May 2013

There were 2 posts published in May.

Does My Dental Office Need a Blog?

To be honest…probably not. Let me explain.

Blogs are a pretty special kind of website. The defining property of a blog is the fact that it is updated “regularly.” Regularly means different things for different kind of blogs. Many news websites are blogs that are updated minute by minute. This blog is updated as regularly as I have ideas and time to write them down. How regularly depends on the goal of the blogger.

Because blogs are websites that are updated regularly, search engines like Google and Bing tend to notice them. These search engines are constantly sending out bots or crawlers to index the internet. Sites that have regular updates get more attention from these bots and often do well in search engine results.

Most dental office websites are relatively static. Their content doesn’t change very much. A website with static content has to rely on other ways for search engines to find them. There are lots of ways to optimize a website to be found by search engines, but updating content is a simple way for non programmers to compete.

So, back to the original question. Does my office need a blog? Well, it depends. Is your current website doing well with the search engines? Do you come up pretty high on the first page when people look for “dentist in your town” or any other keywords you’re trying to connect with? If you’re doing well here, you probably don’t need a blog. If you’re not doing so well with the search engines, a blog could probably help.

Here’s the part you’re going to hate. In order to be helpful, the blog needs to be pretty original. If you have a company that’s managing your social media presence and they include a blog, it’s probably not going to help much with the search engines. In fact, it could be hurting you. If they’re using a stock blog for many of their clients, Google knows this. Google could actually use duplicate content against you.

You should write your own blog. That’s the very best way to do it. It’s time consuming and you don’t have a lot of time. I get it. If that’s the case, just don’t do it.

People can tell when a blog is written by someone who cares about the content. It really shows. You don’t have to be a great writer to have a great blog. But, you do have to be honest and it helps if you write like real people talk.

Another cool thing about blogging is that it is a great way to share ideas. If you have an interesting take on a topic, a blog is a very easy way to get your message out. It’s really easy to amplify your message using social media like Facebook, Google+ or Twitter. All you have to do is copy your blog’s url and paste it into your Facebook status. You just shared your idea with a bunch of your Facebook friends. And if you use Facebook on a somewhat regular basis, your friends there are probably a great audience that may well enjoy your message and help you spread it!

So, does your dental office need a blog? It’s hard to say. Whatever you do, don’t have a blog just because someone selling you something tells you that you need one. A good rule of thumb is that if you won’t write it, at least most of the time, you probably shouldn’t have one.

But then again, what do I know?

Dr. Oz is wrong about amalgam fillings

MrWrong

Dr. Oz is wrong about amalgam fillings. He’s super wrong. He couldn’t be more wrong if his name was W. Wrong Wrongington. An episode of Dr. Oz recently aired where several “experts” weighed in on whether your amalgam fillings are poisoning you. That was the question that all the promos for the show asked: “are your mercury fillings poisoning you?” So I tuned in with bated breath to hear his answer.

His answer, of course, was that yes, they are poisoning you. Seriously, you knew that was the answer, right? If he’s said, “nope, they’re actually pretty safe” that would make the most boring television ever. And Dr. Oz is not about boring TV.

A couple of “experts” weighed in that the problem is the mercury vapor that comes off of silver fillings. According to the experts, any time you contact your teeth together, like chewing or heaven forbid grinding your teeth together, you’re emitting toxic gas into your mouth. That, my friends, is pretty scary stuff. But since you can’t see mercury vapor coming off of your teeth, Dr. Oz and another “expert” did a demonstration to measure how much mercury is released when you brush your teeth.

The demonstration consisted of a plastic model mouth with a bunch of silver fillings in the teeth. The model mouth was kept in a clear box that was ventilated. Dave Wentz, the guy doing the demonstration with Dr. Oz, let everyone know that they do the demonstration in a box so they don’t let any of the toxic mercury out. Which is interesting since it’s very likely that many people in the audience have silver fillings. If they’re that worried about the toxicity of silver filling, wouldn’t they screen the audience to not let folks with toxic fillings in the door? But I digress.

So, they do the demonstration. Dr. Oz puts his hands in the gloves in the clear box and scrubs these amalgam fillings like he’s cleaning the grout in the bathroom tiles. And, low and behold, they measure mercury gas coming off the fillings!

So Dr. Oz is scrubbing away at these silver fillings and asks:

“…at what point should I be concerned. At what [mercury vapor] level is it more than we’re supposed to have?”

