatory reactions to the barbell can lead to overgrowth of the tongue.

The Dental Maven was intrigued by one “body art” site warning that “piercings or tattoos will not be performed on anyone who is drunk or high.” A testament to the frequency of that problem. The Maven will be glad when tongue piercing goes the way of the Pet Rock.