Food for thought

Show Your Pride!

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By: Jamie Jones, ASDA District 6 Blog Editor


In 2018, Gay Pride Month is often associated with bright colors, good times, and most importantly, rainbow flags. While the month of June has evolved into a time of joyous celebration for the world’s LGBT communities, it is important to honor the history of the modern LGBT rights movement and reflect on what this month is all about.

Most of us can agree that in today’s society, it is simply outrageous to imagine a time when being LGBT was considered a crime-or better yet- a mental illness. Nonetheless, gay history is not complete without the mentioning of these trying times for the country’s LGBT population. It wasn’t until June 1969 that the LGBT rights movement undoubtedly took a turn with the Stonewall riots, which many historians refer to as the “watershed moment” and transformative event for LGBT civil rights. The riots and subsequent blossoming of several gay rights campaigns occurred after police raided the Stonewall Inn, a gay bar in New York City’s Greenwich Village. After years of being persecuted and discriminated against, New York’s gay community was fed up- and neighborhood riots broke out over the following three days. This served as a catalyst for the establishment of countless gay rights advocacy groups that began protesting, meeting with political leaders, and building off the momentum of the Stonewall uprising. On June 28, 1970, the first pride march took place in New York City to commemorate the first anniversary of the Stonewall Riots. The tradition stuck with yearly celebrations and demonstrations, and in June 2016, then President Barack Obama established the Stonewall National Monument, a 7.7-acre testament to the location where the Stonewall Riots occurred several years earlier. It is the first U.S. National Monument dedicated to LGBT rights and history and serves as a reminder of the influential turning point that occurred there.

Thanks to the courage and tireless work of many gay rights activists, pride marches and parades are held in at least 158 cities throughout the world, and what was once a political demonstration has now transformed into an entire movement, with Gay Pride Month celebrated on every continent. Although the LGBT community has undeniably come a long way since the Stonewall riots of 1969, incidences such as the 2016 shooting at a gay nightclub in Orlando, FL, show that oppression still exists. Tragedies like this one remind us how important it is to continuously fight for equality for all Americans. Pride lasts just one month, but human rights are something that should be celebrated 365 days a year. 

The personal significance of Pride can be summarized in this inspiring quote by an anonymous OSU dental student: “LGBT Pride Month was chosen as the month of June to commemorate the Stonewall riots which occurred in June 1969. Although society has dramatically changed over the past few decades for LGBT rights, people from all over the world are still facing violence and inequality simply because of how they look or who they love. Rather than to dwell in shame and the social stigma that predominates the outlook toward the LGBT community, we use this month to come together in pride and celebrate our sexual diversity and gender variance. Being LGBT doesn’t define us. It is just one more part of who we are. There are more than 10 million Americans who are LGBT – they are senators, athletes, celebrities, and even your classmates. Be an ally to our community. We are people just like you.”

Oral Health in the Himalayas: The Gift of Toothpaste

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by Nicholas Reece, University of Michigan (2018)


Not many people in the states know about the country of Bhutan. It is a small kingdom nestled in the Himalayas and sandwiched between the two powerhouses India and China. With a population of merely 700,000, the entirely Buddhist culture has been shielded from the developed western world until about 16 years ago in 1999 when they first opened their doors and allowed TV and Internet to penetrate the everyday lives of the citizens. Known most by foreigners for it’s Gross National Happiness rather than Gross Domestic Product and it’s attempt to become 100% organic, Bhutan is the living example of a society that many in our fast-paced stressful world only dream of.

It was to this unique culture that I found myself traveling on August 22, 2015 for my Summer Recess. Cat O’Brien, a good friend who lives and teaches in Bhutan, invited me to visit her school. After hearing her stories and seeing pictures, I knew what a unique opportunity this was and looked for a way to take full advantage of it.

The Taft Room, our then haphazard storage room, was getting cleaned and consolidated at the same time that I was preparing for my trip. I took advantage of this and went to StuCo President Luke Aiura and asked for his help. He found a couple of unexpired cases of pediatric toothpaste that were in line to be discarded. I took these cases with me as a gift for Cat’s students. After hearing about the lack of hygiene awareness in Cat’s school, I knew these were a perfect gift.

I carried on 72 sample size pediatric toothpastes through four airports and thirty-four hours of traveling. After arriving and a four-hour car ride full of green Himalayan Mountainsides later, I found myself in the small village of Thinleygang, Bhutan. Feeling the ten-hour time difference, I ate a small dinner and immediately fell asleep.