“Anything over zero is toxic. We’re at 61. 61 micrograms.”

Then Dr. Oz comes up with: “Now how can anyone dispute that there’s no mercury coming off of amalgams?”

And his guest expert Dave Wentz replies. “You can’t. You really can’t.”

If you aren’t careful or observant, this seems like a smoking gun. Amalgam fillings are dangerous and they are poisoning you. I ask you to step back.

The first thing that jumps out at me is the language that is used to frame the discussion. I typically refer to amalgam fillings as “silver fillings.” I never have thought of this as the element silver, but the color of the fillings, when polished is silvery. The Dr. Oz show refers to them as “mercury fillings.” Neither of these terms is probably adequate. Amalgam is a generic term for something that is mixed together. When the term is used in metallurgy it means: “an alloy made with Mercury.” So probably the most accurate term for these fillings would be “amalgam” and not “silver” or “mercury” fillings.

Language matters. When I use the term silver filling I’m indicating the color. When Dr. Oz uses the term mercury filling he’s pointing out the scary, toxic ingredient of the filling. That’s used to frame the discussion, so right away someone who isn’t thinking critically is thinking, “whoa, I didn’t know they placed mercury fillings!”

The next thing that jumps out at me is the way that they created and measured the mercury gas. It is assumed that the model that they offer (a plastic typodont with a ton of silver fillings in a plastic box) is an accurate representation of what’s going on in a human being’s mouth when they have silver fillings and they brush their teeth. I’m not sure it’s fair to assume that for the following reasons:

  • There was no moisture in this model mouth. A normal human being has saliva flow, which keeps the entire mouth moist and lubricated. Moisture on a surface could clearly affect the amount of vapor coming off the surface of a tooth.
  • We don’t know when these fillings were placed, if they were placed correctly, or if they were polished. All of those things can make a difference in the amount of vapor that might come off of these fillings. It wasn’t mentioned on Dr. Oz’s show.
  • We’ll also ignore the fact that the quadrant of fillings he scrubbed had anywhere between 4 and 7 surfaces of amalgam. I did my best to figure out how many surfaces the teeth had but they never showed the far side of the typodont. In any case, that’s quite a bit of amalgam…more than the average patient has for sure.
  • The model had no lips, tongue or cheeks and also wasn’t breathing. Wouldn’t a more accurate measure come from actual patients with actual fillings that were actually brushing their teeth?

They have measured the vapor that comes off of teeth in human models, and it is true that there is a measurable amount. In fact, there’s some question about the most accurate way to measure mercury vapor released from a silver filling. Is the vapor in someone’s breath the most important factor, or would absorbed levels of mercury in urine and blood be the most important measure? The Dr. Oz show wasn’t interested in an actual discussion. They went from “hey look, there’s mercury vapor in this model” to “your fillings are poisoning you.” No mention of actual outcomes based research. No mention of the millions and millions of teeth saved by the use of amalgam fillings with virtually no verifiable reports of bad health outcomes due to amalgam fillings. Clearly the most important message was that there is scary, poisonous vapor coming off of your silver fillings. Awesome.

The final thorn in my side was the statement made by the guest who was putting on the tooth brushing demonstration, Dave Wentz. He says, “anything over zero is toxic.”

Alternative medicine advocates aren’t known for their nuance. Poisons are dose dependent. In other words, something that is harmless in small doses can become harmful in larger doses. That is the case for most things that are known to be toxic to humans. So, how do we know if we’re getting a toxic dose of mercury vapor? Well, the World Health Organization describes a “tolerable intake” of elemental mercury vapor to be 2 micrograms/kg of weight per day. So if we take an average male of 150 lbs, they can tolerate a daily intake of around 136 micrograms of mercury per day. So, are our amalgams delivering that much? The short answer is no. Dr. Oz was able to generate an impressive 61 micrograms by scrubbing on some silver fillings in a box. However, actual measured amounts in human beings are more like 1-3 micrograms per day, depending on how many surfaces of amalgam a patient has.

There are reasons to dislike silver fillings. However, there is no credible evidence that they will cause anyone harm. The outcry by many poorly informed people has led to the outright ban of this material in some countries and the sharp reduction of it’s use here in the United States. Amalgam fillings are durable, long lasting and safe. That’s what credible evidence states. Until credible evidence says otherwise, I think Dr. Oz is wrong. Really wrong. Super duper wrong. His name should be W. Wrong Wrongington.

That last part is just my opinion, though. The rest of it is the truth as we know it.