The next day I woke up in the clouds and tried to orient myself to the time difference and the village before heading to school with Cat. She teaches English to two sections of Class 4, about sixty students total. Her students were very excited to meet another foreigner and even more excited to learn that I brought them gifts from the States. As I passed out the toothpaste the students had to be instructed by Ms. Cat that, “this is not chocolate, do not eat it.” I followed with a little oral health instruction on how and when to use the toothpaste along with what it does to their teeth.

Word spreads quickly in small villages and very soon after class I had other Bhutanese teachers approaching me asking for “Colgate” –their word for any brand of toothpaste – and even after reaching Cat’s house at the end of the day villagers continued to ask if I had any left.

In my short time in Bhutan I observed that oral hygiene is not a primary concern of their population. Due to their diet of almost entirely rice and organic vegetables, most of the adults do not suffer from very much tooth decay. The young children, however, who are growing up in an increasingly developed country with chips, chocolates, and sweets being imported from India are experiencing exponentially more and more oral problems.

As my trip drew to an end, I reflected on how rapidly the country of Bhutan is changing. With more food being imported from India, oral health will soon gain more attention. After about a month, Cat tells me that she has students telling her that they still have their tubes of toothpaste and that they share it with their brothers and sisters. I felt very privileged to visit this protected country and very happy to be able to raise a little awareness of oral hygiene in the village of Thinleygang. 

I would like to thank Cat, my guides during my trip, as well as the O’Brien’s and others that made this trip possible.

If you would like to learn more or support the organization Cat is involved with, please visit The Bhutan Canada Foundation at

Dentists May Be the First to Diagnose Systemic Health Issues

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by Mudita Agrawal, University of Michigan (2016)


A few weeks ago, a patient of mine walked into the clinic panting and puffing. As a general protocol followed here at school, I took his blood pressure and was shocked to see 220/110 mmHg. Upon asking, the patient reported never having visited a physician, so I requested that he get a consultation done with one as soon as possible. This is a perfect example of ways in which dentists are the first to diagnose not just oral health issues but systemic health issues as well.

During oral examination if we see white or red patches with oral ulcers that do not heal. This could be signs of cancer.  Similarly, HIV or AIDS can present with with unexplained sores or white patches as well as oral yeast infection. Changes in oral healthcare habits and poor oral hygiene can be signs of mental diseases such as dementia.

“Inflamed gums and loose teeth can be warnings of heart disease,” says Alyson Hope Koslow, DDS, a clinical assistant professor of restorative dentistry at the University of Illinois Chicago. “That’s because if you have a gum disease like periodontitis, the bacteria in your gums could travel to your heart and contribute to coronary artery disease.”

Gum disease, bad breath, bleeding gums, and loose teeth may be warning signs of other systemic diseases such as diabetes. These patients may also tend to have a slower healing time. Osteoporosis can cause changes in the bone that supports the teeth, too. This may be seen clinically as receding gum line and loose teeth.

Erosion on the teeth could be signs of gastroesophageal reflux or forced vomiting in a young person with bulimia. The stomach acid wears away at enamel and it makes the teeth more sensitive. Erosion in bulimia tends to occur on the tongue side of the incisors whereas GERD often presents on the upper back molars.  Reflux disease can cause erosion of the esophagus and may even lead to esophageal cancer.

Dry mouth may be caused by medications or it may be a sign of a disease such as diabetes or Parkinson’s disease. Pale oral tissue may appear in anemic patients, and they may also have a swollen and inflamed tongue (termed glossitis).

Infectious Diseases such as herpangina may present with white sores in the mouth and throat. Renal disease may also contribute to soft tissue ulcers and possibly a metallic taste.

There are a lot more diseases which can be diagnosed by a dentist while doing oral examinations. I feel blessed to be a dentist as we could be the ones to diagnose diseases, even before the family physician does. We can save so many lives with some awareness and vigilance to our patients.

Casting Off the D3 Jadedness

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by Riley Schaff, University of Michigan (2017)

As the Class of 2019 donned their white coats for the first time, I couldn’t help but think back two years to my own White Coat Ceremony.  Bright-eyed and smiling, I remember as we posed for photos with the eager anticipation of being one step closer to that prefix “Dr.”  As I’m sure could be easily surmised, I have not been bright-eyed and smiling every day since then.  Getting through each day in dental school can be an arduous task at times, and, as I’m now entering full-time clinical care, school has a whole new set of stressors and challenges.  I, like many of my classmates and third-year counterparts at other dental schools, often feel a little wearied.
Seeing patients full time has been something I’ve looked forward to since I decided I wanted to become a healthcare professional.  Being able to interact with people while helping them achieve better health is an incredibly rewarding experience, and, even after just a few months in the clinic, I have already had my fair share of hugs and thank you notes from my patients.  However, as every third-year (and fourth-year) dental student knows, those experiences are balanced by long days in clinic when things don’t go as planned and patients who don’t show up.  As I reflect on the experiences of both the last few months and the last few years, I do see how I’ve grown both as a person and as a professional. There are many days indeed I feel jaded and dread heading into school, but I am coming to realize those days are balanced by seeing grateful patients that reminds me why I chose dentistry.  Those tough days go a little smoother as I have begun to feel more comfortable and confident in my skin as a clinician.
This halfway milestone, beginning my third year, reminds me why I began dental school bright-eyed and smiling, wearing my white coat free of PVS stains and die stone on my sleeves.  I want to regain my optimism and positivity and cast off this jadedness. Two years closer to my DDS with two years to go, I’m focusing on this contagious excitement to be a member of this profession.  The white coat-donning eagerness of the new D1s is reinvigorating, and I hope I can continue tackling the challenges and triumphs ahead with the D1-esque smile.

Invisalign vs: Fixed Appliances: What’s the Difference?

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by Mudita Agrawal, University of Michigan (2016)


Cosmetic dentistry is becoming increasingly common as people focus on improving their smiles.  Orthodontic treatment is just one facet of this increased attention to cosmetics.  Orthodontics, with its prefix coming from the Greek word meaning “straight,” is the specialty of dentistry that deals with straightening teeth.   Dental professionals use various techniques to straighten teeth. Teeth are moved to give them an ideal position, improve esthetics, and to promote better function of the patient’s bite. Dental professionals improve the patient’s smile while also focusing on his or her oral health.

Most commonly, either braces or Invisalign are used to straighten teeth. Invisalign is a great tool to improve the malocclusion of teeth though it does not work in every case. It uses a series of clear plastic trays to move teeth one step at a time. On the other hand, braces usually use metal wires and brackets to position the teeth.

Invisalign is a great method of doing tooth movements that are not very complicated.  It also works better for esthetic purposes than metallic wires and brackets. These are a set of clear, computer-generated plastic trays ideally worn 24 hours a day and are changed every two weeks. There are certain retention trays given to patients after tooth movement is complete. One of Invisalign’s main advantages is that the trays are thin and unnoticeable. It also offers some degree of comfort because it does not affect the patient’s speech much and also may make him or her feel comfortable in social situations.

Treatment with braces uses brackets which are attached to teeth and subsequently to a wire. An orthodontist or any other trained dental professional is responsible for fixing the dental braces onto the teeth. This supports slight teeth movements that, over time, provide proper alignment and straightening of the teeth. One benefit of dental braces over Invisalign is that these are not removable so patient compliance would not be as great an issue.  Dental braces also afford more precise control of a tooth’s movement compared to Invisalign.  Braces work much more efficiently for complicated tooth movements, and they can also be expected to act faster at closing gaps and aligning the teeth.

Choosing between various orthodontic treatment ultimately is based on the patient’s expectations, desires, and severity of malocclusion.  Considering these three things, the patient and his or her dental professional can decide on an avenue that will give them the smile they have always wanted!

Green Dentistry

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by Mudita Agrawal, University of Michigan (2016)

It was a beautiful Sunday morning in Kolkata, India when I went to the market to get vegetables with my husband. There was the usual chaos of everyone trying to get their hands on the freshest vegetables for the best deal. Suddenly, something caught my attention.  I saw a huge pile of plastic, boxes, and leftovers stacked in the corner of the alley that were covered with animals trying to find their early morning breakfast. It struck me then that we are living in a world where climatic changes have begun to hammer our ecosystems and compromise our living conditions. While undoing past damage is not possible, bettering the situation for future generations is still within our reach. It is then that I realized that we as dentists should go green, too!

Soon enough, I learned about green dentistry and came to know of innovative and easy ways to reduce waste, conserve energy and water, and to reduce pollution. A green dental practice is one that reflects our commitment to the well-being of our patients, team members, community, and the environment. Through diligent planning we can create high-performance green facilities that are a healthy, productive place to work, are less costly to operate and maintain, and would reduce our environmental footprint.

Dental clinic infection control and sterilization processes can be a major source of pollution. These plastic-containing products that do not decompose are used for a short time and end up in landfills. They can jeopardize employee health and can pollute our community’s water systems.  One possible alternative is the use of steam sterilization.  This method can replace more toxic chemical-based sterilization. The use of cloth lab coats, re-usable cloth patient barriers, and FDA-registered re-usable pouches and wraps all reduce the use of disposables in the dental office.

Traditional x-ray fixers contain chemicals such as ammonium thiocyanate and boric anhydride which can be hazardous if ingested or inhaled. Another by-product of traditional x-rays would be lead which is a deadly neurotoxin. Digital imaging is a solution to this issue. If traditional x-rays are taken, fixer and developer solutions can be recycled.

Amalgam filling material contains mercury, silver, tin and copper. Mercury in our drinking, irrigation, and fishing waters can be a serious environmental concern. Nowadays, most dental offices are equipped with amalgam separators.  These are a method of filtration that are readily available, relatively inexpensive, and low-maintenance pieces of equipment.

Clean water is one of the most undervalued dental supplies, considering the worldwide water crisis threatens human health and stability in many areas of the globe. Suction systems, also known as dental vacuum systems, are an important piece of machinery for any dental office. Unfortunately, these systems use a tremendous amount of water. With the world facing such a serious water crisis, we shouldn’t be pouring this precious resource down the drain. High-tech, dry vacuum systems are a green alternative that accomplish the same results while using no water at all.  Green dental practices can also implement water-saving initiatives such as encouraging patients to turn off the water while they brush.

We can take small steps that have the possibility to bring about a huge difference to the ecosystem as a whole.  Recycling materials such as aluminum, glass, plastic, paper, and steel reduces office waste. Dental clinics can also go paperless! We can utilize a virtual office for patient charting, billing and radiography. We can also send appointment reminders through email or text message only. We can save electricity by installing solar electric panels and solar water heaters, using LCD computer screens instead of CRT displays screens, installing skylights to enhance lighting and keeping it energy free, and installing motion detectors and timers for lights.

Contrary to the perception that eco-friendly methods cost more, we now know that, in the long run, going green saves green! Green dentistry lowers supply costs, integrates high-tech innovations, and makes efficient use of staff time, reducing the overhead and increasing productivity for a dental practice.  With cognizance toward how we treat both our patients and our environment, we can all transform how we practice dentistry for the good of all.

Back and Neck Pain, and How to Avoid It!

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by Mudita Agrawal, University of Michigan (2016)

During the first year of dental school, we are taught the importance of patient and operator positioning. However, when we enter the simulation lab, it’s easy to adopt a mindset of learning the dental skills first and the ergonomics later. Soon enough, we feel more comfortable and confident doing those dental procedures in wrong positions. After a few years, these wrong positions start taking a toll on our neck and back muscles. A 2005 study by Dr. David has proven that 46-71% of the students  at dental school experienced neck, shoulder, and back pain with more than 70% reporting pain by their 3rd year.

When the head, neck, and back are tilted to one side while working, the muscles in use on one side become shorter and stronger and the other side becomes lengthened and weakened. The overall effect is muscle imbalance.  On top of that, the shortened muscles getting poorer blood supply. Unequal tension on the spine can cause pain, too, starting as infrequent back and neck pain and developing into chronic pain.  This ultimately can lead to a severe muskoloskeletal disorder which may require surgery or early retirement.

A sobering analogy shows that maintaining your head position in a full upper body lean or tilt of 30 degrees from the pelvis for 10 minutes requires muscular exertion equivalent to curling a 20-pound dumbbell 266 times or curling a 100-pound barbell 53 times!

So what do we do to prevent this chronic pain?  Weightlifting and resistance training can be great exercise with many physiologic benefits. Exercise and physical therapy should be part of every dentist’s routine.  Operator stool selection can help with right positioning as well. Good chair selection can promote healthier ergonomic operator positions.

As dental students, we must break habits that promote poor ergonomics.  With some focus and a mindset of future pain prevention, we can all develop good habits and have long, healthy, pain-free careers.


Citation link-


DAVID W. RISING, BRADFORD C. BENNETT, KEVIN HURSH, OCTAVIA PLESH. Reports of body pain in a dental student population: JADA; Jan 2005; 136(1) ,81-86